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Munir Elias 20-12-2013
Surgical group is like a football team.

 
Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit  neurosurgery.tv

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16-MAY-2010  MUHAMED YAHYA AL-NATSHEH  55 YEARS  EXTRUDED DISC L5-S1 WITH LEFT FORAMINAL AND DOWNWARD MIGRATION.

Anamnesis

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The patient came to the clinic 15-May-2010 complaining of LBP for 8 months with exacerbation and escalation of left sciatica the last 5 days.

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MRI lumbar spine performed 13-May-2010 showing extruded disc L5-S1 with left foraminal and downward migration.

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On examination the patient is limping with agonizing pain with exaggerated scoliotic stance. SLRS was 10 degrees in the left with pain. He has weak dorsi and planterflexion left foot 4/5.

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Left L5-S1 hemiflavotomy with left S1 foraminotomy was done. The extruded disc was severely compressing the root, that it was possible to remove it from under the axilla. Cleaning of the disc space was performed also from under the axilla. After the root became relax, it was shifted medially and further cleaning was achieved.

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Smooth postoperative recovery with full recovery of the power of left foot.


Comments

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The patient  has agonizing sciatica with almost drop foot. Even if the compression was applied to the left S1 root, but the firing pain circuits can involve the other roots, which are nearby epsilaterally.

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Subaxillary removal is performed, since forced elevation of the root could harm the root.

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Notice: Head injuries and very urgent surgeries are also escaped from the plan .

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