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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15-JUNE-2011 MUSTAFA SULAYMAN KHADER 63 YEARS
EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The
patient came to the clinic
12-June-2011
complaining of agonizing left sciatica for three
days without LBP with numbness little toe left
foot.
MRI of the lumbar
spine performed 12-June-2011 showing huge
extruded disc L5-S1 with left downward migration
with bulge L4-5.
On
examination: the patient is limping with
exaggerated scoliotic stance with SLRS was 80
degrees in both sides. The Achilles' Jerk is absent
in the left side. There is weak
dorsiflexion left foot 3/5 and weak
planterflexion left foot 4/5. There is
hypalgesia left S1 territory.
Left S1 foraminotomy with partial
L5-S1 flavotomy was performed from the left. The
extruded downward migrating disc was removed in
one piece lateral to the root. Left sided
cleaning L5-S1 disc space was achieved. The area
was lacking the epidural fat due to severe
compression. The root and dural structures
regained relaxed position at the end of surgery.
Routine
closure of the wound. The sciatica
disappeared and the power of the left leg
improved.
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Comments
The estimated recurrence rate is around 7%
because the disc space was not shallow.
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
