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
21-JUNE-2010 RABI'AH ABDEL-HAFEZ AL-ATRASH 58
YEARS SEVERE LUMBAR CANAL STENOSES L4-5 WITH EXTRUDED DISC RIGHT SIDE.
Anamnesis
The
patient came
to the clinic 16-June-2010 complaining of LBP
for 20 years with intermittent right sciatica for
two months down to the right L5 territory.
On examination: the
patient is limping with scoliotic stance. She
has rheumatoid hands. SLRS was 40 degrees with
pain in the right with weak dorsiflexion right
foot 3/5 and left foot 4/5. There was analgesia
of the right L5 and hypalgesia of the left S1
territories.
MRI lumbar spine done
09-June-2010 showing severe lumbar canal
stenosis with extrusion of L4-5 disc compressing
the right L5 root.
Decompressive laminectomy of L4 and partial of
L5 was done with bilateral flavotomy L3-4.
Foraminotomy both L5 roots was done. The right
L5 root was inspected and rounded extrusion
compressing the root was seen and removed. The
surface of the annulus fibrosis of L4-5 was
inspected and it was decided not to violate the
disc space.
Routine closure of the wound and smooth postoperative recovery with
improvement of the power of both feet.
Comments
The patient had lumbar canal
stenosis, which required surgery by itself.
During that the extruded disc fragment anterior
to the L5 axilla was also removed.
The defect of the annulus
fibrosis was microscopic, for what it was
decided not to violate the intradiscal
structure.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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