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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23-JUNE-2011 SALAMEH NAJEM AL-HWETY 26 YEARS
EXTRUDED DISC L4-5 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The
patient came to the clinic
01-May-2011
complaining of LBP for 8 months with
exacerbation of right sciatica the last 3
months.
On
examination: the patient is limping with
exaggerated scoliotic stance with SLRS was 40
degrees in the right side. There is weak
dorsiflexion left foot 4/5 and right foot -4/5
with hypalgesia right L5 territory.
MRI of the lumbar
spine performed 04-April-2011 showing huge
extruded discL4-5 with right downward migration.
Right L5 foraminotomy with partial
L4-5 flavotomy was performed from the right. The
extruded downward migrating disc was removed in
one piece lateral to the root. Right sided
cleaning L4-5 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 right 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 .
