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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28-NEVEMBER-2012 SUBHI ALI MUHAMED ALI 42 YEARS
HUGE EXTRUDED DISC L3-4 WITH LEFT UPWARD MIGRATION.
Anamnesis
The patient came to the clinic 27-Novemebr-2012
complaining for one moth of LBP and agonizing
left sciatica.
On examination: the patient is limping
with
exaggerated scoliotic stance and with difficulty
was examined because of his pain. SLRS 85 degrees
left side with pain. There is
weak dorsiflexion left foot 4/5. There is
hypalgesia left S1 root. The left KJ was absent
in comparison to the right. The patient was sent
for MRI lumbar spine and dynamic studies of the
lumbar spine, which were done and showed huge
extruded disc L3-4 with left upward migration.
Left L3-4 hemiflavotomy with
foraminotomy left L4 root. The left upward
migrating disc was inspected and it was far,
that it was compressing the axilla of the left
L3 root. The extruded disc was removed in
several pieces and foraminotomy of the left L3
root was done to be sure that no remnant left
there. Left sided cleaning L3-4 disc space.
Routine closure of the wounds. Smooth
postoperative recovery. The power of the left
became normal and the agonizing sciatica
disappeared.
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Comments
The patient still has an
estimated postoperative recurrence below 7%,
because the disc space is relatively shallow.
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