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
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31-MAY-2010 TAYMA MUHAMED ABUL-FILAT 40 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT S1 ROOT COMPRESSION.
to the clinic 23-December-2009 complaining of
LBP for 4 years with left sciatica. MRI
performed 06-June-2005 showed extruded disc
L5-S1 with bulge L4-5. MRI lumbar spine repeated
24-April-2007 showed extruded disc L4-5 with
left downward migration.
On examination at
that time, SLRS was 75 degrees both sides with
pain without weakness or sensory deficit. She
was sent for another MRI which was performed
24-December-2009 showing shrinkage of L4-5 disc
extrusion, but same extrusion of L5-S1. The
patient was advised to keep in conservative
The patient then
came 23-February-2010 complaining of
exacerbation of LBP with bilateral sciatica more
the right with exaggerated scoliotic stance. She
had weak dorsi and planterflexion right foot 4/5
with SLRS 70 degrees in the right with pain.
MRI of the lumbar
spine performed 27-February-2010 showing
extruded disc L5-S1 with compression of the
right S1 root.
Right L5-S1 hemiflavotomy was performed and
foraminotomy right S1 root was achieved. The
extruded disc was identified and removed after
what the root was free of compression.
Inspection of the shallow disc space of L5-S1
revealed that it was empty, for what it was not
Routine closure of the wound and smooth postoperative recovery with
full recovery of the power of the right foot.
The patient had evolution of
the clinical picture and most of the time it was
The extruded disc of L5-S1
was persisting all the time and it became more
large, in the contrary the extrusion of L4-5
shrunk with time.
The patient is in agonizing
right sciatica, for what surgical removal of the
extrusion was the only remaining solution.
The expected recurrence rate
in this case is minimal since the disc space is
shallow and empty.
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