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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21-OCTOBER-2012 TARIQ MUHAMED TALLUSA 37 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 18-October-2012
complaining of severe LBP with agonizing right
sciatica for 15 days with numbness and pain
right foot. The patient has undiagnosed
hypercoagulation state for what he is receiving
warfarin 12.5mg a day and Baby aspirin.
On examination: the patient is unable to stand,
cannot find any position for pain relief and
crying. With difficulty SLRS was 30 degrees in
the right with pain and absent right AJ reflex.
There is hypalgesia of the right L5 and S1
territories. Almost drop right foot and weak
planterflexion right foot -4/5.
The patient was sent for MRI lumbar spine which
revealed bulge of L4-5 of no significance and
huge extruded disc L5-S1 with right downward
migration. The patient was advised to stop
anticoagulants to avoid bloody field during
surgery.
Right S1 foraminotomy. The
extruded disc was removed in one piece from
under the axilla. Right sided cleaning L5-S1
disc space.
Routine closure of the wound. Smooth
postoperative recovery with normalization of the
power of the right foot and disappearance of
right sciatica.
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Comments
The patient still has an
estimated postoperative recurrence around 7%,
because the disc space is still not shallow.
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