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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
09-NOVEMBER-2011 JATHAAN MATHHOUR AL-RUWELY 79
YEARS SEVERE LUMBAR CANAL STENOSIS L3-4 AND L4-5.
patient came to the clinic 18 months ago
complaining of signs of severe lumbar canal
stenosis and he was advised to undergo surgery,
but he escaped. The patient then came
08-November-2011 complaining of bilateral
sciatica and intermittent claudication for 2
years and inability to walk for more than 50
meters. He is using crutches for 18 months. The
patient is a known diabetic for 20 years and he
is insulin dependent for 2 years. He is using
Omnic for 18 months for difficult micturition,
despite the fact that the prostate is normal in
spine performed 08-November-2011 showing severe
lumbar canal stenosis L3-4 and L4-5.
examination: the patient is limping with
exaggerated scoliotic stance. There is weak
dorsi and planterflexion both feet 3/5. There is
hypalgesia both legs below the knee level.
Decompressive laminectomy of L4 and partial
of L3 and L5.
Bilateral flavotomy with bilateral L4 root
foraminotomy. The spinous process is mobile. It
was resected to prevent postoperative pain, when
palpating the spine. Inspection of L4-5
isthmolysis was negative. Revision of the MRI
data were also negative. There is no evidence of
L4-5 nor L5-S1 spondylolisthesis. The epidural
fat at the L3-4 was missing.
closure of the wound. Smooth postoperative
recovery with improvement of the power of both
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
The patient has severe lumbar canal stenosis and
he condition continued to deteriorate during his
LCS is a progressive disease and the sooner the
decompression, the better the postoperative
After surgery, the son of the patient told us
that the patient felt down 4 days ago. This
could explain the presence of the mobile L5
spinous process, but there was no associated
hematoma in this area. 3/4 of the L5 lamina was
left in place and the ligamentous structures
were respected and preserved to avoid iatrogenic
overmobility of L4-5 segment.
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 .