Dr. Ali Al-Bayati

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

The patient came to the clinic 08-July-2000. She is an Iraqi lady was complaining of LBP for 16 years. She had exacerbation of her left sciatica  and left shoulder pain. X-rays performed 1999 showing osteoporosis with spondylolisthesis L4-5 I degree by Meyerding scale. She was complaining of numbness of her II-IV toes left foot. She could walk more than 1 Km at that time. MRI performed 10-July-2000 showed secondary stenosis at L4-5  and she was advised for conservative treatment for pain and osteoporosis.  She was seen 12 times during the following 6 years with ups and downs, but acceptable neurological condition.

The last time, the patient deteriorated  and she could not ambulate and bilateral sciatica with almost drop both feet. MRI performed 14-February-2006 showing escalation of her spondylolisthesis at L4-5 and severe LCS L4-5 , for what she was advised to undergo surgery.

Laminectomy of L4 and 5 was done with bilateral foraminotomy both L5 roots was done. Inspection of the disc surface was negative except for the gap between the L4 and L5 bodies. Using Stryker instrumentation, transpedicular screws were applied , the L3 pedicle was used with polyaxial screws and the L5 pedicles with rigid screws. Distraction was applied about 20 mm reduction. A bridge was inserted between the rods to have more secured stability of the construct. All the operation was guided with the aid of image intensifier. The removed laminae were crushed and used as bone graft lateral to the construct between the transverse processii of L3 and L5 both sides. Routine closure of the wound. 


Postoperative check X-ray of the construct done 12-March-2006

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[2006] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved