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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13-MAY-2011 JIHAD ALI AL-ZUUBI 21 YEARS MULTIPLE
INJURIES WITH BURST FRACTURE L4 WITH BONY COMPRESSION WITH CAUDA EQUINA SYNDROME
MORE TO THE LEFT.
patient admitted to Shmaisani hospital
transferred from Aqaba 12-May-2011 after
suffering falling down 12 meters in elevator
work with minor head injury and burst fracture
L4 with bone compression and fracture both bones
both forelegs. This event was happened
examination: the patient in bed with POP above
knee both forelegs and Foley's catheter with
stable vital signs. The patient is unable to
move his left toes up and down with severe weak
dorsi and planterflexion right foot 2/5. There
is hypalgesia right L5, S1 and below right side
with analgesia left side. There is cauda equina
Skeletonization of L3-4-5 laminae and facet
joints with preservation of the intraspinous
ligament. Using Expedium Depuy Spinal system 2
polyaxial screws 6X45 mm were inserted to L5
pedicles. 2 monoaxial pedicles 6X45 mm were
inserted to L3 pedicles. Titanium 5.5 mm 60 mm
length were used and loosely fixed to the screws
by the Inne set. Using distraction for around
18-20 mm, the rods were tightened to the screws.
Control X-ray showed complete reduction of the
bony alignments. CrossLink connector was used to
aid stability of both rods. 40 cc BoneSave was
closure of the wound. The orthopedic team
started their surgery for the forelegs.
Postoperative X-ray showing excellent reduction and
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The fracture of L4 is unstable and causing
severe bony compression with cauda equina
syndrome. Open reduction is mandatory with
fusion. In this case distraction could achieve
good reduction of the bony elements. If this
goal was not achieved, then special measures
must be performed to decompress the spinal
Preoperative X-rays before reduction and fusion.
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 .