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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23-AUGUST-2011 LAYLA MUHAMED AL-SARAYRA 52 YEARS
FAILED FIXATION OF L3-4 SPONDYLOLISTHESIS WITH REMAINING LEFT SCIATICA.
patient came to the clinic 27-July-2011
complaining of LBP and left sciatica, which did
not disappeared after performing transpedicular
fixation for spondylolisthesis L3-4
several months ago elsewhere. The patient is
claiming that, she did not recover after
surgery, instead her condition became worse.
done 06-March-2011 construct in acceptable
position, but MRI
lumbar spine done 20-March-2011 showing
that the previous extruded disc of L3-4 still
compressing the left L4 root. MRI repeated
03-April showing the same data.
examination: the patient is limping with
exaggerated scoliotic stance. There is weak dorsiflexion
-3/5. SLRS was 70 degrees in the left side with
Exposure all the screws which
are seem to be polyaxial Ziva and they were in
acceptable position and not loose. Foraminotomy
of left L4 root with scarolysis with drilling of
all bony compression. Discectomy of L3-4 from
the left. Depuy Spine Leopard TLIF size 9 was
inserted with Vitos bone graft. The cross
connectors were inserted to the rods after
slight bending. The knots of the screws were
returned back and slight compression was
applied. Check with C-arm showed acceptable
reduction of the spondylolisthesis. The left L4
root is hanging free.
closure of the wound. Smooth postoperative
recovery with improvement of the power of
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Transpedicular screw fixation alone in the
presence of disc extrusion will not help the
patient and he will continue to suffer from the
main problem of root compression.
All the patients with TLIF insertion have
superior results in comparison with the previous
group of patients without TLIF.
Applying connector, gives the construct more
stability. Without this, there is micromovement
of the constructs during walking, which will
trigger pain generation. Applying the connector
will unite the constructs to one stable
showing the construct.
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 .