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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
28-MAY-2014 ABDEL-HAKIM WAHEED AL-JOHARY 57 YEARS
EXTRUDED DISC L2-3 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 27-May-2014
complaining of left sciatica with LBP for 3
weeks with pain to above and below the left knee
with sudden onset. CT-scan of the lumbar spine
done 10-May-2014 showing spondylolisthesis
L4-5. MRI lumbar spine done 17-May-2014 showing
very huge extruded disc L2-3 with left far
downward migration.
On examination; The patient is not limping. SLRS was
85
degrees in the left with pain. There is weak
dorsiflexion left foot 4/5 and the left
quadriceps +4/5. The left knee jerk is
diminished.
Using image-intensifier, the L2-3 level was
identified. Left sided L2-3 hemiflavotomy with
hemilaminectomy upper half of L3 was done. The
extruded disc was removed far down the axilla in
2 pieces. Foraminotomy of the left L3 root. Left
sided cleaning L2-3 disc space.
Smooth postoperative recovery. The power of
left foot became normal.
MRI showing the huge extrusion of L2-3 with left far
downward migration reaching the L3-4 level.
Comments
The patient has many problems with
spondylolisthesis of L4-5 I degree. In this case it is preferable to deal with the
essential problem, which is causing the clinical
manifestations, which is the extruded disc at L2-3.
The estimated postoperative recurrence is
still around 7%, because the disc space is still not
shallow.
The patient has also antelisthesis L2-3,
but the segment was stable. How much this is important, time
will tell.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
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 .
