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10-JUNE-2004 AHMAD SHIHADEH
ODEH 59 YEARS HUGE EXTRUDED DISC L4-5 WITH RIGHT S1 FORAMINAL OCCLUSION.
Anamnesis
The patient was operated by me
26-December-2002 for extruded disc C3-4, 4-5
and c5-6. Then he came 28-January-2004 telling
that he got LBP with left sciatica for 2 months.
On examination, the patient in agonizing pain,
limping with exaggerated scoliotic stance with
weak dorsiflexion left foot 4/5. SLRS was 70
degrees with pain left side.
The patient was sent for
investigations and MRI lumbar spine done
28-January-2004 showing huge extruded disc L4-5
with right downward migration.
Laminectomy L and lower third
of L4. Foraminotomy both L5 roots and right S1
root. Left sided removal of the extrusion and
left sided
intradiscal cleaning L4-5 disc space.
The patient was put in Reverse Trendelenburg
position with Valsalva maneuver and
hyperventilation. No CSF leak. A free fat was
harvested from the
subcutaneous layer and covered the exposed parts
of the dura and roots to minimize postoperative
scarring. Routine closure
of the wound.
Smooth postoperative recovery. The power of
the left foot normalized.
FOLLOW UP
The patient
came to the clinic 19-June-2004 with clean wound and no motor,
nor sensory deficit. SLRS was 70 degrees both sides
with pain.
Comments
There is still an
estimated postoperative recurrence around 7%,
because the disc space is still not completely
collapsed.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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Inomed MER system
Leica HM500
The World's first and the only Head mounted 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
LooksCam II Xenosys in the run starting from 14-March-2021 with
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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 .
