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28-JANUARY-2003 ALAA ISMAEEL SHIHADA 13 YEARS
SLIPPED EPIPHYSIS L4-5 WITH BILATERAL DROP FEET.
Anamnesis
The patient came to the clinic 23-January-2003
complaining of LBP for 1 month with right
sciatica. MRI
lumbar spine done 21-January-2003 showing
slipped epiphysis L4-5 more to the right.
On examination: the patient in agonizing pain,
limping with exaggerated scoliotic stance. SLRS
was 30 degrees with pain both sides. There is
drop both feet and planterflexion
both feet 3/5.
Foraminotomy both L5 roots. The extruded disc was
attacked first from the right, then bilateral
cleaning L4-5 was achieved. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak. Routine closure of
the wound
Smooth postoperative recovery.
The radicular pain decreased and the power of both
feet improved. He was sent to the ward.
Follow Up
The patient came to the clinic 09-February-2003
with clean wound , no scoliosis with weak
dorsiflexion both feet 4/5. SLRS was 60 degrees
without pain.
Comments
The recurrence rate in this case is
unknown because slipped epiphysis is rare and happens in
young age under 16 years age.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Inomed Riechert-Mundinger System, with three point
fixation is the most accurate system in the market. The microdrive and
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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
SheerVision TTL x4 magnification.
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 .
