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Multigen RF lesion generator .
04-SEPTEMBER-2004 AMER SHFEEQ AL-SHARAY'A 37
YEARS EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 28-August-2004 complaining of LBP with
left sciatica for 3 years, then right sciatica
for 1 year with exacerbation of right sciatica
24-July-2004 down to S1 territory. MRI lumbar spine done
09-December-2001 showing extruded disc L5-S1 and
repeated 18-August-2004 showing de novo
extrusion L5-S1 right side over the old one.
On examination: The patient is limping with
exaggerated scoliotic stance. SLRS was 65
degrees in the right with pain and 85 degrees in the
left without pain. There is
weak dorsi and planterflexion right foot 3/5.
Foraminotomy
right S1 roots with
removal of the extrusion lateral to the axilla
from the right side. After
that, the root became lax and right sided
intradiscal cleaning L5-S1 disc space was done.
The patient was put in Reverse Trendelenburg
position with Valsalva maneuver and
hyperventilation. No CSF leak. A fat in pedicle was
transferred 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 right foot became
normal.
He was
sent to the ward.
FOLLOW UP
The patient came to the clinic 13-Septmber-2004
with clean wound and SLRS 90 degrees both sides
with no pain and normal power and sensation.
Comments
The estimated postoperative recurrence is still
ranking around 7%, because the disc space is
still relatively not shallow.
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
its sensor gives feed back about the localization.
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 .
