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
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Multigen RF lesion generator .
22-JUNE-2015 AMIRA HASAN BARAKAT SECOND RECURRENCE
OF EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 10-June-2015
complaining of left sciatica the last 2 weeks
down to the lateral malleolus left ankle joint.
The patient was operated twice in November-2014
for the extruded disc L5-S1 with left downward
migration and the recurrence. MRI lumbar spine
done 21-May-2015 showing the huge recurrence of
L5-S1 with left downward migration.
On examination; the patient is limping with
scoliotic stance. SLRS was 60 degrees with pain
in the left. There is weak dorsiflexion left
foot -4/5 and planterflexion same foot 4/5.
The patient was sent for new investigations and
MRI of the lumbar spine confirmed the huge
recurrence and dynamic studies ruled out the
presence of instability.
Using the old incision, foraminotomy of the left
S1 root was done. The root was severely
compressed by bony hard disc extrusion. The
extruded disc was removed in several pieces and
maneuvers until the disc space of L5-S1 and the
extrusion were clean. The root is hanging free.
Smooth postoperative recovery. The power of
the left foot became better.
Comments
The patient has second recurrence without
instability. During surgery, it was clear that the
pituitaries could not reach the intradiscal space without
drilling the bone to make the instruments reaching the disc
space.
The estimated postoperative recurrence
now is near 0%.
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
ISIS 32 channel Inomed IOM system for intraoperative
neurophysiologic navigation running since 2007.
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 .
