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 .
29-JUNE-2015
AMIRA HASAN BARAKAT DISKITIS OF L5-S1 AFTER PERFORMED THIRD SURGERY
FOR THE RECURRENT EXTRUSION.
Anamnesis
The patient was operated by me
22-June-2015 for second recurrence of L5-S1
with left downward migration. The patient was
doing well until the fourth postoperative day.
After that she started to complain of agonizing
pain in the hips more the left with inability to
stand. She was admitted urgently at the night of
29-June-2015. MRI lumbar spine showed diskitis
of L5-S1 with fluid collection under the skin
and muscles and circumferentially around the
annulus fibrosis. CRP was 198 mg/L and ESR
72 mm/h and WBC 11.000. Samixon 1 gm I/V
was started twice a day.
On examination; the patient cannot walk and in
agonizing pain. The wound externally was looking
acceptable. There is pain upon inspection of the
SIJ both sides more the left. There is no
neurologic deficit. There is no fever.
The old incision was opened and after removing
the subcuticular stitches a gush of orange
fluidly pus came out. It was sent for all
types of CXS. The wound was explored and the
disc space was empty after evacuation of the
fluid. Further distal cleaning of the right side
of the disc space from the left. The disc
material was swollen and friable. Debridement of
the wound and a 1 gm of Vancomycin powder was
inserted to disc cavity. The wound was closed
with less irritant materials and the wound was
closed using nylon 3 zero.
Smooth postoperative recovery. The patient was
sent to the floor.
Comments
The patient during the first visit and
after performing the investigations was advised to start
Zinnat 500 twice a day. In the record there are missing data
why I prescribed this antibiotic, but usually I prescribe it
when suspecting a nidus of infection.
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 .
