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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator
17-OCTOBER-2012 AWWAD MAHMOUD AWWAD 18 YEARS
SLIPPED EPIPHYSIS L3-4 WITH UPWARD MIGRATION.
The patient came to the clinic 17-October-2012
in wheelchair wit severe agonizing LBP and
bilateral sciatica for 1 week and inability to
walk or stand the last 2 days. The patient is
crying and cannot find a position to make him
feel any relief.
MRI lumbar spine done 17-October-2012 showing
huge extrusion of L3-4 with upward migration.
On examination: the patient cannot stand for
scoliotic evaluation and it was hard to examine
him. SLRS was 0 degree in both sides with
complete drop both feet with planterflexion both
feet 0/5 and analgesia of both lower limbs below
the knees. Defecation and micturition telling
that are normal. The AJs are absent both sides.
Using C-arm, the L3-4 level
was identified and 3/4 laminectomy of L3 was
done with bilateral flavotomy and bilateral
foraminotomy of L4 roots. Slipped epiphysis was
noted and the extruded material including the
slipped epiphysis were removed from both sides
and cleaning of L3-4 disc space was done from
both sides, until the roots and the dura were
lax and free.
Routine closure of the wound. Smooth
postoperative recovery with disappearance of the
sciatica and some improvement of the
planterflexion both feet 3/4 and dorsiflexion
left foot 3/4.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
The patient is young and
slipped epiphysis is usually noted in the young
age starting from 10 years and to 18 years of
The patient will need long-term physiotherapy to
recover his neurologic deficit.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision.
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 .