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-2014
BAHIYE ZAYDAN DAYEH 62 YEARS CSF LEAK AFTER PERFORMED SURGERY FOR SPONDYLOLISTHESIS L5-S1 WITH STENOSIS L4-5
AND STRUCTURAL SCOLIOSIS LUMBAR SPINE 24 DAYS AGO.
Anamnesis
The patient was operated by me
05-June-2014 for spondylolisthesis L5-S1,
stenosis L4-5 with structural scoliosis. She was
doing fine and discharged in good condition and
the drop right foot improved dramatically until
normal limit. The patient start to progress CSF
leak 22-June-2014 and conservative measures
failed to resolve the problem.
MRI of the lumbar spine done 28-June-2014
showing a huge CSF pocket extending up and down,
reaching under the skin.
The old incision refreshed. A huge amount
of CSF came out, despite the fact that the head
of the patient was kept below the heart level.
Inspection of the wound revealed that the CSF
was coming out from the previous dural defect
which was repaired in the first operation and
the defect was so tiny, that it was 0.1 mm and
it was functioning as a valve. Three stitches 4
zero nylon were applied and a muscle with
Glubran was added to have more secure closure of
the tiny dural defect. The head was elevated and
Valsalva maneuver was applied and CSF leak was
negative. Inspection of the sites of the wound
and water-tight closure of the wound.
Smooth postoperative recovery.
Comments
The patient had small tear less than 1 mm
in scareous area near the right L5 root. Despite the fact it
was closed by nylon, it was sufficient that 0.1 mm gap to be
the source of such CSF leak.
The scar tissue is not reliable to hold
stitches and it will be wise to use Glubran the next similar
case to avoid such event.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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 .
