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
02-SEPTEMBER-2014 FASAYEL DANAAN AL-RAWASHDEH 56
YEARS II DEGREE SPONDYLOLISTHESIS L4-5 WITH RIGHT SCIATICA.
The patient came to the clinic 30-August-2014
complaining of LBP for 15 years with right
sciatica for 2 years with exacerbation of LBP.
On examination; the patient is not limping with exaggerated scoliotic
stance. SLRS was 80 degrees right side with pain.
Dorsiflexion right foot 4/5. The
patient was sent for investigations and done the
same day: Cervical MRI showing bulge multiple
disci of no clinical significance. Lumbar spine
showing II degree spondylolisthesis L4-5.
Dynamic studies confirming these data with
isthmolysis L4-5 both sides.
Skeletonization of L3,4 and L5.
Decompressive laminectomy L4 with upper fourth of
L5 and foraminotomy both L5 root.
The lamina of L4 was completely flail due to
bilateral isthmolysis. Discectomy of L4-5 with right sided insertion of TLIF cage
9x25x10x40 . Using XIA 3 2 long polyaxial
screws inserted to L4 and 2 monoaxial screws to
L5 with 6.5x45 mm dimensions. Using Inomed ISIS
the roots were responding well to 1-2 mA DNS
stimulation. The screws were not responding even
to 15 mA DNS. Only local muscle response was
seen due to leakage of the current to nearby
muscles. 5 cm rods bended
to accept the natural curve of the spine were
applied and MAC
cross connector 38 mm were used to fuse L4-5
level with slight compression more from the
right. The harvested
bone was melted and applied near the TLIF inside
the disc cavity and lateral to the rods.
closure of the wound.
Smooth postoperative recovery. The power of the
right foot became normal.
The patient had spondylolisthesis and
isthmolysis with complete flail segment. Surgical
stabilization after decompression is the only solution.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
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 .