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
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13-MAY-2015 FATMEH AHMAD JAWASH 55 YEARS
SPONDYLOLISTHESIS L4-5 WITH RIGHT EXTRAFORAMINAL EXTRUSION.
The patient came to the clinic 06-October-2013
complaining of LBP with left sciatica for 3
years with exacerbation the last month with
inability to walk more than 100 meters. She was
limping with SLRS left side 30 degrees with pain
and hypalgesia left anterior thigh and weak
dorsiflexion left foot -4/5. She was also
complaining of neck pain. MRI cervical spine
done showing small extruded disc C6-7 and the
lumbar MRI showed spondylolisthesis L4-5.
Dynamic studies confirmed the instability at
L4-5. The patient then came 10-May-2015
complaining of agonizing right sciatica for 2
On examination; the patient is limping with
exaggerated scoliotic stance. Neck and upper
limbs were neurologically free. SLRS was 80 degrees
both sides. There is weak dorsiflexion
both feet -3/5.
The patient was sent for investigations and MRI
lumbar spine performed 10-May-2015 showing
spondylolisthesis L4-5 with right extraforaminal
extrusion L4-5. There are bulging disci all
Using the C-arm, the L4-5 level was identified.
Using Legacy CDH MAS screws 6.5x45 mm 4 screws
inserted to L4 and L5 levels. The extruded far
lateral disc of L4-5 was removed and right sided
intradiscal cleaning was achieved. The patient
had bleeding tendency, for what Vit K 10 units
was injected. 50 mm bended rods were used and
cross connector 22 were applied to obtain fusion
and distraction about 5 mm both sides. All
stages of surgery were done with C-arm control.
The harvested bone was milt and applied to the
rods. Routine closure.
Smooth postoperative recovery.
The patient was tolerating the
spondylolisthesis, but when the extrusion took place, she
urged for surgery. Both problems were corrected accordingly.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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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 .