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29-APRIL-2003 FATMEH ABED SHAHEEN 72
YEARS RIGHT EXTRAFORMAINAL EXTRUSION L4-5 WITH DOWNWARD MIGRATING
EXTRUSION L1-2.
Comments
The recurrence rate in this case still
ranking around 14% because the disci spaces are not completely
collapsed.
Anamnesis
The patient came to the clinic
25-April-2003
complaining of LBP for 25 years after performed
spine surgery with bilateral sciatica more the
right for
2 years with progressive deterioration. MRI lumbar spine showing
severe stenosis L1-2, 2-3, 3-4, 4-5 with
extruded disc L1-2 left side and extruded disc
L4-5 with right extraforaminal occlusion.
On examination: the patient in pain,
limping with exaggerated scoliotic stance. SLRS
was 45
degrees with pain both sides. There is weak
dorsi and planterflexion both feet 3/5 and
abduction and adduction of the knees. Hypalgesia
below the knees.
Decompressive laminectomy L2,3,4
lower half of L1 and upper half of L5. Discectomy
L1-2 was performed from the left and discectomy L4-5
was performed from the right with removal of the
extraforaminal extrusion. Foraminotomy all L2,3,4
and L5 roots. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak. Routine closure of
the wound
Smooth postoperative recovery.
The radicular pain disappeared and the power of the
legs improved. She was sent to the ward.
Follow Up
The patient came to the clinic 10-May-2003
with clean wound with some improvement of the
power of both lower limbs. The sensory deficit
still the same.
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
Leica HM500
The World's first and the only Head mounted 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
LooksCam II Xenosys in the run starting from 14-March-2021 with
SheerVision TTL x4 magnification.
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 .
