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 .
23-JULY-2015 FIKRAT RATEB EMAESH 50 YEARS
SPONDYLOLISTHESIS L3-4 WITH SEVERE STENOSIS.
Anamnesis
The patient came to the clinic 12-May-2015
complaining of LBP with left sciatica for 14
months which became bilateral more to the left.
She has neck pain for 6 years with numbness both
hands more the right for 5 months. The patient
is a known rheumatoid without treatment. MRI
lumbar spine performed 08-October-2014 showing
extruded disc L3-4 with bulge L4-5 and L5-S1.
On examination; The patient is in agonizing
pain, limping with exaggerated scoliotic stance.
There is neck pain when turning the head to both
sides and up. There is weak grip and extension
right hand 4/5 and the right triceps muscle 3/5.
SLRS was 85 degrees with pain in the left.
There is weak dorsiflexion both feet -4/5 and
planterflexion left foot 4/5.
The patient was sent for investigations and MRI
of the lumbar spine performed 16-May-2015
showing spondylolisthesis L3-4 with severe
segmental stenosis same level. Dynamic studies
confirmed the mobility of this segment.
Using the C-arm, the L3-4 level was identified.
Skeletonization of L3,4 and partial of L5 was
performed with exposure of the transverse
processes of L3 and L4 both sides. Using
Legacy system 4 F.A. 6.5x45 mm transpedicular
screws were inserted to L3 and L4 bodies.
Decompressive laminectomy L3 and L4 with
foraminotomy both L5 roots. Inspection of the
disc structure ruled out its violation. Bended
rods 55 mm length and cross connector were
applied with 4 mm distraction at the left side. Routine closure
of the wound.
Smooth postoperative recovery. The power of the
right foot became normal. The patient and was
sent to the floor.
Comments
The patient has spondylolisthesis with
segmental scoliotic deformity. Both were corrected.
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
ISIS 32 channel Inomed IOM system for intraoperative
neurophysiologic navigation running since 2007.
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 .
