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Munir Elias 20-12-2013
Surgical group is like a football team.

 
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

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Inomed Stockert Neuro N50. A versatile
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Multigen RF lesion generator .

 

15-JULY-2009  HADIYEH MUHAMMED HARB  61 YEARS  EXTRUDED DISC L5-S1 WITH RIGHT FORAMINAL COMPRESSION.

Anamnesis:

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The patient was transferred from other hospital with clinical signs of agonizing right sciatica for 4 days. The patient is a known diabetic.

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MRI lumbar spine performed 13-July-2009 showing extruded disc L5-S1 with right foraminal occlusion.

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On examination: the patient is limping with scoliotic stance and weak dorsi and planterflexion right foot 3/5 with hypalgesia of the right S1 root.

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Right S1 foraminotomy was performed and the ligamentum flavum was reflect to the left. Removal of the extrusion lateral to the axilla and meticulous cleaning of L5-S1 space from the right. Considering that the disc space of L5-S1 was still high and the defect in the annulus fibrosis was wide, it was mandatory to insert the Satellite PEEK nucleus replacement No 15 after the last trail of No 14 from the left side. Check X-ray showed acceptable position. The patient had osteoporosis, for what so as to prevent slipping of the device, it was pushed more centrally and chips of bony fragments were inserted to the right side of the sphere. The sphere was not movable inside the disc space. Routine closure of the wound.

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Smooth postoperative recovery with improvement of the power of the right foot.


Comments

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The expected recurrence rate in this case is high, for what the Satellite PEEK nucleus replacement was applied to prevent further future collapse and minimize the rate of postoperative recurrence.

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With presence of osteoporosis, insertion of the trail devices must be done with care and it is advised to modify the shape of the squashed trail sphere to have more tapered angle at the anterior edge to minimize the traumatic insertion

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