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Multigen RF lesion generator .
04-DECEMBER-2007 HANAN MUHAMED HASAN 33 YEARS HUGE EXTRUDED
AND SEQUESTRATED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 03-December-2007
complaining of LBP with right sciatica for 18
months. Exacerbation of the right sciatica the
last 5 days with numbness of the S1 territory.
MRI performed 02-December-2007 showing huge
extruded and sequestrated disc L5-S1 right side
with a huge fragment separated from the disc
material travelling down.
On examination: the patient limping with mild
scoliotic stance, with agonizing sciatica. SLRS
was 20 degrees in the right with almost drop
right foot and weak planterflexion right foot
4/5. There was hypalgesia of the right S1
territory.
The patient asked for small incision, for what
35 mm length incision was made and right L5-S1
hemiflavotomy with right S1 root foraminotomy
was performed. The upper part of the extrusion
was removed and cleaning of the disc space was
performed from the right. The separated piece
was explored and it was found 10 mm below the
disc space pushing the S1 root medially. It was
exposed and a huge big piece was removed in one
piece. The epidural fat was transferred to cover
the right S1 root.
Smooth postoperative recovery.
Comments
The patient asked for small incision. It
means, that during flavotomy it is necessary to use the
loupes with magnification to see exactly what is going on
and to perform the usual tasks.
The neurosurgeon must be a good MRI reader so
as not to miss the separated piece. Foraminotomy was extended
more than usual so as not to escape such far migrating piece.
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 in the run starting from 14-March-2020
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 .
