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20-OCTOBER-2003 HASAN SAEED AWWAD 44 YEARS HUGE
RECURRENT DISC L5-S1 WITH DOWNWARD MIGRATION.
Anamnesis
The patient a Yemeni citizen came to the clinic
19-October-2003 telling that he was operated
elsewhere December-2002 for PLD L5-S1 with right sciatica.
The patient did not improve with exacerbation of
LBP with right sciatica the last 2 months. MRI done
15-October-2003 showing huge recurrent disc L5-S1.
On examination: the patient is in agonizing
pain, limping with exaggerated scoliotic stance.
SLRS was 30 degrees right side with pain. There
is weak dorsi and planterflexion right foot with
hypalgesia right S1 territory.
The old incision refreshed. Decompressive laminectomy
L5-S1. There was massive scar in this
area and scarolysis with foraminotomy right S1
roots was achieved. The first big piece was
removed subaxillary. The
other extruded disc material of L5-S1 was removed from the
right
side with right sided intradiscal cleaning L5-S1 was achieved.
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 power of the
right foot normalized.
FOLLOW UP
The patient
came to the clinic 28-October-2003 with clean wound
no motor, nor sensory deficit. SLRS was 80 degrees
right
side without pain.
Comments
There is still an
estimated postoperative re-recurrence around 7%
because the disc space not completely shallow.
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
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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 .
