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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23-JUNE-2012 HUSNIEYH HUSSEIN ABDEL-QADER 65 YEARS
SEVERE LUMBAR CANAL STENOSIS WITH SPONDYLOLISTHESIS L4-5.
Anamnesis
The patient came to the clinic 02-May-2012
complaining of numbness both lower limbs up to
the umbilicus for three months with difficult
walking. She can walk only 5-10 meters.
On
examination, the patient is limping with
exaggerated scoliotic stance with SLRS 75 degree
with pain both sides. The AJ is absent both
sides with hypalgesia 5 cm above the inguinal
region. There is weak quadriceps muscles both
lower limbs 4/5 and almost drop both feet 3/5
and weak planterflexion both feet -4/5.
New MRI was requested and done 06-May-2012
showing old wedge fracture D12 with
calcification with L1. There is stenosis L3-4
and L4-5 with spondylolisthesis L4-5.
Decompressive laminectomy
L2,3,4 and partial of L5. Foraminotomy both L5
roots. Discectomy of L4-5 with insertion of TLIF
cage Novel TL large size, 10x10x25 mm
dimensions. with artificial bone. Using IsoBar 4
transpedicular screws polyaxial 6.5x45 mm to the
L5 body and monoaxial 6.5x45 mm to the L4 body,
fusion of L4-5 with slight compression was done
with cross connector.
Routine closure of the wound. Smooth
postoperative recovery with improvement of the
power of both lower limbs..
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Comments
The patient had several
problems which need surgical correction.
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 .
