Inomed Stockert Neuro N50. A versatile
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Multigen RF lesion generator .
12-NOVEMBER-2015 IMAD MUHAMED SANAD 50 YEARS
HUGE EXTRUDED DISC L5-S1 WITH SEVERE STENOSIS AND RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient was operated by me
12-June-2004 for
extruded disc L4-5 with right sciatica. The
patient then came 08-November-2015 complaining
of right sciatica with LBP for one month.
On examination: the patient is limping with no
sciatica. SLRS was 70 degrees with pain right
side. There is no sensory or motor deficits.
The patient was sent for investigations and MRI
done 08-November-2015 showing huge extruded disc
L5-S1 with segmental stenosis and right downward
migration. Dynamic studies showed very mild
elements of retrolisthesis L4-5 without signs of
recurrence.
Foraminotomy right S1 root
with removal of the extrusion lateral to the
axilla. Right sided intradiscal cleaning L5-S1.
There was a dural defect, which was repaired by
6 zero nylon one stitch. Check for CSF leak was
negative. Using MultiGen, a pulsed mode
RF with 42 Celsius, 240 sec, 2 Hz and 20 msec
duration the right S1 root was achieved.
Routine closure of the
wound.
Smooth postoperative recovery. The patient was
sent to the ward.
MultiGen
FOLLOW UP
The patient
came to the clinic 23-November-2015 with clean wound and no motor,
nor sensory deficit. SLRS was 80 degrees both sides
without pain.
The patient
then came 23-October-2016 with MRI lumbar spine
performed 22-October-2016 showing huge recurrence of
L5-S1 and he was advised for surgery, but he
disappeared.
Comments
There is still an
estimated postoperative recurrence around 7%,
because the disc space is still not completely
collapsed.
This is the 17th case using the PRF mode
with MultiGen.
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 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 .
