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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
09-MARCH-2014 ISA MUHAMED ISA 37 YEARS
EXTRUDED DISCS L3-4, L4-5 WITH SEVERE SEGMENTAL STENOSIS.
Anamnesis
The patient came to the clinic 24-February-2014
complaining of LBP for 2 months with left
sciatica, which increased the last 45 days. MRI
lumbar spine done 22-February-2014 showing
severe lumbar canal stenosis L3-4 and L4-5 with
suspected lesion in the left L4-5 extraforaminal
territory. The patient is diabetic for the last
5 months.
On examination; the patient is in agonizing
pain, limping, with exaggerated scoliotic
stance. SLRS was 80 degrees both sides. There is weak dorsiflexion
left foot 4/5 and hypalgesia left L5 territory.
MRI of the lumbar spine repeated
25-February-2014 showing extruded disc L3-4 and
L4-5 with severe segmental stenosis.
Using C-arm, the L4-5 level identified.
Laminectomy L4 with lower third of L3 and upper
third of L5 was done. During that, several
pieces of suspected tissue fragments were
collected for histologic studies. Left L4, L5
foraminotomies. Discectomy L4-5 and the material
sent for CXS. Discectomy L3-4 and left sided
intradiscal cleaning L3-4 and L4-5 was achieved.
Routine closure of the wound.
Smooth postoperative
recovery. The power of the left foot became
normal.
Comments
The patient still have an estimated
postoperative recurrence rate above 30%, because
the disc space of both levels still not shallow.
In case of infection, antibiotics will be
planned for several months.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
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 .
