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14-OCTOBER-2002 ISMAEEL HAMMAD AL-KOOZ
57 YEARS HUGE EXTRUDED DISC L5-S1 RIGHT SIDE.
Anamnesis
The patient came to the clinic
03-October-2002
complaining of LBP with right sciatica for 2
years. Hypertensive for 1 years. Had MI 1 year
ago and stinting 01-January-2002. The condition
is deteriorating and using crutches the last
week.
On examination: The patient is limping, has LBP with
exaggerated scoliotic stance. There is weak dorsiflexion
right foot
3/5 and planterflexion right foot 4/5 and SLRS was
40
degrees with pain right side. There is
hypalgesia right L5 and S1 roots territories.
The patient was sent for investigation and MRI
lumbar spine performed 09-October-2002 showed extruded disc L5-S1 right
side. There is lumbarization of S1.
Foraminotomy
of the right S1 root with removal of the extrusion lateral to the axilla
and drilling of the osteophytes with right sided
intradiscal cleaning of L5-S1 disc space. The root
still compressed for what Left S1
foraminotomy with left sided cleaning of L5-S1 with
osteophytectomy lateral to the axilla. After that
right subaxillary removal of huge extrusion was
achieved. The root became lax. 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 still the same. He was sent to the ward.
Follow Up
The patient came to the clinic 26-October-2002
with clean wound and hypalgesia right L5 and S1 root
territories and weak dorsiflexion right foot 4/5.
Comments
The estimated postoperative recurrence is
around 7%, because the disc space is still not 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
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 .
