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
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30-SEPTEMBER-2014 JIHAD MAHMOUD FARASH 40 YEARS
HUGE EXTRUDED DISC L5-S1 WITH LEFT FORAMINAL OCCLUSION AND BULGE L4-5 MORE TO
The patient came to clinic 29-Sptember-2014
complaining of LBP with left sciatica for 5
years with exacerbation last 2 months and
further deterioration last 20 days after
physiotherapy. MRI lumbar spine done
19-July-2014 showing bulge L4-5 and extruded
disc L5-S1 with left foraminal occlusion.
On examination; the patient is limping walking
with aid and using crutches for with
exaggerated scoliotic stance. SLRS 30 degrees
with pain in the left and 75 degrees in the
right. There is almost drop left foot.
MRI repeated today showing further enlargement
of the L5-S1 extrusion with same bulge of L4-5.
Skeletonization of L5, upper sacrum and lower
third of L4 laminae. There is recent fracture of
the upper sacrum at its spinous process, for
what C-arm was used to check level. Foraminotomy
both S1 roots and left L5 root. Bilateral
cleaning of the extruded disc L5-S1 with
bilateral intradiscal cleaning of its space.
Inspection of the extruded disc of L4-5 from the
left showed old changes without mobile material,
for what it was decided not to violate the disc
material. Instead, good decompression of the
root canal was achieved.
Routine closure of
Smooth postoperative recovery. The power of the
left foot became better.
The patient still has an estimated
postoperative recurrence around 7%, because the disc space
is still not completely shallow.
If both disci were violated then the
recurrence rate would be around 30%.
The fractured elements of upper sacrum
could not be figured by MRI.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
Inomed MER system
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 .