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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator
12-MARCH-2014 KHULUD RADWAN AL-SMADY 43 YEARS
SECOND GRADE SPONDYLOLISTHESIS L5-S1.
The patient came to the clinic 15-January-2014
complaining of LBP for 20 years with left
sciatica for 7 months down to the III toe left
foot. CT-scan done 18-April-2013 showing
spondylolisthesis L5-S1. Dynamic studies
confirmed the same data. MRI lumbar spine done
01-May-2013 showing spondylolisthesis L5-S1.
On examination; the patient is limping, with exaggerated scoliotic
stance. SLRS was 80 degrees left side with pain. There is
weak dorsiflexion left foot 4/5. It was agreed
with the patient that in case of conservative
treatment failure then to consider surgery. The
patient then came 08-February-2014 telling that
conservative measures failed to improve her.
MRI of the lumbar spine done
08-February-2014 confirming the presence of
Using C-arm, the L5-S1 level identified.
Skeletonization of L4, L5 and upper sacrum. The
L5 lamina is completely flail. All the flail
lamina was removed and foraminotomy both L5 and
S1 roots was achieved. Discectomy of L5-S1 from
the right side with trail to reduce the
spondylolisthesis. TLIF Novel TL cage 9x10x28 mm
inserted to the L5-S1 disc space. Using Isobar
TTL module in system, 2 reduction monoaxial
screws 6.2x45 were inserted to L5 body and 2
monoaxial screws 6.2x45 mm to upper sacrum. All
stages of surgery were done under the control of
C-arm. Transpedicular reduction fixation was
performed at L5-S1 level with slight compression
from the right side. The harvested bone was melt
and used lateral to the bended rods 60 mm length
with the cross connector between them. Routine
closure of the wound.
recovery. The power of the right foot became
The patient has progressive
spondylolisthesis with flail lamina. Surgical
decompression and reduction with fixation is the
best treatment choice.
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
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 .