Munir Elias 20-12-2013

Dr. Ali Al-Bayyati and Dr. Munir Elias

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

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31-OCTOBER-2012  MAISOON MUHAMED AL-ZAGHA  52 YEARS  SPONDYLOLISTHESIS L5-S1  II-III DEGREE.

 

Anamnesis

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The patient came to the clinic 26-September-2012 complaining of LBP and bilateral sciatica more to the left for 18 months. She cannot walk more than 100 meters with difficulty and pain.

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MRI lumbar done 01-October-2011 and 28-September-2012 showing spondylolisthesis L5-S1 II-III degree.

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On examination: the patient is limping with exaggerated scoliotic stance. SLRS 20 degrees with more pain in the left side. There is weak dorsiflexion both feet 3/5 and planterflexion both 3/5 more weak in the right.

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Decompressive laminectomy of L5 with foraminotomy both S1 roots. Discectomy L5-S1 from the right side with insertion of Depuy interbody cage 8x32 mm with tricalcium phosphate granules mixed with his own bone. Using Jonson&Jonson Depuy Spine system, transpedicular screws - Reduction polyaxial 6x45 mm inserted to L5 body. Polyaxial 6x40 mm screws inserted to the S1 body, trying during that keep visual control of the S1 roots. 2 connecting rods 5.5 mm thickness and 45 mm length curved to accept the normal curve of the area. Cross link was added to increase the stability of the construct after performing slight compression. Further bone graft was applied to the areas lateral to the rods.

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Routine closure of the wounds. Smooth postoperative recovery. The power of both feet became better.

 

 

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Comments

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The patient has spondylolisthesis with which she cannot tolerate her stile of life. Surgical correction is the only solution.

 

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Back Up!

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 .

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