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
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.
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.
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.
Routine closure of the wounds. Smooth
postoperative recovery. The power of both feet
became better.
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Comments
The patient has
spondylolisthesis with which she cannot tolerate
her stile of life. Surgical correction is the
only solution.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .