Munir Elias 20-12-2013

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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20-FEBRUARY-2014  MARIAM DARWEESH HALEES  62 YEARS  EXTRUDED DISC L1-2 MORE TO THE RIGHT WITH SEVERE STENOSIS AT D12-L1, L1-2 AND L4-5.

 

Anamnesis

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The patient came to the clinic 08-February-2014 complaining of LBP for 1 year with inability to walk more than 20 meters and weak both legs more the right. The patient was diagnosed elsewhere as having Guillain-Barre syndrome without performing minimal investigations. The patient is a known hypertensive.

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On examination; the patient walking with help of one or 2 persons. SLRS was 70 degrees due to weak right lower limb. AJ was absent in both sides. Babinski was positive in the right and questionable in the left. Weak dorsiflexion both feet 3/5 and planterflexion right foot 4/5.There is weak right quadriceps muscle and both knees abduction 4/5. Sensation intact.

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The patient sent for MRI of the dorsal and lumbar spine and done 08-February-2014, showing extruded disc L1-2 more to the right and severe stenosis D12-L1, L1-2 and L4-5.

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Using C-arm, the level of L1-2 was identified. Decompressive laminectomy D12, L1 and upper third of L2. The disc of L1-2 was inspected from the right side. It was compressing the crossing root. Discectomy of L1-2 disc space with right sided cleaning. The root then became lax and free. Through another incision, laminectomy of L4 and upper third of L5 with bilateral foraminotomy both L5 roots. Routine closure of the wounds.

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Smooth postoperative recovery. The power of both lower limbs improved.

 

 

Comments  

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There is still an estimated postoperative recurrence around 7%, because the disc space is still not completely shallow.

 

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.


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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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