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04-DECEMBER-2004 MUHAMED SALEH AL-SAYYED 25 YEARS
NON REDUCIBLE BONE COMPRESSION AFTER TRANSPEDICULAR REDUCTION AND
FIXATION.
Anamnesis
The patient was operated by me
01-December-2004. Check CT-scan performed
the next day after the first surgery showing
slight, but unacceptable bony compression of L4.
On examination: The patient is the same and was
planned for surgery the following day.
The wound was opened and the
cross connector was removed with subsequent
laminectomy of L4. The bony compressed elements were
manually pushed down by impactors to reduce them
form both sides. Inspection of the right L5 root
showed severe damage with a tear of the dural
sleeve, but not requiring stitching. After regaining
acceptable realignment, the cross connector
reapplied. No CSF leak. Routine
closure of the wound.
Smooth postoperative recovery.
The neurological status still the same.
He was sent to the ward.
Follow Up
The patient then came to the clinic
22-December-2004 with clean wound and SLRS 45
degrees both sides with pain and drop right foot
with no sensory deficit.
The patient then came 21-February-2005 walking
with SLRS 70 degrees with pain and improvement
of the power of dorsiflexion right foot 4/5 with
numbness right L5 territory. After that the
patient did not showed up.
Comments
All the time check your actions during
surgery, if feasible or the next day.
In this case the bony reduction was not
complete and unacceptable, for what redo surgery was
performed.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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