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Multigen RF lesion generator .
07-MAY-2004 MUHAMED TALEB MUSTAFA SAFI 59
YEARS EXTRUDED DISC L4-5 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient came to the
clinic 02-May-2004 complaining of LBP with
right sciatica for 1 week. He was felt down 1979
with LBP then recovered than 1980 and 1996.
On examination, the patient in agonizing pain,
limping with exaggerated scoliotic stance with
weak dorsiflexion right foot 4/5 and hypalgesia
right L5 and S1 root territories. SLRS was 40 degrees right side with
pain.
The patient was sent for
investigations and MRI lumbar spine performed
05-May-2004 showing huge extrusion of L4-5
with right downward migration.
Foraminotomy right L5
root was achieved. Right sided intradiscal cleaning L4-5 was
performed.
The patient was put in Reverse Trendelenburg
position with Valsalva maneuver and
hyperventilation. No CSF leak. A free fat was
harvested from the
subcutaneous layer and covered the exposed parts
of the dura and roots to minimize postoperative
scarring. Routine closure
of the wound.
Smooth postoperative recovery. The power of
right foot normalized.
FOLLOW UP
The patient
came to the clinic 15-May-2004 with clean wound and no motor deficit,
but hypalgesia right L5 root. Senimet was started
for his tremor.
The patient
then came several times and MRI lumbar spine done
12-July-2004 showing no recurrence.
The last time
he came 10-June-2007 with left sciatica with
MRI done 24-April-2007 showing no recurrence and
upon examination he had osteoarthritis of the left
knee and he was sent for ortho consultation.
Comments
There is still an
estimated postoperative recurrence around 7%,
because the disc space is still not completely
collapsed.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Inomed Riechert-Mundinger System, with three point
fixation is the most accurate system in the market. The microdrive and
its sensor gives feed back about the localization.
Inomed MER system
Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
LooksCam II Xenosys in the run starting from 14-March-2021 with
SheerVision TTL x4 magnification.
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 .
