Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
12-JULY-2016 MUHAMED IBRAHEEM RIZIQ HUGE EXTRUDED
DISC L1-2 WITH CAUDA EQUINA SYNDROME.
Anamnesis
The patient came to the clinic
11-July-2016 complaining of LBP and bilateral
sciatica for 18 days with difficult walking with
both hips pain and signs of cauda equina
syndrome with difficult urination. MRI
lumbar spine performed 09-July-2016 showing
huge extruded disc L1-2 with with severe spinal
cord compression with right upward posterior
migration.
On examination: the patient is walking with help
and using crutches and unable to be evaluated
for scoliotic
stance. SLRS was 60 degrees both side without pain
due to weakness. There is weak
both quadriceps 4/5, abduction and adduction
right knee 3/5 and left knee 4/5. Weak
dorsiflexion both feet 3/4 and planterflexion
both feet 4/5. There is hypalgesia S2-3-4 both
sides.
Using the C-arm, the
L1-2 level was identified and
decompressive laminectomy L1 and upper third of
L2 was done. Foraminotomy both L2 root was achieved. The extruded disk was removed from
left side and bilateral cleaning of L1-2 was
performed. The extruded disc material was hard in
consistency. Using MultiGen, bipolar motor stimulation of
both L2 roots was achieved with 1.4 V. A
bipolar pulsed mode
RF with 42 Celsius, 240 sec, 2 Hz and 20 msec
duration to both L2 roots was achieved using
4 bended catheters 10 mm exposed length. Further
motor stimulation done to the same roots and the
response was 1.4 V. Routine closure of the
wound.
Smooth postoperative recovery. The power of both legs
dramatically improved and he was sent to the ward.
MultiGen
Comments
The patient still have an estimated
postoperative recurrence around 7%, because the disc space
is still not shallow.
This is the 67th case using the BPRF mode
with MultiGen. This procedure regained routine acceptance.
It
became
a usual part of the spine surgery.
Click here for
reference.
It still unclear to evaluate the differences of pre
and post application motor responses. The only sure thing
that it tell that the electrodes did not migrate during the
procedure and the nerve is functioning properly. Here there
was no difference of power of motor stimulation before and
after the procedure.
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 Headmounted 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
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 .
