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Multigen RF lesion generator .
17-MARCH-2004 MUHAMED TALEB AL-MUHANADI 34
YEARS HUGE EXTRUDED DISC L5-S1 WITH LEFT UPWARD MIGRATION.
Anamnesis
The patient a Yemeni citizen came to the clinic 16-March-2004
complaining of LBP with left sciatica for 1
month with numbness of the left L5 and positive
cough sign. MRI lumbar spine performed
15-March-2004 showing huge extruded disc L5-S1
with left upward migration.
On examination: the patient is limping with
exaggerated scoliotic stance. SLRS was 80
degrees left side with pain. There is weak dorsi and planterflexion
both feet 4/5 more the left with hypalgesia
left L5 territory.
Foraminotomy left S1 root with
removal of the extrusion lateral to the axilla. After
that, the root became lax and left sided
intradiscal cleaning L5-S1 disc space was done.
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 root, to
minimize postoperative scarring. Routine closure
of the wound. Smooth postoperative recovery. The
power of both feet normalized.
FOLLOW UP
The patient came to the clinic 27-March-2004
with clean wound and SLRS 90 degrees both sides
without pain and normal power both feet and
sensation.
Comments
The estimated postoperative recurrence is still
ranking around 7%, because the disc space is
still relatively not shallow.
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 .
