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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Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

19-JUNE-2014  MUHAMED HASAN AL-QADUMI  28 YEARS  HUGE EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.

 

Anamnesis

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The patient came to the clinic 18-June-2014 complaining of LBP with right sciatica for 3 months with exacerbation the last three days with numbness of the right S1 territory with positive cough sign. MRI lumbar spine done 16-June-2014 showing huge extruded disc L5-S1 with right downward migration.

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On examination; The patient cannot set in chair, limping with exaggerated scoliotic stance. SLRS 5 degrees with pain in the right  and 40 degrees with pain shooting to the right leg. The right AJ is decreased in the right side. there is weak dorsiflexion right foot -3/5 and planterflexion same foot 2/5.

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Using the C-arm, the L5-S1 level identified. Using MICRODISCXS and VITOM, foraminotomy of right S1 root was done. Before reaching the dura, there was a CSF leak coming from the upper corner of the field, for what flavotomy was extended up and the dural defect was identified. It was in midline with very thin dura and it was adherent to the ligamentum flavum. The dural defect was closed by nylon 6 zero. Check by Valsalva maneuver ruled out CSF Leak. The downward migrating disc was removed lateral to the axilla in several pieces. Right sided intradiscal cleaning L5-S1 disc space. Routine closure of the wound.

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Smooth postoperative recovery. The power of the right foot became normal and the agonizing right sciatica disappeared.

 

 

Comments  

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The patient still has an estimated postoperative recurrence around 7% because the disc space is still not completely shallow.

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The center of the sleeves must be identical with the plane of the disc space, so as to perform intradiscal cleaning.

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.

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.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014


Back Up!

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 .

WELCOME TO AL-SHMAISANI HOSPITAL

 


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