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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator
27-DECEMBER-2014 MUNTASER YOUSEF AL-RAJABI
49 YEARS MULTI-ORGAN INJURY WITH FRACTURE DISLOCATION D5-6 WITH COMPLETE
The patient was admitted to Emergency of
Shmaisani hospital 24-December-2014 after
suffering severe trauma by sticking between 2
heavy objects, that caused fracture of the right
5-7 ribs and dislocation of D5-6 with paraplegia
and internal bleeding. He came with under-water
seal tube from another hospital. He mentioned
that he did not suffer loss of consciousness,
but got immediate paraplegia. Radiologic
investigations were performed, demonstrating
shuttered liver and rupture spleen with
dislocation of C5-6 with fracture right 5-7th
ribs. The patient was bleeding actively and
emergency laparatomy was done with repair of the
lever and resection of 2/3 of the spleen. There
was retroperitoneal hematoma over and behind the
spleen. MRI of the dorsal spine showing
contusion of the spinal cord with minimal
compression due to 7-9 mm dislocation of the
After correcting the homeostasis and the patient
was seen by cardiologist, it was decided to
perform fixation through right thoracotomy
The right 5th rib exposed and resected from the
fracture site anterior about 15 cm. Thoracotomy
achieved with deflation of the right lung.
Double-lumen intubation was applied. The D5 and
D6 were exposed and the slipped disc material
was noted with the chip fracture in the right
upper corner of D6 was removed. Using Medtronic
CDH ANTARES system was used with caudal and
rostral spikes 23 mm. CDH FAS 6.5x35 mm screws
were used with 2 rods 5.5 mm diameter with the
long one 60 mm and the short one 45 mm to reduce
and fix the D5-6 levels. Strict hemostasis and
routine closure of the wound and the underwater
seal was left in place.
Smooth postoperative recovery. The neurologic
status still the same. The patient was sent to
During the impact of trauma the spinal
cord suffered major injury with dislocation around 3-4 cm,
but it returned immediately to the seen at the preoperative
MRI and CT-scans. It is hard to tell early the prognosis in
such case and the aim of surgery to make the patient set as
early as possible.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
Inomed MER system
ORS Visual reconstruction showing the site of the fractures and
ORS Visual showing the fracture pieces of upper corner of D6under
the disc space of D5-6. The transverse distance of the bodies are
around 33 mm.
The construct in place.
ORS Visual showing the location of the screws the next day after
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 .