Inomed Stockert Neuro N50. A versatile
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Multigen RF lesion generator .
09-FEBRUARY-2004 MUSA MRAWEH ABU-JAMOUS 48
YEARS EXTRUDED DISC L4-5 WITH RIGHT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 07-February-2004 complaining of
LBP with right
sciatica for 2 years with exacerbation last
month down to the right S1 root territory with
numbness of the right foot with positive cough
sign.
MRI lumbar spine done 26-January-2004 showing
huge extruded disc L4-5 with right downward migration
and bulge L3-4.
On examination: The patient is using crutches, limping with
exaggerated scoliotic stance. SLRS was 30 degrees
in the right with pain and 85 degrees in the
left without pain. There is
drop right foot and
planterflexion right foot 3/5 with hypalgesia
right L5 territory.
Right L5 foraminotomy with
removal of the huge extrusion lateral to the axilla. After
that, the root became lax and right sided
intradiscal cleaning L4-5 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 the right foot slightly improved.
FOLLOW UP
The patient came to the clinic 21-February-2004
with clean wound and SLRS 85 degrees both sides
without pain and weak dorsiflexion right foot
4/5. Sensation preserved.
The patient then came 20-June-2004 complaining of
LBP with right hip pain with SLRS was 80 degrees
right with pain and no motor nor sensory
deficit. The patient given medications and sent for investigations
but he disappeared.
Comments
The estimated postoperative recurrence is still
ranking around 7%, because the disc space is
still relatively 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 .
