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12-APRIL-2004 MUSTAFA HASAN ABDALLA 33 YEARS RECURRENT
EXTRUSION L4-5 LEFT SIDE.
Anamnesis
The patient a Palestinian citizen came to the
clinic 07-April-2004 complaining of LBP with
left sciatica for 3 months. He was operated
there 1994 for left sciatica. CT-scan done
11-February-2004 showing recurrence of L4-5 and
L5-S1.
On examination, the patient in agonizing pain,
limping with exaggerated scoliotic stance with
weak dorsiflexion both feet, more the left and hypalgesia
left L5 and S1
territories. SLRS was 30 degrees left side with
pain.
The patient was sent for
investigations and MRI lumbar spine performed
08-April-2004 showing huge recurrence of L4-5
left side.
Neurolysis left L5 root with
foraminotomy left L5
roots was achieved. Left sided intradiscal cleaning L4-5 was
performed.
The patient was put in Reverse Trendelenburg
position with Valsalva maneuver and
hyperventilation. No CSF leak. His epidural fat
was transposed over the left L5 root and a free fat was
harvested from the
subcutaneous layer and covered the exposed parts
of the dura and roots 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 22-April-2004 with clean wound
and the power of the feet normalized
and SLRS was 80 degrees both sides without pain.
There is hypalgesia left L5 root.
Comments
There is still an
estimated postoperative re-recurrence around 7%,
because the disc space is still not completely
collapsed.
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
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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 .
