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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
10-OCTOBER-2015 NATHAR MUHAMED SALAM 68 YEARS
SPONDYLOLISTHESIS L3-4, L4-5 WITH SEVERE STENOSIS L4-5.
Anamnesis
The patient came to the clinic 23-September-2007
complaining of LBP for 10 years with bilateral
sciatica and inability to walk more than 100
meters with intermittent claudication. She was
hypertensive for 10 years and cath with stinting
done 2003. On examination that time, she was
limping with exaggerated scoliotic stance. SLRS
was 70 degrees with pain right side and 80
degrees with pain in the left shooting to the
right leg. Dorsiflexion right foot was 3/5.
Planterflexion right foot and dorsiflexion left
foot was 4/5. The patient was sent for
investigations and MRI done at that time showed
severe LCS L4-5 with spondylolisthesis and she
was advised to undergo surgery but she
disappeared. The patient then came
03-October-2015 telling that her condition is
deteriorating the last 2 years with right
sciatica the last 4 days and walking with help.
On examination: the patient was limping with
exaggerated scoliotic stance. She could walk
with help. SLRS was 60 degrees with pain in the
right. Weal dorsiflexion both feet -4/5 with
numbness both feet.
The patient was sent for investigations and MRI
Lumbar spine done 04-October-2015 showed spondylolisthesis
L3-4, L4-5 with severe segmental stenosis at
L4-5. The patient was asked to stop Aspirin and
to be seen by cardiologist as preoperative
evaluation.
Transpedicular fixation with
distraction-reduction of L3-4-5 using XIA 3 system with
4
monoaxial 6.5x45 mm screws and 2 long-arm screws
6.5x45 mm to L4 level. Decompressive laminectomy L3,4 and upper
third of L5 with foraminotomy L4 and L5 roots
both sides. Using MultiGen , pulsed mode
RF with 42 Celsius, 240 sec, 2 Hz and 20 mesec
duration both L4 and L5 roots were manipulated.
42 mm multiaxial cross connector was applied and
melted
bone harvested from the patient was used and
applied lateral to the rods. Routine closure of the
wound.
Smooth postoperative recovery. The power of
the feet became normal. No sciatica. The patient was
sent to the ward.
MultiGen
Comments
The patient has a progressive condition
that only surgery can stop her deterioration.
This is the 12th case during which PRF was
used to both L4 and L5 roots both sides.
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 Headmounted 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
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 .
