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Multigen RF lesion generator .
29-NOVEMBER-2002 NAZMI TAWFEEQ AL-SHURBAJI
67 YEARS HUGE RECURRENT DISC L4-5 WITH LEFT SCIATICA.
Anamnesis
The patient was operated by me 26-December-1998
for PLD L4-5 with left sciatica. The patient was
doing well until he came 03-November-2002,
telling that he got LBP with left sciatica for
10 days. MRI lumbar spine performed
02-November-2002 showing huge recurrence of L4-5
disc.
On examination: The patient in agonizing pain,
limping with exaggerated scoliotic stance.
SLRS
45 degrees
with pain in the left and 75 degrees in the
right with less pain. There is severe weak dorsi planterflexion
left foot 3/5, with hypalgesia left
L5 and S1 territories.
Scarolysis of the area.
Bilateral extended L5 foraminotomy with removal of the
extrusion lateral to the axilla first from the
right. Bilateral intradiscal cleaning L5-S1. The
left downward migrating piece was removed fro
under the right axilla. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak.
Routine closure of the wound.
Smooth postoperative recovery.
The power of the left foot improved.
He was sent to the ward.
Follow Up
The patient came to the clinic 28-December-2002
with clean wound with slight weak dorsiflexion
right foot with
SLRS 70 degrees without pain both sides.
Comments
There is still an estimated postoperative
re-recurrence around 7%, because the disc space is still not
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 .
