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
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21-NOVEMBER-2012 NESRIN MUHAMED RAJAB 57 YEARS
II DEGREE SPONDYLOLISTHESIS L4-5 WITH SEVERE SEGMENTAL STENOSIS.
The patient came to the clinic 17-November-2012
complaining of both knees pain for 8 years and
difficult standing and walking for 3 years. For
more than 4 years, she has shooting pain to the
III-V toes right foot.
MRI of the lumbar spine done 10-November-2012
showing II degree spondylolisthesis L4-5 with
severe segmental stenosis. Dynamic studies
confirmed the overmobility of the
spondylolisthesis with isthmolysis.
On examination: the patient is limping with
exaggerated scoliotic stance. SLRS 70 degrees
both sides with pain. There is
weak dorsi and planterflexion both feet 4/5 and
hypalgesia both legs below the knees.
Laminectomy of L4 with upper
part of L5 and foraminotomy both L4 and L5 roots. There
was severe stenosis at L4-5. Discectomy of L4-5
was done with trail to reduce the
spondylolisthesis during that. Using Scientex
Alphatec Spine - Isobar TTL In System with Novel
TL system: Inner nut polyaxial screws 6.2x45 mm
were inserted to the L5 body. Inner nut
monoaxial screws 6.2x45 mm were inserted to the
L4 body. Novel TL, TLIF cage large 7x29 mm was
inserted to the disc space from the left with
bone graft. Transpedicular fixation with rods 5
mm 30 mm length with slight compression of L4-5
Routine closure of the wounds. Smooth
postoperative recovery. The power of both feet
Please! wait for 3-5 min till the
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The patient still has
severe lumbar canal stenosis due to
spondylolisthesis of L4-5. Surgery is the only
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