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Multigen RF lesion generator .
16-MAY-2002 RASEM NIMER AWAD 56 YEARS
EXTRUDED DISC L4-5 WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
The patient came to the clinic 13-May-2002
complaining of LBP and right sciatica
for 15 months. At 21 years age had fracture L3.
MRI lumbar spine performed 06-March-2001 showing
extruded disc L4-5 with right foraminal
occlusion with old fracture of L3.
On examination: The patient is in agonizing pain,
limping with exaggerated scoliotic stance
with right sciatica. SLRS was 50 degrees with
pain in the right. There is drop right foot for
3 months, weak planterflexion same foot 3/5,
abduction right knee 4/5 with hypalgesia right
L5 territory.
Decompressive laminectomy L4-5 with right
extended L5 foraminotomy with removal of the
extrusion lateral to the axilla and bilateral
cleaning L4-5 disc space. 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 right foot improved.
He was sent to the ward.
Follow Up
The patient came to the clinic 27-May-2002
with clean wound and sciatica free and weak
dorsiflexion right foot 4/5. SLRS was 70 degrees in the
right without pain.
The patient then came 17-June-2002 telling that
he was hospitalized for duodenal ulcer 2
weeks ago, but neurologically he was free with
minimal scoliosis and limping. He was advised to
take tramal if in pain.
Comments
There is still an estimated postoperative
recurrence around 7%, because the disc space still not
shallow.
In retrospective analysis, it was unnecessary
to perform bilateral cleaning. (14-April-2021).
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 .
