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Multigen RF lesion generator .
17-JANUARY-2003 RIMA ABDALLA QARBEK 32 YEARS
HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic 15-January-2003
complaining of LBP for 30 days with left
sciatica with numbness left L5 territory.
On examination: the patient in agonizing pain,
limping with exaggerated scoliotic stance. SLRS
was 40
degrees with pain in the left. There is weak
dorsi and planterflexion left foot 3/5 with hypalgesia left
S1 root territory.
The patient sent for investigation and MRI
lumbar spine showing Huge extruded disc L5-S1
with left far downward migration.
Left L5-S1 hemiflavotomy with left
S1 foraminotomy. The far downward migrating piece
was removed in three big pieces and left sided intradiscal
cleaning L5-S1 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 radicular pain decreased and the power of left
foot normalized. She was sent to the ward.
Follow Up
The patient came to the clinic 27-January-2003
with clean wound with SLRS 90 degrees without
pain with no sensory, nor motor deficit. Still
having mild scoliosis.
The patient then came several time complaining
of neck pain. MRI cervical spine done
11-March-2004 showing bulge C3-4 and C6-7. She
was treated conservatively.
The patient came 20-September-2005 complaining
of left hip pain, but SLRS was 100 degrees both
sides with no motor or sensory deficit. She was
treated conservatively.
Comments
The recurrence rate in this case still
ranking around 7% because the disc space is 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
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 .
