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12-OCTOBER-2003 SALEH SALEM SALMEEN 53
YEARS HUGE EXTRUDED DISC L1-2 LEFT SIDE.
Anamnesis
The patient a Yemeni citizen came to the clinic
08-October-2003 complaining of LBP for 32 years.
He was operated 1971 for left sciatica. The last
year exacerbation of left
sciatica, then bilateral the last month.
On examination: the patient is in agonizing
pain, limping with exaggerated scoliotic stance.
SLRS was 80 degrees both sides with pain. There
is weak dorsiflexion right foot with weak planterflexion
both feet. Weak both quadriceps muscles also
noted.
The patient was sent for investigation and MRI
lumbar spine performed 11-October-2003 showing
huge extruded disc L1-2 more to the left.
Decompressive laminectomy
L1-2 with foraminotomy both L2 roots .The very huge piece was removed from
under the left L2 axilla. Left sided L1-2
discectomy lateral to the
axilla and left sided intradiscal cleaning of
L1-2 space was achieved. The epidural fat was
transferred around the L2 root to minimize
postoperative adhesions. 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 still weak 4/5.
FOLLOW UP
The patient
came to the clinic 20-October-2003 with clean wound
and the power of both lower limbs normalized. SLRS was
80 degrees. There is
hypalgesia right L5 and S1 territories.
Comments
There is still an
estimated postoperative recurrence around 7%
because the disc space is not completely 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
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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 .
