Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
12-APRIL-2016 SAMER MUHAMED JUDEH 33
YEARS RECURRENT DISC L5-S1 CENTRAL MORE TO THE LEFT.
Anamnesis
The patient came to the clinic 04-April-2016
telling that he was operated elsewhere for
extruded disc L5-S1 for left sciatica 2011. The patient was doing will
for one year after what he got LBP. MRI lumbar
spine performed 14-APril-2012 showing recurrent
disc L5-S1. MRI repeated 07-November-2015
showing enlargement of the recurrence. The
patient was advised to enjoy sport after what,
he got bilateral sciatica.
On examination: the patient is not limping nor
having scoliotic
stance. SLRS was
80 degrees with pain in both sides. The patient
was neurologically free, except for the pain.
The patient was sent for investigations and MRI
lumbar spine performed 04-April-2015 showing
further enlargement of the recurrence of L5-S1 with
central more to the left extrusion. Dynamic
studies were normal and Lab investigations were
normal.
The old incision refreshed
and dissection carried out down to both
upper corners of the previous bone defect and
neurolysis of both S1 roots was achieved. The
extruded disc was removed lateral to the axilla
and the central part removed.
Right S1 foraminotomy with bilateral
cleaning of the disc space was achieved. Using MultiGen, a
bipolar pulsed mode
RF with 42 Celsius, 240 sec, 2 Hz and 20 msec
duration to both S1 root was achieved using 4 bended catheters 10 mm exposed length.
Stimulation of the right S1 root with 1 V showed brisk response,
stimulation of the left was identical with 1.2 V. Routine closure of the
wound.
Smooth postoperative recovery. The patient
is sciatica free. He was sent to the ward.
MultiGen
Comments
The patient still having an estimated
postoperative recurrence around 7%, because the disc space
is still not shallow.
This is the 50th case using the BPRF mode
with MultiGen. This procedure regained routine acceptance it
became
a usual part of the spine surgery.
Click here for
reference.
If there is scar, it hard to predict the
correlation between the root response to stimulation
amplitude and the postoperative recovery. Bipolar
stimulation of the roots gave identical response to
different voltage. The scar was minimal at the operative
site stimulation.
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 Headmounted 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
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 .
