Munir Elias 20-12-2013

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  neurosurgery.tv

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Multigen RF lesion generator .

17-JULY-2014  SAMIR RASHEED ABU-AL-AYNAIN  55 YEARS  EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.

 

Anamnesis

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The patient came to the clinic 08-December-2012 complaining of LBP with left sciatica for 10 days with with numbness down to the big toe left foot with intermittent LBP for 8 years. The patient underwent cath 2007 and stinting was applied.

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The patient at that time was limping with mild scoliotic stance. SLRS was 30 degrees in the left with pain and 60 degrees right side with less pain. There was weak dorsiflexion left foot 3/5. The patient was sent for investigations and MRI lumbar spine done 11-December-2012 showed extruded disc L4-5 with left downward migration. he patient was advised to undergo surgery but he was reluctant and disappeared.

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The patient then came 14-July-2014 with agonizing LBP and right sciatica for 2 months. The patient is unable to set in a chair. MRI lumbar spine bad quality open type was done 09-July-2014 showing as be having an extruded disc of L5-S1 with right downward migration. He underwent cath 2011 and the cath results were acceptable.

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On examination; the patient in agonizing pain, was limping with exaggerated scoliotic stance. Positive cough sign, SLRS was 40 degrees with pain in the right and 70 degrees without pain in the left. Weak dorsi and planterflexion right foot -4/5.

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The patient was sent for investigations and the MRI lumbar spine performed the same day, showing the extruded disc of L5-S1 with right far downward migration. The old extruded disc of L4-5 in the left side suffered shrinking. Dynamic studies were normal.

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Right S1 foraminotomy with preservation and reflection of ligamentum flavum to the right was done. The extruded disc was removed lateral to the axilla. Right sided intradiscal cleaning of L5-S1 disc space. Routine closure of the wound.

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Smooth postoperative recovery. The power of the right foot became normal.

 

 

Comments  

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The estimated postoperative recurrence is still around 7% because the disc space height is still not shallow.

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Preservation of the ligamentum flavum is the best way to decrease the scar formation after disc surgery. Efforts are paid to preserve the epidural fat during surgery

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014


Back Up!

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 .

WELCOME TO AL-SHMAISANI HOSPITAL

 


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