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23-MARCH-2003 SAMIRA HASAN HUSSEIN 60 YEARS
LCS L3-4 WITH EXTRUDED DISC L4-5.
Comments
The recurrence rate in this case still
ranking around 7% because the disci spaces are not completely
collapsed.
Anamnesis
The patient came to the
clinic 08-February-2003
complaining of LBP for 10 years with left
sciatica with exacerbation last month. The
patient is a known diabetic and hypertensive for
10 years in medication. LSS-X-ray done
17-October-2002 showing osteopenia and wedging
of L1 and L2.
On examination: the patient in pain,
limping with exaggerated scoliotic stance. SLRS
was 80 degrees with pain left side. There is
weak dorsiflexion both feet, planterflexion
right foot and hypalgesia both L5 and S1
territories both feet.
The patient was sent for investigations and MRI
lumbar spine performed 19-February-2003 showing
severe stenosis L3-4, L4-5 with huge extrusion
L4-5. The patient was advised to stop
anticoagulants and to be seen by cardiologist.
Decompressive laminectomy of L4,
upper half of L5 and lower half of L3.
Foraminotomy both L4 and L5 both sides. The extruded disc
of L4-5 was
attacked from the right and right sided intradiscal
cleaning done. Left sided cleaning of L4-5 was also
done. 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 both
feet slightly improved. She was sent to the ward.
Follow Up
The patient came to the clinic 31-March-2003
with oozing wound improved motor and sensation
still the same. SLRS was 85 degrees with less pain
right side. The patient was advised to continue
dressing until the wound is dry and prescribed
Zinnat 500 mg twice daily until the wound is
dry.
The patient then came 23-April-2003 with dry
wound and the sensation improved slightly except
for diabetic neuropathy.
The last time she was seen 03-September-2003
complaining of right knee and sent for
orthopedic consultation.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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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
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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 .
