Dr. Fuad Al-Masri Syrian neurosurgeon.

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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Inomed Stockert Neuro N50. A versatile
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Multigen RF lesion generator .

13-SEPTEMBER-2013  SULAYMAN AHMAD ABDO  57 YEARS  HUGE EXTRUDED DISC L4-5 WITH CAUDA EQUINA SYNDROME.

 

Anamnesis

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The patient was admitted to Emergency Shmaisani hospital coming from Saudia with a history of LBP for 1 week with bilateral sciatica. 3 days ago while walking, he felt due to profound weakness both legs with micturition problems and numbness of the perianal region.

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MRI lumbar spine done 10-September-2013 showing huge extruded disc wide based with left upward migrating sequester, resulting in severe segmental stenosis.

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On examination: the patient in bed, could pass urine with difficulty, with SLRS 70 degrees without pain. The AJ is absent both sides. There is analgesia in the perianal region, extending down to medio-posterior aspect both thighs.

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Using the C-arm, the L4-5 level was indentified. Partial laminectomy L4 and L5. Foraminotomy L5 root both sides. The extruded left upward migrating disc was removed in one big piece. Left sided intradiscal cleaning L4-5 space. Inspection from the right side, revealed no extrusion. Routine closure of the wound.

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Smooth postoperative recovery. The power of both feet became normal.

 

 

Comments

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The patient has stenosis with upward migrating huge disc, which together caused the cauda equina syndrome.

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SLRS was not dramatic, because the extruded disc was separated from the annulus fibrosis.

 

Leica HM500

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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 .

WELCOME TO AL-SHMAISANI HOSPITAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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