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27-OCTOBER-2003 UMAR SABRI MUHAMED 27
YEARS HUGE EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.
Anamnesis
The patient came to the clinic
06-October-2003 complaining of
LBP for 1 year with left sciatica the last 4 months. MRI done
23-April-2003 showing huge disc L5-S1 with left
downward migration.
On examination: the patient is in agonizing
pain, limping with exaggerated scoliotic stance.
SLRS was 30 degrees left side with pain. There
is weak dorsi and planterflexion left foot with
hypalgesia left S1 territory.
The patient was sent for new MRI and performed
and the data were the same.
Decompressive laminectomy
L5-S1. Foraminotomy left S1
roots was achieved. The first big piece was
removed subaxillary. The
other extruded disc material of L5-S1 was removed from the
left
side with left sided intradiscal cleaning L5-S1 was achieved.
A free fat tissue piece obtained from the
subcutaneous layer obtained and transferred to
the root area to minimize postoperative
scarring. 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
left foot normalized.
FOLLOW UP
The patient
came to the clinic 08-November-2003 with clean wound
no motor, nor sensory deficit. SLRS was 80 degrees
right
side with mild pain and numbness left S1 territory.
The patient
then came 26-May2009 complaining of LBP and pain in
the lower quadrants of the abdomen for 10 days. He
is not limping, no scoliosis with normal sensory and
motor functions He was given medications and sent
for investigations, but he disappeared.
Comments
There is still an
estimated postoperative recurrence around 7%
because the disc space 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 .
