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18-APRIL-2003 WAEL FUAD AL-SAJAHEER 36
YEARS EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.
Comments
The recurrence rate in this case still
ranking around 7% because the disc space is not completely
collapsed.
The epidural fat was pushed over the dura
to minimize scar formation.
Anamnesis
The patient came to the
hospital 18-January-2003
complaining of LBP with left sciatica for 1 week
with agonizing pain. MRI lumbar spine performed
yesterday showing huge extruded disc L4-5 with
left downward migration.
On examination: the patient in agonizing pain,
limping with exaggerated scoliotic stance. SLRS
was 30
degrees with pain left side. There is
weak dorsi and planterflexion left foot with
hypalgesia left L5 and S1 territories.
Left sided hemiflavotomy L4-5 with
extended foraminotomy left L5 root. The extruded disc
of L4-5 was
attacked from the left axilla and left sided cleaning until the root s became
lax. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak. The
epidural fat was pushed over the nude dura to
minimize scar formation. Routine closure of
the wound
Smooth postoperative recovery.
The radicular pain disappeared and the power of left
foot normalized. He was sent to the ward.
Follow Up
The patient came to the clinic 29-April-2003
with clean wound with no sensory or motor
deficit. SLRS was 70 degrees without pain left
side.
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 .
