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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
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Multigen RF lesion generator .
20-MAY-2014 WAFA IZZIDEEN MUHAMED AL-ALI 57 YEARS
SEVERE LUMBAR CANAL STENOSIS L4-5, L3-4 WITH RIGHT L4-5 EXTRAFORAMINAL
EXTRUSION.
Anamnesis
The patient came to the clinic 11-May-2014
complaining of LBP with left sciatica for 5
years with headache, neck and left upper limb
pain for 8 years. The patient is hypertensive
for 5 years.
On examination; the patient is limping with
exaggerated scoliotic stance. SLRS was 40 degrees
with pain in the left. Weak
dorsiflexion right foot 3/5 with hypalgesia
right L5 and S1 roots territories.
The patient was sent for new investigations: MRI
done 14-May-2014 showing the right far-lateral
extrusion L4-5 with stenosis at L3-4 and L4-5
level. Dynamic studies not confirmative.
Laminectomy L4. upper third of L5 and lower 2/3
of L3 was done with foraminotomy right L4 and L5
roots. The right far-lateral extrusion of L4-5
was removed in several pieces and the exposure
of the annulus fibrosis was extended so that the
right L4 root was running free at this level.
Check for instability was negative for all
levels. Meticulous intradiscal cleaning of L4-5
disc was performed from the right. 2 ml Hydr,Os
bone graft was inserted to the disc space.
Routine closure of the wound.
Smooth postoperative recovery. The
power of the right foot became normal.
Comments
The estimated postoperative recurrence is
still around 7%, but here 2 ml of bone graft was inserted to
the disc space to prevent future collapse of the area and
promote fusion of L4 and L5. Time will tell how effective
this procedure is.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Leica HM500
The World's first and the only Headmounted 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
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 .
