Dr. Ali Al-Bayyati and Dr. Munir Elias

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Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


 

Multigen RF lesion generator .

16-FEBRUARY-2002  ZAHRA AL-IZZA  70 YEARS  SEVERE LCS L3-4 AND L4-5.

 

Anamnesis

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The patient came to the clinic 10-February-2002 complaining of LBP with bilateral sciatica for more than 3 years with inability to walk more than 50 meters. The condition is progressing.

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MRI of the lumbar spine showing severe stenosis both L3-4 and L4-5.

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On examination: The patient is limping with exaggerated scoliotic stance, walking bended anterior with SLRS was 60 degrees with pain both sides and weak dorsi and planterflexion both feet.

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Decompressive laminectomy L3.4, upper border of the L5 and lower half of L2 with foraminotomy both L4 and L5 both sides. Due to severe compression at L4-5, the ligamentum flavum was penetrating the dura, for what after its removal the dural tear was stitched by 6 zero nylon. The lower edge of the field had also tear which was stitched accordingly. Inspection for overmobility was negative and the annulus fibrosis both disci were in good shape. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound.

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Smooth postoperative recovery. The power of both feet improved. She was sent to the ward.

Follow Up

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The patient the came to the clinic 28-February-2002  with clean wound with improvement of the power of both feet and normal walking.

 

Comments

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The surgical intervention for progressive stenosis, the sooner the better the outcome.

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Due to long standing severe stenosis with severe compression, expect presence of dural tears, which must be dealt accordingly.

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In retrospective analysis after long years, in these cases we put the patient in Trendelburg position to decrease the intradural pressure.

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Use of Thompson frame decrease the intra-abdominal pressure and venous bleeding.

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Use of Tranexamic acid 1000 mg I/V increase the clotting process, which make the field almost dry.

 

 

 

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.

 

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision and very bad MRSD4 quality.


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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