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Multigen RF lesion generator .

30-JANUARY-2003  SUHAILA MUHAMED YOUSEF 56 YEARS LCS L4-5, L5-S1 WITH EXTRUDED DISC L4-5 MORE TO THE RIGHT.

 
 

Anamnesis

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The patient came to the clinic 20-January-2003 complaining of LBP for 2 years with right sciatica with numbness left L5 territory. The patient is hypertensive for 1 year. MRI lumbar spine done 03-November-2002 showing extruded disc L4-5 more to the right.

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On examination: the patient in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 90 degrees both sides. There is almost drop right foot and planterflexion right foot 2/5. Analgesia right L5 and hypalgesia S1 territories.

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The patient was sent for investigation and MRI done the same day showing lumbar canal stenosis L4-5, L5-S1 with extruded disc L4-5 more to the right.

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Decompressive laminectomy L5, lower third of L4 and upper edge of the sacrum. Foraminotomy both L5 and S1 roots. The extruded disc was attacked first from the right, then bilateral cleaning L4-5 was achieved. 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 radicular pain decreased and the power of right foot improved. She was sent to the ward.

Follow Up

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The patient came to the clinic 10-February-2003 with slight scoliosis and same sensory deficit, but slight weak dorsiflexion right foot 4/5.

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The patient came several times with the hypalgesia progressing even to the left left L5 root. MRI performed 10-October-2003 showing bulge L5-S1.

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The patient then came 02-January-2006 telling that she felt down in October-2003 and she was operated elsewhere for right CTS 5 months ago without improvement. MRI cervical spine performed 06-November-2005 showing cervical canal stenosis C3-4, 4-5 and C6-7 with malacia of the spinal cord and OPLL. MRI lumbar spine performed 31-May-2005 showing mild spondylolisthesis L4-5. She is diabetic in treatment for 18 months. She can walk 100 meters. There is neck pain when rotating the head up and to the right. There is weak grip. extension right hand and right triceps muscle 4/5 with hypalgesia right ulnar distribution and the right leg below the knee and the left leg below the ankle. After that she disappeared.

 

Comments  

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The recurrence rate in this case still ranking around 7% because the disc space is not completely collapsed.

 

 

 

 

 

 

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 its sensor gives feed back about the localization.


Inomed MER system

Leica HM500

Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

LooksCam II in the run.
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 .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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