Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
15-FEBRUARY-2017 ADEL MAHMOUD QASEM 56 YEARS
EXTRUDED DISC L4-5 WITH LEFT FORAMINAL OCCLUSION.
The patient came to the clinic
complaining of LBP for 2 years with exacerbation
last month with left sciatica down to the right
ankle last week. The patient is a known diabetic
with arterial hypertension and underwent right
nephrectomy 2 years ago.
On examination, the patient is limping with exaggerated scoliotic stance. SLRS
was 75 degrees both sides with pain in the left. There is weak
dorsi and planterflexion left foot 4/5.
he patient was sent for investigations and MRI
lumbar spine performed showing extruded disc
L4-5 with left foraminal occlusion. The patient
was sent for cardiac evaluation.
Foraminotomy left L5 root. The extruded disk was removed
lateral to the axilla of the left L5 root. The
extruded upward migration was also removed.
Left sided cleaning of L4-5 was performed.
MultiGen, bipolar motor stimulation of the left L5
was achieved with 2.2 V. A
bipolar pulsed mode
RF with 42 Celsius, 240 sec, 2 Hz and 20 msec
duration to left L5 root was achieved using
2 bended catheters 10 mm exposed length. Further
bipolar motor stimulation of the left L5
was achieved with 1.9 V. Interestingly the motor
response was bilateral. Routine closure of the
Smooth postoperative recovery. The power of
left foot normalized and he was sciatica free.
He was sent to the ward.
The patient still having an estimated
postoperative recurrence around 7%, because the disc
space is still not shallow.
This is the 108th case using the BPRF mode
with MultiGen. This procedure regained routine acceptance.
It became a usual part of the spine and peripheral nerves
surgery. Click here for
It still unclear to evaluate the
differences of pre and post application motor responses. The
only sure thing that it tells that the electrodes did not
migrate during the procedure and the nerve is functioning
properly. Here there was some improvement of the threshold of stimulation
power of motor stimulation of the left L5.
With accumulation of data, it became
clear that the irritated nerve with aberrant currents
running in the C fibers up, not only causing no change or elevation of
the required voltage to achieve motor response, but they could cause the preoperative
weakness. Ablation of such currents results in facilitation
of the motor response and improvement of function with
disappearance of pain.
It is unclear why the roots have several
motor response with different patients, despite the fact
that the neurological status is the same and the anaesthesia
protocol also the same.
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
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
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 .