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21-APRIL-2003 ALI MUHAMED AL-WAKHYAN 46
YEARS EXTRUDED DISC L3-4 AND L4-5, BOTH LEFT SIDE.
Comments
The recurrence rate in this case still
ranking around 14% because the disci spaces are not completely
collapsed.
Anamnesis
The patient came to the
hospital 29-March-2003
complaining of LBP with left sciatica for 1 year
with exacerbation last 20 days
with agonizing pain and positive cough sign.
On examination: the patient in agonizing pain,
limping with exaggerated scoliotic stance. SLRS
was 75
degrees with pain left side. There is
almost drop left foot with weak planterflexion left foot with
hypalgesia left L5 and S1 territories.
The patient was sent for investigations and MRI
lumbar spine performed 01-April-2003 showing
huge extruded disc L3-4 left side and stenosis
L4-5 with extrusion left side.
Decompressive laminectomy L4 with
lower half of L3 and upper half of L5 with
extended foraminotomy both L4 and 5 roots both sides. The extruded disc
of L3-4 and L4-5 were
attacked from the left axilla and bilateral cleaning
of L3-4 and left sided cleaning of L4-5 was achieved until the roots became
lax. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak. Routine closure of
the wound
Smooth postoperative recovery.
The radicular pain disappeared and the power of left
foot improved. He was sent to the ward.
Follow Up
The patient came to the clinic 03-May-2003
with clean wound with no sensory or motor
deficit. SLRS was 80 degrees with minimal pain left
side.
The patient then came 02-June-2003 with further
improvement, but complaining of numbness II-IV
toes left foot.
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
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 .
