Munir Elias 20-12-2013

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.fr

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
cns-online.com
cns.surgery
cns.today
e-neurosurgery.com
neurosurgery.ag
neurosurgery.bz
neurosurgery.co
neurosurgery.cz
neurosurgery.fr
neurosurgery.gallery
neurosurgeryvideo.gallery
neurosurgicalvideo.gallery
neurosurgery.guru
neurosurgery.me
neurosurgery.mx
neurosurgery.photos
neurosurgery.tips
neurosurgery.tv
neurosurgery.tw
neurosurgeryspine.org

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.com
neurosurgicalencyclopedia.net
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
craniopharyngiomas.net
ependymomas.com
ependymomas.net
glioma.co
gliomas.info
glioma.ws
meningiomas.info
meningiomas.org
neurooncology.me
neurooncology.tv
neurooncology.ws
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com
pituitaryadenoma.net
schwannomas.com
theneuro-oncology.com

Neuroanatomical Sites
diencephalon.info
diencephalon.org
humanneuroanatomy.com
medullaoblongata.info
mesencephalon.org
microneuroanatomy.com

Neuroanesthesia Sites
neuroanesthesia.info

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com
neurophysiology.ws

Neuroradiological Sites
neuroradiology.ws

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com
vascularneurosurgery.net

Personal Sites
cns.clinic
cns-clinic.net
cnsclinic.org
munirelias.com

Spine Surgery Sites
spine.surgery
spinesurgeries.org
spinesurgery.ws
spondylolisthesis.info
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


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


Multigen RF lesion generator .

05-NOVEMBER-2014  AMNEH AREF MUSTAFA  50 YEARS  EXTRUDED DISC L1-2  LEFT SIDE WITH WIDE-BASED EXTRUSION L4-5 WITH SEVERE STENOSIS BOTH LEVELS.

 

Anamnesis

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The patient came to the clinic 04-November-2014 complaining of LBP with bilateral sciatica for 2 years with exacerbation last 5 months with drop left foot for this period. CT-scan of the spine done twice not informative.

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On examination, the patient is limping with exaggerated scoliotic stance. There is pain when turning the head to the right, up and downward. There is weak grip left hand 3/5, extension both hands 3/5 and both triceps muscles 3/5. SLRS was 60 degrees with pain in the right and 50 degrees with pain in the left. The left foot is completely drop with weak planterflexion left foot -3/5. Weak dorsiflexion right foot 2/5 and planterflexion same foot 4/5. There is analgesia left L5 root with hypalgesia left S1 root. Weak both quadriceps 3/5. Loss of hearing left ear for 6 years.

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The patient was sent for investigations and done the same day. MRI of the brain was normal. MRI of the cervical spine showed PCD C5-6 wide-based, not compressing the spinal cord. MRI lumbar spine showing huge extruded disc L1-2 more to the left causing severe stenosis. Severe stenosis of L4-5 with wide extrusion. Dynamic studies were normal.

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Using the C-arm, the L1-2 level was identified. Left L1-2 hemiflavotomy was performed with drilling to achieve exposure of the area without applying traction of the spinal cord. The extruded disc was identified and removed. Intradiscal cleaning L1-2. Through another separate incision, decompressive laminectomy L4 and upper 1/3 of L5 was achieved. Foraminotomy both L5 roots was performed. Inspection of the annulus fibrosis revealed that it is better not to violate the intradiscal structures. Further foraminotomy of the left L5 root to ensure that no additional compression was present in its canal.  Routine closure of the wound.

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Smooth postoperative recovery. The power of the right foot became normal and the planterflexion of the left foot became normal. The drop left foot remained the same.

 

 

Comments  

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The patient still has an estimated postoperative recurrence around 15%, because the disc spaces are still not completely shallow.

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It is rarely to see recovery of complete drop for when it has place for long time. Time will show if this case could be an exclusion.

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, 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


Inomed MER system



Back Up!

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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