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
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IOM Sites
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Neurosurgical Sites
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Neurosurgical Encyclopedia
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Neurooncological Sites
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Neuroanatomical Sites
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Neuroanesthesia Sites
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Neuroendocrinologiacl Site
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Neurohistopathological
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Neuro ICU Site
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Neurophysiological Sites
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Neuroradiological Sites
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NeuroSience Sites
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Neurovascular Sites
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vascularneurosurgery.net

Personal Sites
cns.clinic
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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-JUNE-2014  BAHIYE ZAYDAN DAYEH  62 YEARS SPONDYLOLISTHESIS L5-S1 WITH STENOSIS L4-5 AND STRUCTURAL SCOLIOSIS LUMBAR SPINE.

 

Anamnesis

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The patient came to the clinic 11-May-2014 complaining of LBP with bilateral sciatica for 5 years  for what she was operated in Huston USA in September-2013. The patient claim that she got drop right foot after surgery and she did improve for numbness, but the LBP and bilateral sciatica persisted and increased and the difficulty to walk became more evident.

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On examination; The patient is limping with exaggerated scoliotic stance. SLRS was 90 degrees in both sides without pain. There is drop right foot with planterflexion same foot 4/5, weak dorsiflexion left foot 3/5. Hypalgesia L5 root right side.

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MRI lumbar spine done the same day with contrast, showing spondylolisthesis L5-S1 grade II with foraminal stenosis right L4-5. CT-scan and dynamic studies showed bone graft at the lateral areas of L5-S1 with presence of instability.

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Neurolysis of the right L5, S1 roots was performed after exposing all the lateral masses of L3-4, L4-5, L5-S1 and upper sacrum. During neurolysis of the right L5 root a 1 mm tear of the scar was noticed and repaired by 4 zero nylon. The nerves were studied using Inomed ISIS system and the right L5 root was responding occasionally to 4 mA current DNS. The right S1 root was responding well to 2mA DNS, which means severe damage to the right L5 root. The bone graft used at first surgery was mobile and with pseudojoints. Using Stryker Xia 2 system, 4 monoaxial 6.5x45 mm length were inserted to L4 and L4. 4 ployaxial 6.5x40 mm were inserted to L5 and S1 segments. Bended rods were applied and slight distraction in the left aside between L5-S1 was applied. Distraction of all segments in the right side to eliminate the scoliotic curve. Cross connector was applied. Routine closure of the wound. All stages of surgery were done using C-arm control.

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Smooth postoperative recovery. The power of left foot became better.

 

Comments  

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The patient has several problems, most of them could be corrected surgically. The exposed severely damaged right L5 root is not among them. All other problem were taken to consideration and corrected surgically.

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


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 .

  

 

 

 

 

 

 

 

 

 

 

 

 

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