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
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
cns-online.com
cns.surgery
cns.today
e-neurosurgery.com
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neurosurgery.gallery
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neurosurgery.guru
neurosurgery.me
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neurosurgeryspine.org

Neurosurgical Encyclopedia
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Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
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ependymomas.com
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glioma.co
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neurooncology.me
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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
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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
e-neuroradiology.com
neuroradiology.ws

Neurovascular Sites
vascularneurosurgery.com
vascularneurosurgery.net

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

Spine Surgery Sites
spinesurgeries.org
spinesurgery.ws
spondylolisthesis.info
paraplegia.co
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
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Multigen RF lesion generator .

05-MARCH-2014  GERALDINE MARGARET ABED  58 YEARS  EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.

 

Anamnesis

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The patient came to the clinic 12-March-2008 complaining of LBP for 26 years with bilateral sciatica. The left sciatica progressed the last 6 months with neck and both shoulders pain with numbness left hand. On examination at that time, there was neck pain when looking to left and up with weak grip and extension left hand 4/5. There was hypalgesia median distribution right hand. SLRS was 70 degrees with pain in the left with weak dorsiflexion left foot 4/5. MRI of the brain done 19-March-2008 showed scattered small lacunar infarctions both cerebral hemispheres. PCD C4-5, C5-6 with mild spinal cord compression. Bulge D12-L1, L1-2, L4-5 and L5-S1. The patient was advised to be treated conservatively.

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The patient then came 10-February-2014 complaining of LBP with agonizing left sciatica for 2 weeks. MRI lumbar spine done 09-February-2914 bad quality, but showing extruded disc L5-S1 with left foraminal occlusion.

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On examination; the patient is in agonizing pain, limping, with exaggerated scoliotic stance. There is left sided hemihypalgesia. The neck movements and power both upper limbs were normal. SLRS was 10 degrees with pain in the left. There is weak dorsi and planterflexion left foot 3/5.

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MRI of the lumbar spine repeated the same day showing extruded disc L5-S1 with left downward migration. It was agreed with the patient to try conservative treatment and in case of not improving to consider surgery. The patient then came 03-March-2014 urging for surgery.

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Using C-arm, the L5-S1 level identified. Far foraminotomy left S1 root. The extruded disc was severely compressing the root. The extruded disc was removed lateral to the axilla. The root was in bad shape due to old compression. Inspection of the root and subaxillar area. Routine closure of the wound.

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Smooth postoperative recovery. The power of the left foot became normal.

 

 

Comments  

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The patient  still have an estimated postoperative recurrence rate below 7%, because the disc space still not completely shallow.

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.


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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