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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator
05-MARCH-2014 GERALDINE MARGARET ABED 58 YEARS
EXTRUDED DISC L5-S1 WITH RIGHT DOWNWARD MIGRATION.
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
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
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.
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.
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.
recovery. The power of the left foot became
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.
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
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 .