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.tv
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10-AUGUST-2015 HASAN MUSA HUSSEIN 52 YEARS
EXTRUDED DISC L3-4 WITH RIGHT DOWNWARD MIGRATION AND SEVERE SEGMENTAL STENOSIS.
Anamnesis
The patient came to the clinic 03-August-2015
complaining of LBP with right sciatica for 5
days with numbness of all toes right foot. The
patient was operated elsewhere 1999 for PLD L4-5
and was operated by me
16-May-2002 for the
recurrence with left sciatica.
On examination: He was limping, using crutches with exaggerated scoliotic stance.
SLRS was 20 degrees with pain right
side. There is drop right foot with weak planterflexion right foot
2/5 with hypalgesia right L5 and S1 roots
territories..
The patient was sent for investigations and MRI lumbar spine performed
03-August-2015
showed extruded disc L3-4 with right
downward migration and severe segmental stenosis. Dynamic studies
were negative for over mobility. He had gout for
what pain killers and Zyloric were prescribed.
Using the C-arm the L3-4 level was identified.
Foraminotomy of right L4 root was performed. The
downward migrating extrusion was removed. Discectomy L3-4 from
the right. The root became lax and free. Routine closure of the
wound.
Smooth postoperative recovery. The drop right
foot still the same, but the planterflexion of the
right foot became better.
Follow Up
The patient came to the clinic 22-August-2015
with clean wound with no sciatica, but drop
right foot, planterflexion same foot 5/5 and
analgesia right L5 territory.
Comments
The patient still has an estimated
postoperative recurrence around 7% because the disc space
still not completely shallow.
The drop foot needs long time to recover
and in some cases no recovery could be noticed. Time will tell.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Inomed Riechert-Mundinger System, with three point
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Inomed MER system
Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
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After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
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 .
