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Dr. Fuad Al-Masri Syrian neurosurgeon.

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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07-OCTOBER-2013  HASNEH AHMAD AL-HARAHSHEH  57 YEARS  SPONDYLOLISTHESIS L4-5 WITH SECONDARY STENOSIS.

 

Anamnesis

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The patient came to the clinic 26-September-2013 complaining of LBP for 2 months with right sciatica.

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MRI lumbar spine done 19-August-2013 showing spondylolisthesis L4-5 with severe segmental stenosis.

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On examination: the patient is limping with scoliotic stance. SLRS was 40 degrees with pain in the right and 60 degrees with pain in the left. She has weak dorsiflexion right foot 3/5 and planterflexion right foot 4/5. She has hypalgesia right L5 and S1 territories.

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Skeletonization of L3,L4, L5 with laminectomy L4, L5 with foraminotomy both L5 roots. The L4-5 disc was attacked from the left side. Discectomy L4-5 was done. Insertion TLIF Alphatec Spine 10x17x15 mm with BoneSave to L4-5 disc space. The space near the device was filled with bone graft. Using 4 screws 6.2x45 mm monoaxial, transpedicular fixation of L4, L5 was achieved with 2 rods 60x5.5 mm, bended to accept the normal curve of the spine. Cross connector was added with minimal compression. BoneSave was added lateral to the rods. All stages of surgery were guided by C-arm. Routine closure of the wound.

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Smooth postoperative recovery. The power of both feet became normal.

 

 

Comments

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The patient has minimal spondylolisthesis, but with gross clinical manifestations. Micromotion could irritate the neural structures.

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Surgical correction is the only solution.

Leica HM500

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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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