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.tv

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Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

16-DECEMBER-2014  IBRAHEEM MUHAMED ALI AL-MAHASNEH  75 YEARS  LUMBAR CANAL STENOSIS L2-3, L3-4 WITH GANGLION LEFT FACET L5-S1..

 

Anamnesis

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The patient came to the clinic 08-December-2014 complaining of left sciatica for 2 years  and right hip pain for 10 days. MRI lumbar spine done 30-November-2014 bad quality showing stenosis of L3-4. The patient was operated by me 1994 for PLD L4-5 and 1996 for recurrence of the same disc.

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On examination, the patient using crutches  for 2 years and cannot now walk more than 50 meters. He is limping with exaggerated scoliotic stance. SLRS was 70 degrees both sides with pain in the left. There is hypalgesia below the left L1 root .Complete drop left foot with weak dorsiflexion right foot 4/5.

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The patient was sent for MRI of the dorsal and lumbar spine. MRI lumbar done the same day showing lumbar canal stenosis L2-3. 3-4 with ganglion of the left L5-S1 facet compressing the left S1 root. Dorsal spine was normal. Dynamic studies showed bamboo spine with fusion all the lumbar vertebral bodies.

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Through inferior incision left S1 foraminotomy was done and all the compressive elements were eliminated. The disc of L5-S1 is hard. Laminectomy L3 and lower half of L2 and the remnant of L4 were removed through another incision. The dura due to severe compression at L3-4 was missing in several areas. Some of the areas were stitched using 6 zero nylon and some were stitched with muscle and aided with surgicele. Water-tight closure of the wounds.

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Smooth postoperative recovery. The power of the right foot became normal, but the drop left foot still the same.

 

 

Comments  

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The severity of stenosis was that the dura was eaten in several places. Several types of repair were applied to avoid postoperative CSF leak.

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


Inomed MER system


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 .

WELCOME TO AL-SHMAISANI HOSPITAL

 


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