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
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Neurosurgical Sites
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Neurosurgical Encyclopedia
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Neurooncological Sites
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Neuroanatomical Sites
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diencephalon.org
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Neuroanesthesia Sites
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Neuroendocrinologiacl Site
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Neurobiological Sites
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Neurohistopathological
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Neuro ICU Site
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neuroophthalmology.org

Neurophysiological Sites
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Neuroradiological Sites
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NeuroSience Sites
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Neurovascular Sites
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Personal Sites
cns.clinic
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cnsclinic.org
munirelias.com

Spine Surgery Sites
spine.surgery
spinesurgeries.org
spinesurgery.ws
spondylolisthesis.info
paraplegia.ws

Stem Cell Therapy Site
neurostemcell.com


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


Multigen RF lesion generator .

27-DECEMBER-2014  MUNTASER  YOUSEF AL-RAJABI  49 YEARS  MULTI-ORGAN INJURY WITH FRACTURE DISLOCATION D5-6 WITH COMPLETE PARAPLEGIA.

 

Anamnesis

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The patient was admitted to Emergency of Shmaisani hospital 24-December-2014 after suffering severe trauma by sticking between 2 heavy objects, that caused fracture of the right 5-7 ribs and dislocation of D5-6 with paraplegia  and internal bleeding. He came with under-water seal tube from another hospital. He mentioned that he did not suffer loss of consciousness, but got immediate paraplegia. Radiologic investigations were performed, demonstrating shuttered liver and rupture spleen with dislocation of C5-6 with fracture right 5-7th ribs. The patient was bleeding actively and emergency laparatomy was done with repair of the lever and resection of 2/3 of the spleen. There was retroperitoneal hematoma over and behind the spleen. MRI of the dorsal spine showing contusion of the spinal cord with minimal compression due to 7-9 mm dislocation of the D5-6.

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After correcting the homeostasis and the patient was seen by cardiologist, it was decided to perform fixation through right thoracotomy approach.

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The right 5th rib exposed and resected from the fracture site anterior about 15 cm. Thoracotomy achieved with deflation of the right lung. Double-lumen intubation was applied. The D5 and D6 were exposed and the slipped disc material was noted with the chip fracture in the right upper corner of D6 was removed. Using Medtronic CDH ANTARES system was used with caudal and rostral spikes 23 mm. CDH FAS 6.5x35 mm screws were used with 2 rods 5.5 mm diameter with the long one 60 mm and the short one 45 mm to reduce and fix the D5-6 levels. Strict hemostasis and routine closure of the wound and the underwater seal was left in place.

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Smooth postoperative recovery. The neurologic status still the same. The patient was sent to the ICU.

 

 

Comments  

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During the impact of trauma the spinal cord suffered major injury with dislocation around 3-4 cm, but it returned immediately to the seen at the preoperative MRI and CT-scans. It is hard to tell early the prognosis in such case and the aim of surgery to make the patient set as early as possible.

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


ORS Visual reconstruction showing the site of the fractures and dislocation.


ORS Visual showing the fracture pieces of upper corner of D6under the disc space of D5-6. The transverse distance of the bodies are around 33 mm.


The construct in place.


ORS Visual showing the location of the screws the next day after surgery.

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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