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24-AUGUST-2002 MUSA HAMZEH AL-ORANI 56
YEARS HUGE RECURRENCE OF L3-4 AND DE NOVO EXTRUSION L2-3 LEFT SIDE .
Anamnesis
The patient came to the clinic
13-August-2002 complaining of LBP the last 5
months with left sciatica down to the left
L5 territory. He was operated by me
14-January-2001 for PLD L3-4 with right
sciatica. MRI lumbar done 11-August-2002 showing
huge recurrence of L3-4 and de novo extrusion
L2-3 left side.
On examination: The patient using crutches for
walking with exaggerated scoliotic stance, SLRS
was 80 degrees with pain left side. There is
weak dorsi and planterflexion both feet 4/5 with
hypalgesia right L5 and both S1 territories.
Decompressive laminectomy L3, upper half of L4
and lower half of L2 with foraminotomy both L3
and L4 roots both sides. Bilateral cleaning L3-4
and stitching a dural defect above the right
axilla using nylon stitches aided with Biopad
tampon. The extruded disc of L2-3 was cleaned
from the left side. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak.
Routine closure of the wound. Routine
closure of the wound.
Smooth postoperative recovery.
The power of both feet normalized.
He was sent to the ward.
Follow Up
The patient came to the clinic 04-September-2002
with clean wound and full power of the feet, but
still having hypalgesia right L5 territory.
the patient then came 14-December-2002 with
still with hypalgesia of the right L5 root. He
was treated conservatively.
Comments
There is still an estimated postoperative
recurrence for the de novo disc and the re-recurrence for
the recurrent disc around 7% each.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Inomed Riechert-Mundinger System, with three point
fixation is the most accurate system in the market. The microdrive and
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Inomed MER system
Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
LooksCam II Xenosys in the run starting from 14-March-2021 with
SheerVision TTL x4 magnification.
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 .
