Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
18-JANUARY-2016 NASER MUHAMED AL-FADEL 41 YEARS
LBP WITH DEHYDRATED L1-2, L4-5, L5-S1 WITH MILD RETROLISTHESIS L4-5.
Anamnesis
The patient came to the clinic 19-December-2015
complaining of both legs pain below the knee for
12 years with LBP for 2 years with
exacerbations last 2 months more during sleeping. MRI lumbar spine done
15-December-2015
showing dehydration of L1-2, L4-5, L5-S1.
On examination: the patient is not limping nor scoliotic
stance. SLRS was 90 degrees both sides. There is weak dorsiflexion
both feet 4/5. There was also weak extension
right hand and right triceps 4/5 with tightness
when turning the head to the left.
The patient was sent for new investigations and
MRI cervical spine performed 19-December-2015
showing bulge disc C3-4 and C5-6 with normal
dorsal spine. Dynamic studies showed mild degree
of retrolisthesis L4-5.
The patient then came 16-January-2016 telling
that conservative measures failed to relief his
pain and he still suffering of bursts of LBP
with bilateral sciatica. Neurologically at this
time was free and he asked for Tramal. It was
explained to him that RF could alleviate his LBP
and he agreed to undergo RF to ameliorate the
facet producing pain.
With the patient in prone
position with transparent Wilson frame and C-arm
the eyes of Scottie dog of L3,4, 5 and the canal
of left S1 root were reached. The stimulation of
each one with the same protocol of Gauci et. al
was that with 0.5 V telling that there is sore
sensation. The motor response was that no motor
response from the lower limbs except for
multifidus contractions. 1 ml Xylocain injected
to each and ablation with 80 degrees and 90
second done for each. Another 1 ml Xylocain with
Depomedrol injected to the sites.
The patient was discharged
after 1 hour.
MultiGen
Comments
The patient has no major morphologic
problem, but has annoying LBP depriving him to live
normally.
It is still unclear what exactly the
patient must feel with sensory stimulation. Is it the moment
of pain, or the log soaring sensation?
This is the 6th case using the TRF mode
with MultiGen. This procedure was performed according to
directions of Charles A. Gauci.
Reference:
1. P.P.M. Menchetti (ed.), Minimally Invasive
Surgery of the Lumbar Spine, Springer-Verlag London 2014 (49-58).
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
its sensor gives feed back about the localization.
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
documentation.
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 .
