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11-JULY-2002 SALEH ABDEL-AZIZ AL-HAJMI 72 YEARS
EXTRUDED DISC L4-5 WITH STENOSIS L4-5 AND L5-S1.
Anamnesis
The patient a Yemeni citizen came to the clinic
08-July-2002
complaining of inability to walk for 2 months
with LBP and bilateral
sciatica, more the right. The condition is
progressing. TUR performed 1996.
On examination: The patient in pain. SLRS
30 degrees both sides with pain. There is weak planterflexion both feeet-4/5
and drop both with hypalgesia both L5 and S1
roots territories.
The patient was sent for investigation: MRI
lumbar spine performed 09-July-2002 showing
severe lumbar canal stenosis L4-5 and L5-S1.
Normal dorsal spine MRI.
Decompressive laminectomy L4, L5, upper edge of
S1. Foraminotomy both L5 and S1 roots both
sides. Inspection both disci revealed that the
L4-5 is causing compression at the right L5
root, for what discectomy L4-5 was performed and
bilateral cleaning starting from the right side
of L4-5 was achieved. The patient was put in
Reverse Trendelenburg position with Valsalva
maneuver and hyperventilation. No CSF leak.
Routine closure of the wound.
Smooth postoperative recovery.
The power of both feet improved.
He was sent to the ward.
Follow Up
The patient came to the clinic 20-July-2002
with clean wound and the power of the feet
improved. SLRS was 80 degrees in the right
without pain and 70 degrees in the left without
pain. Sensation normalized.
Comments
The sooner the surgical decompression,
the better the outcome.
Even with bilateral cleaning of the disc
space the recurrence rate still be around 7%.
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 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 .
