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06-APRIL-2003 SALEM ABDEL-MUHDI
AL-TARAWNEH 50 YEARS RECURRENT EXTRUSION L4-5 WITH SEVERE COMPRESSION.
Comments
The recurrence rate in this case still
ranking around 7% because the disc space is not completely
collapsed.
Anamnesis
The patient came to the
clinic 13-March-2003
complaining of LBP with left sciatica for 3 months with numbness of the
entire left foot. The patient was operated
twice, 02-August-2001 and 28-November-2001 and MRI lumbar spine performed
09-March-2003 showing huge recurrent extruded disc L4-5
with left foraminal occlusion.
On examination: the patient in pain,
limping with exaggerated scoliotic stance. SLRS
was 90 degrees with pain left side. There is
weak dorsi and planterflexion left foot, hypalgesia
left L5 and S1
territories.
Left L4-5 scarolysis with
foraminotomy left L5 root. During dissection a dural
tear took place antero-medial to the axilla, which
was stitched using nylon 4 zero. The extruded disc
of L4-5 was
attacked from the left and left sided intradiscal
cleaning done. 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 radicular pain decreased and the power of the
left foot improved. He was sent to the ward.
Follow Up
The patient came to the clinic 24-April-2003
with clean wound, slight improvement of power and sensation
left foot. SLRS was 70 degrees with less pain
left side. There is numbness both feet with less
scoliotic stance.
The patient then came 28-August-2003 complaining
of LBP and left
sciatica. SLRS was 90 degrees both sides and no
motor deficit. There is hypalgesia left S1 root. He was treated
conservatively.
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 .
