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Multigen RF lesion generator .

16-APRIL-2007 SHAREEFEH HAMDY KALBUNEH 57 YEARS EXTRUDED DISC L5-S1 RIGHT DOWNWARD MIGRATION.

 

Anamnesis

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The patient came to the clinic 01-March-2007 complaining of LBP for 15 years. Exacerbation of right sciatica the last 2 months.

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MRI lumbar spine done 12-February-2007 showing small extrusion L5-S1 right side. MRI done 11-December-2005 showed at that time a huge extrusion L5-S1.

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The patient was given the opportunity to try conservative treatment, and she came 17-March-2007 confirming that here condition is improving.

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On examination: The patient had scoliotic stance. She had SLRS 70 degrees in the right with shooting sciatica right side. She had severe weak dorsi and planterflexion right foot and hypalgesia right S1 root territory.

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The patient then came asking for urgent surgery, because her condition is deteriorating.

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Right S1 foraminotomy was done with partial right sided flavotomy and the swollen root was inspected and the extruded disc L5-S1 was removed lateral to the axilla. All the fresh and old fragments of the extrusion were removed. Meticulous cleaning of the disc space was performed. It was clear, that the extrusion was old and part of it was adherent to the root, for what it was dissected of the root. The congestion decreased and the foramen was checked for patency. There was no sufficient epidural fat to transfer, then the most near fat was transferred to cover the roots to minimize postoperative scar formation.

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Smooth postoperative recovery and normalization of the power of right foot.

Comments  

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The patient in the first visit was in clinical status, that surgery could be avoided, for what surgical treatment was not decided at that time.

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The deteriorating clinical picture made it clear that surgery is indicated.

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The patient had a protracted course with long history, that the root was adherent to the extrusion.

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Preservation of the epidural fat and using it to cover the most mobile neural parts is the best solution to prevent scar formation and ease pain in the long run, but when it is not available, then transferring the most near fat is the next alternative.

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

Leica HM500
The World's first and the only Head mounted 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

LooksCam II in the run.
LooksCam II in the run  starting from  14-March-2020

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 .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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