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Multigen RF lesion generator .

05-NOVEMBER-2007 TARIQ IBRAHEEM AL-TARAWNEH 33 YEARS EXTRUDED DISC L4-5 RIGHT SIDE.

 

Anamnesis

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The patient was operated by me 04-Noveber-2004 for PLD L5-S1. The patient improved, then reappeared 05-March-2007 complaining of LBP with MRI performed 04-March-2007 showing dehydration of L4-5 and L5-S1 without signs of recurrence. He was neurologically free at that time. MRI lumbar spine done 22-October-2007 showing extruded disc L4-5 with right extrusion. The patient came to the clinic 31-October-2007 with the performed MRI.

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On examination: the patient has scoliotic stance with weak dorsiflexion right foot. SLRS was 40 degrees right side.

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Right L4-5 hemiflavotomy with right L5 root foraminotomy was performed. The extruded disc was attacked lateral to the axilla. It was removed in several pieces and meticulous cleaning of the disc space of L4-5 was done from the right side. No attempt was paid to widen the defect in the annulus fibrosis.

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

Follow Up

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The patient came to the clinic 19-November-2007 with clean wound, normal power and sensation.

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The patient then appeared 10-February-2008 with LBP for 3 weeks with cramps both lower limbs. He was treated conservatively and disappeared.

 

 

Comments  

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The patient underwent surgery for PLD L5-S1 3 years ago. No recurrence was noted up today, but he got PLD L4-5 which was small 8 months ago in the MRI findings.

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It could be that the patient had the same problem 8 months ago and the static MRI was not showing the extrusion, since the patient was investigated in supine position. It could be that there was an extrusion and if the patient performed the MRI in the sitting position, the extrusion could be caught.

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These speculations hold the importance of performing dynamic MRI.

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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