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Multigen RF lesion generator .

01-APRIL-2007 UTHMAN TAHER AL-WAZEER 35 YEARS EXTRUDED DISC L5-S1 WITH LEFT DOWNWARD MIGRATION.

 

Anamnesis

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The patient came from YAR to the clinic 31-March-2007 complaining of agonizing left sciatica for 2 months with escalation the last week and numbness of the left L5 and S1 roots territory. The patient was operated 25 years ago for PLD L4-5 in UK.

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MRI of the lumbar spine performed 24-March-2007 showing extruded disc L5-S1 with no recurrence at L4-5 level. The MRI was of bad quality.

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On examination: the patient walking with aid and crutches. The patient is limping and has scoliotic stance. SLRS was 35 degrees in the right and 5 degrees in the left. The left AJ is absent in the left with analgesia for pin-brick at the left S1 root territory and hypalgesia of the L5 territory. There is weak dorsiflexion left foot 4/5.

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The patient was sent for new MRI of the lumbar spine, which was performed and more clearly demonstrated the extrusion and the left side downward migration of the piece.

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Left L5-S1 hemiflavotomy with left S1 foraminotomy was performed. The root was severely compressed from anterior and it was necessary to perform discectomy of L5-S1 to regain some ample and to withdraw the extrusion back to the disc space cavity, after what it was possible to remove the extrusion in one piece lateral to the axilla. Further cleaning of the disc space was performed from the left side. The root regained relaxed position. Routine closure.

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


 

Comments  

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The extruded disc was not large enough, but the root was severely compressed by the extruded and downward migrating piece, causing complete loss of the function of the left S1 root.

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So as to avoid surgical trauma to the already traumatized root, it was necessary to decompress the disc material, then the extrusion was removed, after pushing it inside the disc space. Avoidance of surgical trauma to the neural structures, make postoperative deterioration of them a rarity.

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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