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Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


 

Multigen RF lesion generator .

12-SEPTEMBER-2002  WAJDI JAMIL AL-IKER  62 YEARS  LCS L2-3, 3-4, 4-5, L5-S1 WITH EXTRUDED DISC L4-5 RIGHT SIDE AND L5-S1 LEFT SIDE.

 
 

Anamnesis

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The patient came to the clinic 05-September-2002 complaining of LBP for 15 years with right sciatica and weak both lower limbs. Exacerbation of the condition with left sciatica. MRI lumbar spine recently done showing lumbar canal stenosis L2-3, 3-4, 4-5.

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On examination: The patient in agonizing pain, limping with exaggerated scoliotic stance. SLRS 40 degrees both sides with pain. There is severe weak dorsi and planterflexion both feet 3/5, with hypalgesia left leg below L2 dermatome.

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The patient sent for investigations and dorsal MRI was uneventful and has severe lumbar canal stenosis L2-3, L3-4, L4-5 and L5-S1 with possible extrusions. 

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Decompressive laminectomy L3,4,5 lower third of L2 and upper edge of the sacrum. Bilateral L3, 4, 5 and S1 foraminotomy both sides. Inspection of the disc revealed extruded disc L5-S1 left side, which was removed and left sided cleaning L5-S1 was achieved. Discectomy L4-5 from the right with right sided intradiscal cleaning L4-5. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound.

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Smooth postoperative recovery. The power of both feet improved. He was sent to the ward.

Follow Up

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The patient came to the clinic 26-September-2002 with clean wound and still having slight weakness dorsiflexion right foot with the hypalgesia regressed to the medial aspect of the lower third of the left foreleg. SLRS was 80 degrees without pain both sides.

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The patient then came 27-October-2002 telling that he still have right sciatica with difficulty in walking. SLRS was 45 degrees right side and 35 degrees left side without pain. The power of both feet normalized, but the right quadriceps was 4/5. with hypalgesia left L5 and S1 territories. He was treated conservatively.

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The patient then came 19-November-2002 still complaining of right sciatica and weak right quadriceps femoris 4/5 with SLRS 70 degrees both sides without pain.

Comments  

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The sooner the surgical decompression in progressive LCS, the better the outcome.

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The patient has also extruded disci with recurrence rate postoperatively around 14%.

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In retrospective analysis of this case, it was preferable to make check MRI and dynamic studies and in case of new events to make the appropriate intervention. (28-April-2021).

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Our policy at the present time (2020), when we do discectomy in lumbar spine for 2 adjacent levels, transpedicular fixation is a must.

 

 

 

 

 

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 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 .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WELCOME TO AL-SHMAISANI HOSPITAL

 


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