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Multigen RF lesion generator .

03-SEPTEMBER-2002  WAJIHA ABDALLA SHAHWAN  36 YEARS  RECURRENT EXTRUDED DISC L4-5 LEFT SIDE.

 
 

Anamnesis

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The patient was operated by me 24-January-1999 for PLD L3-4 and L4-5. Video recording at that time was not available. She continued to suffered episodically and MRI lumbar spine performed 27-May-2002 showed no recurrence. The patient then came to the clinic 25-August-2002 complaining of LBP with left sciatica for several days.

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On examination: The patient in agonizing pain, limping with exaggerated scoliotic stance. SLRS 80 degrees right side with pain and 45 degrees with more pain in the left. There is drop left foot and severe weak planterflexion same foot 2/5, with hypalgesia left L5 and S1 territories.

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She was sent for investigations and MRI lumbar spine performed 31-August-2002 showing huge recurrence at L4-5, more to the left.

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Bilateral L5 foraminotomy with removal of the extrusion lateral to the axilla. Left sided intradiscal cleaning L4-5. After that right sided intradiscal cleaning. 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 the left foot still the same. She was sent to the ward.

Follow Up

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The patient came to the clinic 14-September-2002 with clean wound and weak dorsi and planterflexion left foot 3/5 with hypalgesia left L4 root. SLRS was 45 degrees without pain in the left.

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The last time she came 06-October-2002 with still weak dorsiflexion left foot with hypalgesia left L5 territory with SLRS 70 degrees with pain left side. She was advised to be treated by physiotherapy and medical treatment.

Comments  

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There is still an estimated postoperative recurrence around 7%.

 

 

 

 

 

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 .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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