The Flex-Bar Retractor Kit The set, except for the table attachment (black handle), is sterilized. At the appropriate time during micro-diskectomy, the large, solid retractor bar, is passed through a small slit in the drapes to a non-sterile nurse, who affixes it to the table attachment and tightens it into the position held by the … Continue reading Microdiskectomy for Lumbar HNP, Part 4
A Periosteal Elevator - its width is the length of the incision. With the patient asleep and turned prone, a metal marker is placed over the intended level and a portable X-ray is taken to verify. The small vertical midline skin incision is deepened to the tops of the spinous processes above and below the … Continue reading Microsurgery for Lumbar HNP – Part 1
When you need not wait for lumbar HNP surgery
Left - X-ray showing balance line created by lordosis. Right - MRI scan of normal lumbar spine; T = thoracic (w 12 pairs of ribs not shown). L = lumbar, S= sacral (a solid bone w rudimentary disc spaces) The intervertebral discs have three components that enable them to flex and twist while bearing lots … Continue reading What are the Lumbar Discs?
Radicle is a medical term for a spinal nerve root as it comes out of the spinal dural sac and goes through its exit canal between two vertebrae. Pathology is an abnormality of body structure. So radiculopathy indicates an abnormality in a nerve root. How do you tell it's the nerve root and not the … Continue reading What is Radiculopathy?
A company called Geno Pharmaceuticals sells a pill for back pain called LOBAK. I think I named my AI program for managing lower back pain I call LOBAK in 1989 before they produced this pain medicine. Their pill is hard to find. Geno is based in India. The LOBAK pill might work pretty well. It … Continue reading LOBAK Tablets
A Lumbar Microdiskectomy in Progress In this photo the muscle retractor is in place and the bayonetted nerve root retractor is mounted and ready to be put in place. Its flexibility will be restored by loosening the wire-tightening lever. It will be tightened again when the retractor is in position. A cautery forceps (rt. hand) … Continue reading Microdiskectomy for Lumbar HNP. Part 6
Above is the nerve root retractor mentioned in part 4. The flexible arm clamps onto the top (right side of this photo). The "bayonet" offset keeps it out of the line of sight. The curved flange at the tip (on the left end in photo) holds the dura and nerve root over. The flange is … Continue reading Microdiskectomy for Lumbar HNP. Part 5
Surgical instrument for performing partial laminectomy
The Caspar Microdiskectomy Retractor The muscle retractor shown above is open. On turning the thumb screw, it goes through one arm, pushes the other arm open and holds it there (not shown). With it closed and after the muscle alongside the spine has been freed from bone, it can be slipped between the bony spinous … Continue reading Microdiskectomy for Lumbar HNP. Part 2
Cm Scale on Scalpel Handle Beside Micro-HNP Incision The above shows the incision made for a lumbar micro-diskectomy just before closing the skin. Subsequently I'll describe how the operation is done and show the instruments used. Patient is asleep prone (on stomach) and the incision is vertical, in the midline of the lower back, placed … Continue reading 2 cm incision for lumbar HNP
One way to do microsurgery is to use jeweler's loupes and a headlight as shown above. If more than 2X or 3X magnification is needed, the surgeon must hold very still to stay in focus. Another difficulty is that the light and the glasses are not quite in the same plane, so in a deep … Continue reading Magnification for Microsurgery