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
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
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
When you need not wait for lumbar HNP surgery
Photo of dissatisfied pregnant woman feels pain in back, frowns face from displeasure, wears casual clothes, has problems with health, sits at comfortable sofa. Future mother suffes from backache A lumbar HNP sometimes occurs during pregnancy and can cause disabling leg pain. Treatment of course, should be conservative and any drugs that could affect the … Continue reading Pregnancy with Back and Leg Pain
L5/S1Herniation of Nucleus Pulposus (HNP) Large Extrusion of L5/S1 Disc After describing the structure of a spinal disc in the previous blog, here are MRI scans showing a small and a large herniation of the L5/S1 nucleus pulpous. The disc doesn't slip (a lay term) - the end plates stay attached. The disc annulus (capsule) … Continue reading What Is A Slipped Disc?
An Axial (Cross-Section) MRI showing a large HNP on the left. MRI scans are done while lying on the back and the display is as viewed when looking up from the foot of the bed. Thus the left is on the right of the image. As noted in the caption above, MRI displays can be … Continue reading Lumbar HNP on MRI Cross-Section View
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?