Surgical Case Update

Overview

• Location: San, California
• Surgeon: Joel Chen
• Patient Origin: New Mexico
• Procedure: Two different types of surgeries in one setting under general anesthesia.

Patient Diagnosis and Initial Assessment

1. Discretation:
   • Location: 34 central diseasure.
   • Condition: Annular tear on the left side.
   • Treatment: Diagnostic injection confirmed issues.
2. Bertolotti's Lesion:
   • Appearance: Aberto lesion near false joint, injected with anesthetic.
   • Outcome: Anesthetic improved symptoms.

Surgical Procedure Details

• Endoscopic Surgery:

  • Tools: Computer navigation for precision.
  • Challenges: Separating false joints and removing scar tissue.
  • Techniques: Use of articulating curettes and removal of tissue adhesions.

• Framinal Disc Protrusion with Stenosis:

  • Observation: Semi-empty area with nerve irritation due to adhesions.

• Special Instruments:

  • Radio Frequency Probe: For dissecting and clearing space.
  • Navigation Pointer: For identifying neural foramina and ensuring proper pathway clearance.

Surgical Observations

• Scar Tissue and Bone Spurs:

  • Presence of scar tissue around nerve which needed careful extraction.
  • Bone spurs not directly causing issues but potentially pressuring discs and nerve.

• Cautious Dissection:

  • Aim: Protect nerves by clearing scar tissue and adhesions.
  • Technique: Use of endoscopic tools for precision.

Post-Surgery Remarks

• Condition of Lesions:
  • Some lesions were rock solidly fused, making further dissection unnecessary.
  • Future consideration: Pain possibly inflammation-related, not solely caused by articulation issues.

Outcomes

• Surgical Success: Procedures completed without major complications.
• Anticipated Recovery: Expectation of significant symptom improvement and fast recovery.

Additional Notes

• Bertilotti Lesion: Unique case with specific characteristics; future monitoring required.
• Surgical Methods: Preference for minimal incision technique to reduce overall trauma.
• Post-operative Care: Commitment to patient recovery and symptom alleviation.

Best Wishes: Team is optimistic for patient recovery and overall improvement in quality of life.