Marcio Robertti Ramalho da Cunha
Freie Universitat, Germany
Scientific Tracks Abstracts: J Neurol Neurophysiol
We have a lot of causes to entrap the lumbar nerve roots, bringing sciatica as a major symptoms, these entrapments can be a result from many etiologies such as intervertebral disc herniation, spinal stenosis, the formation of osteophytes and the fibrous adhesive entrapment (5,7 )We present A 58-year-old woman presented to our clinic in March 2017, complaining of severe right sciatica her complains were aggravated by walking and coughing and prolonged sitting position, she was also experienced numbness and a tingling sensation in the lateral portion of her right foot. On physical examination the straight leg raise test was positive only in her right side, with a 45 angle raise, her Achilles tendon reflex was abolished. The Lumbar MRI showed no remarkable signs of the nerve block in the level L5/S1 to explain the origin of the pain. We've made a nerve root block using 01 cc of lidocaine of the right S1 root with complete relief of the symptoms for eight hours. In face a positive result of the blockage test, we´ve done a full endoscopy interlaminar approach.We've made the procedure under the steps of the full endoscopic interlaminar approach by Rueten technical (8,3,4) After opening the yellow flavum ligament we could see a total S1 root entrapment by fibrous adhesive tissue with no signs of the S1 root, after some manipulations we could see how entrapped was the nerve root with some surgical maneuvers using the dissector and scissor punch, we could liberate the nerve root until its entrance in the foramen. The procedure took around 34 minutes with a patient hospital discharge around six hours, using a single painkiller to control the lumbar back pain in the first 24 hours. After almost one year of follow up, the patient got no sciatica just a residual low back pain.
Marcio Robertti Ramalho da Cunha is the senior in Neurosurgery department at Trauma Centre Brazil. He was the medical student of UFRN in 1983-1989. He completed this medical residency at the Base Hospital of the Federal District - Brasíl. He did his post graduation in the Area of Column Surgery at Rwth Aachen – Germany and another postgraduate course at Frei Universitat Of Berlin - Germany. He is trained in the minimally invasive treatment of the Spine in the Space Coast Pain Institute Merritt Island, Florida - USA. Dr. Marcio Robertti Ramalho da is the active Member of the Brazilian Society of Neurosurgery, Brazilian Society of Column and ASIPP (American Society Of International Pain Physician). He served as Chairman of Neurosurgery service of the General Hospital in the year 2014 and Assitant professor in Neurosurgery Department in U.F.R.N in the year 1996 – 1999. He has expertise in spinal endoscopic surgery.
E-mail: maramalho65@gmail.com
