NEWS

January/06/2007

Surgical treatment in paraplegia survey:

Cross-anastamosis in paraplegia below D9 started to give results. The last documented case operated 1 year ago in a patient from Israel came to the clinic 3 weeks ago. ECS and EMG performed showed that there is starting innervation of Th 11 and 12. The patient's lower limbs muscles became bulky and he could contract the lower abdominal muscles and some movements in the pelvic girdle. Crude sensation descended down to the inguinal level both sides. If you are more interested in this topic, click here!

March/08/2007

Tuberculosis of the spine

In the last 2 years the incidence of tuberculosis of the spinal column is becoming more frequent and having different clinico-morphologic picture. This phenomenon is alarming sign as the residual of the use of dirty bombs and several radioactive materials in the surrounding dirty wars in the region. For demonstration click here! and here!

20-AUGUST-2007

SIEMENS Digital C-arm is implemented and functioning in the Shmaisani hospital.

30-AUGUST-2007

The Inomed ISIS Highline neurophysiologic navigation system start to work at the operating room.

01. 02-DECEMBER-2007 YOUSRA ISMAEEL ABU-TAHA 67 YEARS SEVERE CERVICAL CANAL STENOSIS WITH MALACIA OF THE SPINAL CORD AT C3-4 DOWN TO C5-6 DUE TO LIGAMENTUM FLAVUM HYPERTROPHY.

Anamnesis

	The patient came to Shmaisani hospital 02-December-2007 complaining of severe weak four limbs, more the left side with progressive course.
	MRI performed 5 days ago showing severe cervical canal stenosis with maximal stenosis at C3-4 down to C5-6 with the maximal compression arising from behind, from the hypertrophied ligamentum flavum with malacia of the spinal cord at these levels.
	On examination: the patient is unable to walk for 2 months and have profound weak for limbs right 3/5 and the left 1/5 with the level up to C3.
	The patient was taken to the operating and before induction of anaesthesia the patient could not tolerate the hyperextension position, for what intubation was done avoiding, during that extension of the neck.
	Laminectomy of C3-6 and partial of C2 and C7 was achieved. There was no epidural fat and the hypertrophied ligamentum flavum was removed. Check for instability was negative.
	Routine closure of the wound and smooth postoperative recovery with some improvement of the power of the four limbs.

Comments:

The compressive elements were from behind the spinal cord, despite the fact, that the patient had minimal OPLL. The logical decompression in this case was posterior decompression.