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 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.
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01.
02-JULY-2007 ASYAT SHUAYYEB HAMZOGAH 62
YEARS PCD C3-4 WITH SEVERE COMPRESSION OF THE
SPINAL CORD AND MALACIA WITH SUBLUXATION OF C2-3.
Anamnesis
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The patient came to the
clinic 16-August-1998 with right shoulder pain
for 6 months with right lower limb pain for one
month. MRI lumbar spine showed PLD L4-5 and she
was treated conservatively. |
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The patient came
26-March-2001 with exacerbation of neck pain for
6 months with headache and hypertension. MRI of
the cervical spine was done 28-March-2001
showing assimilation of C2-3 which was
considered as a whole as C2. There were gliotic
changes in the spinal cord at C3-4 without
compression. The patient was treated
conservatively. |
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The patient came 25-May-2004
with left shoulder pain. There was weak grip,
extension of the left hand and the triceps
muscle left side. MRI was asked but she came
26-February-2006 with MRI bad quality showing
PCD C4-5 and C5-6. She was asked to perform
another MRI of the cervical spine. |
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The patient came 30-June-2007
with MRI performed 26-June-2007 showing
retrolisthesis of C2-3 with PCD C3-4 with
severe compression of the spinal cord with
malacia at that level. |
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The patient had profound weak
all muscles upper limbs more in the left side
with numb both hands and Hoffmann sign positive
both sides. |
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Discectomy of C3-4 with
osteophytectomy was done. The bone was profusely
bloody oozing, for what waxing was needed
several times and the posterior longitudinal
ligament was bony hard, for what it was
necessary to drill it out, after what the dural
was seen. |
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Using 2 level cervical
miniplate, fusion of C2-3-4 was done after
nibbling the antero-inferior border of C3 bush
it anteriorly. |
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Smooth postoperative recovery
with normalization of the power of both upper
limbs. |
Comments:
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The patient had gliotic
changes, which mostly are present for several
years. Immediate improvement of the power
indicate, that these changes cannot give the
conclusion for bad recovery. |
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The aim of the surgery is
arrest the escalation of deterioration. In case
of improvement, it is a bonus to the patient. |
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