|
|
 |
|
|
 |
|
|
|
|
|
|
|
|
| |
 |
 |
|
 |
 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.
|
|
| |
 |
 |
|
|
|
|
|
 |
|
 |
5. 05-APRIL-2007 RAJAA
MUHAMED TBESHAT 37 YEARS FAR LATERAL
EXTRUSION OF L5-S1 DISC RIGHT FORAMINAL
COMPRESSION.
Anamnesis
 |
The patient came to the
clinic 19-February-2007 complaining of LBP for 15
years with right sciatica. Exacerbation of
the LBP with left sciatica the last 7 months without
numbness. |
|
|
MRI lumbar spine done
17-July-2006 showing assimilation of L4 and L5
and D11 and D12 with bulge L5-S1. |
|
|
On examination: The patient
had scoliotic stance. SLRS was 90
degrees in both sides with pain in the right. There was no sensory
or motor deficit. |
|
|
The patient then progressed
severe agonizing right sided sciatica the last
10 days , for what MRI was repeated and showed
extrusion of the L5-S1 disc with migration to
the right S1 root foramen with severe
compression. |
|
|
The patient came to the
emergency of Al-Shmaisani hospital 04-April-2007
with agonizing pain and drop right foot with
severe weak planterflexion right foot. |
|
|
Right L5-S1 hemiflavotomy with
left S1 and L5 roots foraminotomy was performed.
The extruded disc was was migrating upward and
compressing the right L5 root, which was
unusual, because she had several abnormalities,
making image intensifier a must, so
as to understand the presence and location of
the foramina. |
|
|
The far-lateral extrusion was
removed in piece-meal fashion and the right L5
root was inspected and all the compressing
elements were eliminated. |
|
|
Smooth postoperative recovery
and normalization of the power of the left foot. |
Comments:
|
|
The patient had an abnormal
anatomy, making the use of image-intensifier a
needed procedure to know exactly what to do.
Using the bony guides, were useless in this
case. |
|
|
The extruded disc was
migrating upward and the compression was
directed to the right L5 root, which is unusual.
The distance between the L5-S1 annulus fibrosis
and the running L5 root was minimal, causing
misunderstanding of the anatomical
relationships. |
|
|
Presence of such
extrusion with complete occlusion of the foramen
caused severe compression of the right L5 root,
which made it necessary to undergo surgery. |
|
 |
| |
 |
|
|
