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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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05.
08-AUGUST-2007 MAHMOUD SALAMEH HUSSEIN 73
YEARS HUGE PCD C3-4 WITH FRACTURE OF THE OSSIFIED
C3-4 DISC.
Anamnesis
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The patient came to the
clinic 14-April-2007 complaining of neck pain
for 5 months with quadriplegia. |
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MRI of the cervical spine
performed 20-November-2006 showing huge PCD
C3-4 with malacia of the spinal cord at
that level. |
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On examination: the patient
is unable to walk with quadriparesis 3/5 of all
four limbs and pathologic reflexes and
exaggerated all deep reflexes with
quadrihypalgesia below C3. |
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Inspection of the anterior
alignments of the cervical column showed
fracture of the ossified C3-4 disc. Drilling of
the anterior osteophytes and discectomy of C3-4
with removal of all the extrusion which was
severely compressing the dura. Further removal
of the osteophytes compressing the dura.
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Using Hybrid cervical
miniplate, fusion C3 and 4 was performed. |
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Smooth postoperative
recovery. Some improvement of the power of all
four limbs. |
Comments:
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The patient was quadriplegic
for 9 months and showed slight improvement with
Nucleo-CMP, Somazina, Neurontine and Neurobion.
But this modality of treatment is not substitute
for surgery. It seems, that the patient was
reluctant for surgery, which could play a
negative role in the degree of his future
improvement. |
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Fracture of the OPLL at the
C3-4 level was impossible to predict before
surgery. The inspection during surgery,
confirmed the presence of such fracture with
subsequent extrusion of the disc material and
severe compression of the spinal cord. |
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The presence of huge anterior
osteophytes are an obstacle for discectomy and
reduction. They must be drilled off to have good
alignment with proper positioning of the
miniplate. |
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