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.

06. 08-DECEMBER-2007 ZAYNAB SALEH HAMMAD 54 YEARS HUGE EXTRUDED DISC L2-3 WITH CENTRAL AND LEFT UPWARD AND LEFT FAR-LATERAL EXTRUSION WITH OA RIGHT KNEE.

Anamnesis

	The patient came to the clinic 05-December-2007 complaining of LBP with bilateral sciatica for 3 years and right knee pain for three months.
	On examination: the patient limping with exaggerated scoliotic stance, with agonizing sciatica. SLRS was 30 degrees in the right and 45 degrees in the left. There was weak dorsiflexion both feet 4/5 and planterflexion right foot 4/5, with osteoarthritis both knees with pain of the right knee.
	MRI performed 05-December-2007 showing huge extruded and sequestrated disc L2-3 with central and left upward and left far-lateral extrusion.
	Under image-intensifier, the L2-3 was identified and left hemiflavotomy of L2-3 was performed and foraminotomy of left L3 root was achieved. The extruded part was removed lateral to the axilla and the far-lateral pieces were removed and the upward migrating piece was removed separately. Meticulous cleaning of the disc space was done. The epidural fat was absent in the compressed area and the root was in bad shape.
	Routine closure of the wound and smooth postoperative recovery.

Comments:

	The patient has pathological process in the right knee, but considering that the extrusion is a major one, priority for surgical treatment of the PLD L2-3 was given.
	The disc space is shallow, which indicate low recurrence rate.
	The bad shape of the root, could anticipate bad recovery of this root, but elimination of compression could yield good result, considering that the other roots were involved in the process.