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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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03. 08-OCTOBER-2007
MUHAMED AHMED SAEED 55 YEARS HUGE EXTRUDED DISC
C5-6 WITH MILD STENOSIS C4-5 AND C6-7 AND
RADICULO-MYELOPATHIC SYNDROME .
Anamnesis
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The patient came to the
clinic 22-September-2007 complaining of right
shoulder pain for
2 years. 4 months ago got numbness and weakness
right hand and the last 2 months noticed weak
and numb both lower limbs. |
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MRI lumbar spine done
06-May-2007 showing huge extrusion C5-6 more the
left side with elements of mild stenosis at C4-5
and C6-7 levels. |
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On examination: the patient
limping when walking with severe atrophy
of the interossii of the left hand. Hoffmann
positive both sides. There is weak grip both
hands 4/5 and extension both hands: right
4/5 and left- 3/5 with severe weak triceps
muscles both upper limbs -3/5. There weak
dorsiflexion both feet and the guadriceps
femoris: right 3/5 and left - 4/5. There is
hypalgesia all volar surface right hand and
ulnar side left hand. |
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MRI
cervical spine done 29-September-2007 showing
the same data as in the previous MRI. |
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Using Inomed Highline IOM,
the operation was performed using TES-MEP
protocol. Discectomy of C5-6 was performed and
all the compressing elements were removed,
including the bony elements. |
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Smooth postoperative recovery
and improvement of the power of four
limbs. |
Comments:
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The patient has severe
compression at C5-6 and mild stenosis above and
below. It was decided to decompress the spinal
cord at C5-6, leaving the other levels. If, in
the remote future these findings became evident,
then this will be corrected accordingly. |
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The disc extrusion had a
protracted course, which predict relatively
persistent pain in
the long postoperative course. |
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Inomed Highline IOM TES-MEP
mode was used
in this case. |
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