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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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8. 11-APRIL-2007
AHMAD MUSA AL-JALOUDY 43 YEARS LCS L3-4,
L4-5 WITH EXTRUDED DISC L3-4 LEFT SIDE
Anamnesis
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The patient came to the
clinic 2 months ago complaining of LBP for
4 months with with left sciatica and weak
dorsiflexion left foot and hypalgesia of
the left L4 territory. |
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MRI lumbar spine done
at that time showing extruded disc L3-4
with left downward migration and bulge L4-5 with
segmental stenosis at these levels. |
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The patient was given the
opportunity to try conservative treatment, but
he came 08-April-2007 confirming that his
condition is deteriorating. |
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On examination: The patient
had scoliotic stance. He had SLRS 40 degrees
both sides with shooting sciatica left side. He
had severe weak dorsi and planterflexion both
feet and hypalgesia both forelegs below the
knee. |
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Decompressive laminectomy L4
and partial of L3 and L5 with foraminotomy of
both L4 and L5 roots left side.
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Inspection of the L3-4 disc
showed extrusion, mandating removal of the
extrusion from the left side with meticulous
cleaning of disc space from the left side, after
what the left L4 root became relaxed.
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The epidural fat was
preserved during surgery to minimize
postoperative scar formation. |
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Smooth postoperative recovery
and normalization of the power of both feet. |
Comments:
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The patient in the first
visit was in clinical status, that surgery could
be avoided, for what surgical treatment was not
decided at that time. |
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The deteriorating clinical
picture made it clear that surgery is indicated. |
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The patient is a tall person
and the spinous processii were abnormally long,
requiring long incision. |
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Preservation of the epidural
fat and using it to cover the most mobile neural
parts is the best solution to prevent scar
formation and ease his pain in the long run. |
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