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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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4. 15-FEBRUARY-2007
MAJIDAH FAKHRY MARAQAH 71 YEARS SEVERE
LUMBAR CANAL STENOSIS L3-4 AND L4-5 WITH FORAMINAL
STENOSIS BOTH SIDES.
Anamnesis
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The patient came to the
clinic 30-October-2005 complaining of LBP with
left sciatica for 1 week with numbness of
the left foot. The patient is a known
hypertensive and in L-thyroxin for 30 years
after thyroidectomy. |
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MRI lumbar spine done
21-April-2005 showed lumbar canal stenosis L3-4
and L4-5 |
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On examination: the patient
could not walk than 5 meters and was limping
with exaggerated scoliotic stance. She had weak
dorsiflexion both feet more in the left. |
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The patient was sent for
another MRI of the lumbar spine and she
disappeared. |
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The patient came
01-February-2007 with continuous numbness both
feet and bilateral sciatica. The scoliotic
stance was inverted with weak dorsi and
planterflexion both feet. |
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The patient sent for MRI with
MRMyelography, which confirmed the presence of
more severe degree of lumbar canal stenosis at
the above mentioned levels. |
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Decompressive laminectomy of
L4 and 2/3 of L3 and 1/3 of L5 was performed
with foraminotomy of L4 and L5 roots both sides.
There was no epidural fat and in some places the
ligamentum flavum was adherent to the dura,
which was transparent and very thin, that, it
was possible to see the running roots inside the
dura. |
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Routine closure and smooth postoperative recovery and
improvement of the power of both feet.
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Comments:
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Lumbar canal stenosis is a
progressive disease. When there are clinical
manifestations , related to the pathologic
process, the sooner to operate, the better the
prognosis for recovery of the neural structures. |
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Inspection of the foramina is
important, so as to decompress the neural
structures at the root level. For that a special
probe must be applied to check the patency of
the foramen. |
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