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.

12. 17-NOVEMBER-2007 KHAYRIYEH AHMAD QALABATA 65 YEARS SEVERE LUMBAR CANAL STENOSIS L2-3, L3-4 AND L4-5 WITH LEFT LATERAL RECESS SYNDROME.

Anamnesis

	The patient came to the clinic 05-January-1999 complaining of LBP for three years with left ankle pain for 1 week. On examination at that time, she was neurologically free with polyarthralgia and she had non-steroidal with anti-osteoporosis treatment.
	The patient came 04-December-2001 with neck and right shoulder pain with numbness of the ulnar distribution both upper limbs. MRI of the cervical spine showed degenerative changes with mild cervical canal stenosis. She was treated conservatively.
	The patient then came 13-November-2007 with exacerbation of the LBP for one month and bilateral sciatica more the left with difficult walking. She could walk only 5-7 meters. The pain increase during night and walk with bending foreword. MRI lumbar spine performed 09-November-2007 showing severe lumbar canal stenosis L2-3, L3-4 and L4-5 with left lateral recess syndrome. MRI cervical spine showing mild cervical canal stenosis.
	On examination: The patient has scoliotic stance with SLRS 70 degrees in the left, hypalgesia left L5 territory with weak dorsiflexion both feet 4/5 right and 3/5 left.
	Decompressive laminectomy of L3-4 and partial of L2 and L5 with foraminotomy of both L4,5 roots was performed. The dura was lacking the epidural fat and its wall was very transparent.
	Routine closure of the wound and smooth postoperative recovery with normalization of the power of both feet.

Comments:

Lumbar canal stenosis is a progressive disease and if it is showing deteriorating course, surgery is mandatory to prevent further damage to the neural tissues.