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20-NOVEMBER-2007 Case Two |
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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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15. 20-NOVEMBER-2007
NIHAD MAHMOUD ABU-HLAL 29 YEARS PCD C6-7
WITH RIGHT FORAMINAL OCCLUSION.
Anamnesis
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The patient came to the
clinic 27-October-2007 complaining of neck
and right shoulder pain for 1 year after lifting
heavy object. MRI cervical spine performed
14-April-2007 showed extruded disc C6-7 with
left foraminal engorgement. The patient improved
and deteriorated the last 3 weeks. |
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On examination: the patient
has neck movement when looking to the left and
with limitation when looking up and down (
i.e.., moving the head). |
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He had weak grip and
extension of the right hand and the triceps of
the right arm. |
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The patient was sent for
another MRI of the cervical spine, which
revealed huge extrusion of the C6-7 disc with
complete occlusion of the right foramen. |
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Using Inomed Highline ISIS
HSG KHBW scenario, discectomy of C6-7 was
performed with removal of the extrusion and the
osteophytic bone at that area. |
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Routine closure of the wound
and smooth postoperative recovery with
improvement of the power of the right upper
limb. |
Comments:
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Using IOM prevent possible
complications during surgery, even in the remote
sites of the CNS, as in this case the AEP was
stable all the time and symmetrical from both
sides and SEP with the medianus N20 and tibialis
P40 were stable all the time from both sides
during the surgery. MEP at times was recorded
and it was acceptable. The successive EMG from
both glossoph, thenar facials and
hypoglossi both sides, were acceptable
during the whole procedure. |
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The preparation for setup for
such iom protocol, is time-consuming and with
time, the sense of normalcy and when to use such
technology will grow and becoming established. |
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