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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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13.
26-APRIL-2007 HANAA KHADER ABBAS 46 YEARS
POSTDISCECTOMY III DEGREE SPONDYLOLISTHESIS L4-5 WITH
AGONIZING SCIATICA AND WEAK BOTH FEET.
Anamnesis
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The patient came to the
clinic 23-April with agonizing bilateral
sciatica and severe weak both feet with
inability to walk more than 100 meters. |
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The patient was operated
22-May-2006 for PLD L4-5 with subsequent
deterioration of her condition. |
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MRI done 26-January-2007 with
LSS X-ray confirmed the presence of III degree
spondylolisthesis L4-5 with complete absence of
the isthmi. |
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On examination: the patient
had exaggerated scoliotic stance with SLRS
40 degrees both sides with more pain in the
right. The right foot dorsi and planterflexion
were 3/5 and the left 4/5. There was hypalgesia
of the right L5 and S1 territories. |
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Skeletonization of the
lateral masses of L5-S1 both sides and the L4-5
respectively. There were no lateral masses. The
transverse processii were identified and using
transpedicular screws 45 mm length and 7.5 mm
width with 2 polyaxial type in the upper side
and rigid in the lower part, transpedicular
screw fixation was performed with
distraction-reduction with bridge inserted
between the 2 rods. |
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Smooth postoperative recovery
with normalization of the power of both feet.
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Comments:
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The patient underwent surgery
for discectomy 1 year ago elsewhere. The
isthmi were destroyed with subsequent
progression of III degree spondylolisthesis. It
is hard to tell if that was the result of
surgery, or a hidden finding, which was escaped
during surgery. It happens, as
in this example,
that the patient got fracture of the isthmi
before surgery, but removing the isthmi during
the first surgery still possible. |
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In either cases, considering,
that the patient had deterioration, without
improvement during the 12 months period, surgery
with fusion is the only solution to this
situation. |
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| Postoperative Lateral LSS
X-ray |
Postoperative LSS X-ray
AP-view |
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