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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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6. 27-MARCH-2007 ALLAA
NAEEM RADWAN 28 YEARS FLEXION FRACTURE OF C5
Anamnesis
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The patient was transferred
from another hospital with falling down three
days ago, during diving, during what he got
flexion facture of the C5. |
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MRI cervical spine performed
26-March-2007 showing the fracture of C5 without
disc prolapse and intact spinal cord. |
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On examination: the patient
is neurologically free with collar and cut
wound of the scalp in the forehead. |
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Considering that the fracture
is an unstable one, reduction and stabilization
was suggested. |
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Discectomy of C4-5 was
performed to secure the process of reduction
with distraction, using the Hallo ring with 8 Kg
applied with slight hyperextension. |
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Using three level 24 mm
length Stryker cervical miniplate, fusion of
C4-6 with 18 mm screws applied with divergent
angulation, to aid the distraction and
consequently the reduction. The most difficult
part of surgery, was to insert the construct to
the intended site, due to small incision.
Several check X-rays demonstrated good alignment
and reduction of the bony structures. |
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Routine closure of the wound
and smooth postoperative recovery with
improvement of the motor power both feet. |
Check X-ray 6 hours after surgery
after ambulation of the patient.
Comments:
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Considering that the fracture
is an unstable one and cannot stand load with
severe angulation and decrease of the anterior
height of the body of C5 less than 10% than
normal, reduction and fusion of the fracture
one level above and one level below must be
done. |
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To avoid slippage of the
fractured C5 during reduction and
fixation, discectomy of C4-5 was performed and
the body of C5 was left without screwing to
prevent such possible complication. This was
done with visual control through the discectomy
site. |
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