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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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Case report
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A young 45 years age, underwent several operations for sacrococcygeal chordoma , followed by radiation 6000 Rad 1998. He came to the clinic with a huge mass. He had bilateral drop feet with inability to walk, with micturition problems, for what he was operated 1998: Removal of the tumor was undertaken with preservation of the L5 down to the coccygeal nerves. It was impossible to remove the tumor dirt invading the neural structures. The pelvic cavity was not violated. Using modified bended Luque, fixation of L3-4-5 was achieved with the iliac bones with wires. The operation was bloody and the patient required 26 units of blood with 12 units of FFP. Despite that the wound was complicated by infection, the neurological state of the patient improved and he could walk without aid and the micturition improved.
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The patient then came another time with recurrence and was operated 6-11-2000. The pathologic bone structures and about 3 cm of the surrounding healthy bone was removed and the pelvic cavity was violated , with dissection of the tumor from the ano-rectal structures and dissection of the tumor off the aorto-iliac arteries and veins. The Luque construct was aided with another metallic devices , so as to regain more fixation, down to the acetabular surfaces above the hip joints.
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The patient then came 10-4-2004 with complains of left leg pain with inability to stand for 9 months with prominent scoliotic deformity of the pelvis. On examination, the patient had hypalgesia left L5 and S1 territories with drop left foot with weak planterflexion both feet. It was evident that the device was loose in in the right side. The patient was admitted and operated through the right iliac region to booster the fixation. During that, it was noticed that recurrence of the tumor had place, and it was the reason for bone loosening. |
Postoperative
studies:
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