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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.

28-November-2013

Magnetom Skyra 3 tesla with all clinical applications start to run.

 

 
 
 
 

02.  05-AUGUST-2007  TAGHREED MUHAMED DIYAB  37 YEARS  RESIDUAL AFTER POSTOPERATIVE CAUDA EQUINA SYNDROME AFTER DISCECTOMY L4-5.

 

 
 

Anamnesis

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The patient came to the clinic 20-May-2007 complaining of difficult walking  with left sciatica  and progression of cauda equina syndrome with loss of defecation and micturition sensation after discectomy performed 18-December-2007  elsewhere. She was reoperated 25-December-2007 without improvement.

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MRI performed after fist surgery showing recurrence and the one performed 19-April-2007 showing another recurrence.

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On examination: the patient is limping  with weak dorsiflexion both feet 3/5 and planterflexion 4/5 and hypalgesia both L5 roots and cauda equina syndrome with loss of defecation and micturition sense.

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Revision of the wound was performed and all the stenotic elements at L4-5 level was eliminated and foraminotomy of left L5 root was performed and the remnant of the extrusion was removed and meticulous cleaning of L4-5 disc space was achieved.

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The L5 lamina was mobile and that mobile segment was removed.

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Smooth postoperative recovery. The power of both feet improved immediately after the operation, but the bladder and defecation problems still the same.

Comments:

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The patient is undergoing the third operation for complicated status.

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The considerable improvement of the power of both feet is a good sign for future recovery of her defecation and micturition drive.

 
     
 

Copyright [2007] [CNS Clinic]. All rights reserved