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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.

 

 
 
 
 

2.  05-JUNE-2007  NIZAR MUHAMED SALEM  32 YEARS  EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.

 
 

 
 

Anamnesis

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The patient came to the clinic 03-June-2007 complaining of LBP with left sciatica for three months with pain and numbness down to left L5 root territory.

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The patient had normal stance, but limping, as dragging the left foot. On examination: the patient had severe weak dorsiflexion left foot 3/5 with hypalgesia of the left L5 root territory. SLRS was 70 degrees in the right  and 60 degrees with shooting pain in the left.

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MRI of the lumbar spine performed 29-May-2007 showing extruded disc L4-5 with left downward migration.

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Left L4-5 hemiflavotomy with left L5 root foraminotomy was performed and the extruded disc was removed lateral to the axilla. It was adherent to the root, that piece-meal resection was achieved.

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Meticulous cleaning of the disc space from the left side was performed.

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Routine closure of the wound and fat transfer to epidural space with smooth postoperative recovery and normalization of the power of the left foot.

Comments:

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The patient is very fat with weight 135 Kg and the thickness of the subcutaneous fat layer was around 20 cm. This factor made most of the usual instrumentations useless and unreachable to perform surgery. Using the percutaneous set and the transsphenoidal instrumentation, made it possible to perform such surgery.

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The heavy weight of the patient and the still high disc space of L4-5, despite the meticulous cleaning of the disc space, make expected recurrence more than the average.

 
     
 

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