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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.

 

 
 
 
 

05.  05-NOVEMBER-2007  TARIQ IBRAHEEM AL-TARAWNEH  33 YEARS  EXTRUDED DISC L4-5 RIGHT SIDE.

 

 
 

Anamnesis

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The patient was operated by me 03-Noveber-2004 for PLD L5-S1. The patient improved, then reappeared 05-March-2007 complaining of LBP with MRI performed 04-March-2007 showing dehydration of L4-5 and L5-S1 without signs of recurrence. He was neurologically free at that time.

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MRI lumbar spine done 22-October-2007 showing extruded disc L4-5 with right extrusion. The patient came to the clinic 31-October-2007 with the performed MRI.

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On examination: the patient has scoliotic stance with weak dorsiflexion right foot. SLRS was 40 degrees right side.

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Right L4-5 hemiflavotomy with right L5 root foraminotomy was performed. The extruded disc was attacked lateral to the axilla. It was removed in several pieces and meticulous cleaning of the disc space of L4-5 was done from the right side. No attempt was paid to widen the defect in the annulus fibrosis.

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Smooth postoperative recovery with normalization of the power of the right foot.

Comments:

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The patient underwent surgery for PLD L5-S1 3 years ago. No recurrence was noted up today, but he got PLD L4-5 which was small 8 months ago in the MRI findings.

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It could be that the patient had the same problem 8 months ago and the static MRI was not showing the extrusion, since the patient was investigated in supine position. It could be that there was an extrusion and if the patient performed the MRI in the sitting position, the extrusion could be caught.

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These speculations hold the importance of performing dynamic MRI.

 
     
 

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