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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.

 

 
 
 
 

06.  06-NOVEMBER-2007  MAEN MUHAMED JABER  42 YEARS  EXTRUDED DISC C5-6 WITH OCCLUSION LEFT FORAMEN.

 

 
 

Anamnesis

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The patient came to the clinic 20-October-2007 complaining of neck and left shoulder pain for 2 years with exacerbation the last 2 weeks and numbness the thumb left hand.

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MRI cervical spine done 17-October-2007 showing PCD C5-6 with left foraminal occlusion.

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On examination: the patient has limitation and pain of neck movement for all directions with weak grip and extension of the left hand and hypalgesia of the index of the left hand.

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Using ISIS Highline Inomed IOM with right carotid scenario, discectomy of C5-6 was performed and the extruded fragment was removed from the foramen.

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According to the records of the iom, the latency of P40 was trouble shooting several times, despite the fact that, no compression was applied to the right carotid. This could be related to the anaesthesia protocol.

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Routine closure of the wound.

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Smooth postoperative recovery with normalization of the power of the left hand.

Comments:

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The patient was monitored for carotid scenario using Inomed ISIS IOM. Alarms came more than 5 times manifesting the decrease or increase of latency of P40. It will be a good idea to eliminate warning in case that the latency decrease in time, so as to reduce the number of false warnings.

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TOF (train of four) is mandatory during iom, so as to have stable balanced anaesthesia , so as to reduce false alarms.

 
     
 

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