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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.  08-AUGUST-2007  MAHMOUD SALAMEH HUSSEIN  73 YEARS  HUGE PCD C3-4 WITH FRACTURE OF THE OSSIFIED C3-4 DISC.

 

 
 

Anamnesis

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The patient came to the clinic 14-April-2007 complaining of neck pain for 5 months with quadriplegia.

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MRI of the cervical spine performed 20-November-2006  showing huge PCD C3-4  with malacia of the spinal cord at that level.

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On examination: the patient is unable to walk with quadriparesis 3/5 of all four limbs and pathologic reflexes and exaggerated all deep reflexes with quadrihypalgesia below C3.

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Inspection of the anterior alignments of the cervical column showed fracture of the ossified C3-4 disc. Drilling of the anterior osteophytes and discectomy of C3-4 with removal of all the extrusion which was severely compressing the dura. Further removal of the osteophytes compressing the dura.

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Using Hybrid cervical miniplate, fusion C3 and 4 was performed.

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Smooth postoperative recovery. Some improvement of the power of all four limbs.

Comments:

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The patient was quadriplegic for 9 months and showed slight improvement with Nucleo-CMP, Somazina, Neurontine and Neurobion. But this modality of treatment is not substitute for surgery. It seems, that the patient was reluctant for surgery, which could play a negative role in the degree of his future improvement.

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Fracture of the OPLL at the C3-4 level was impossible to predict before surgery. The inspection during surgery, confirmed the presence of such fracture with subsequent extrusion of the disc material and severe compression of the spinal cord.

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The presence of huge anterior osteophytes are an obstacle for discectomy and reduction. They must be drilled off to have good alignment with proper positioning of the miniplate.

 
     
 

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