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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.

 

 
 
 
 

1.  08-JANUARY-2007 RIMA NAZEER TAEF 31 YEARS RECURRENT PLD L4-5 WITH LEFT DOWNWARD MIGRATION.

 

 

Anamnesis

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The patient was operated by me 8 months ago for huge PLD L4-5 left side. The patient improved for short period of time, then her condition dramatically deteriorated the last week with agonizing left sciatica.  MRI performed yesterday, showed a huge recurrence at the same place.

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On examination: the patient was in agonizing patient with almost drop left foot with inability to stand. She even refused to perform preoperative preview, because she was crying all the time.

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The old wound refreshed and foraminotomy of the left L5 root was performed and the root was followed upward until the axilla was free of scars.

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The extrusion was removed and the fragmented disc material inside the disc space was removed. A huge amount of disc material was removed.

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Smooth postoperative recovery.

Comments:

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The recurrence rate is around 30%  by postoperative MRI studies and 7% require surgery as in this case.

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The cause of recurrence and the continuous process of fragmentation of the intradiscal material and triggered by overactivity of the patient. In some cases even with strict behavior of the patient, recurrence can have place.

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Now the disc pace height is narrower than before, which make the re-recurrence lower than usual, but the defect in the annulus fibrosis is large, which could lead to slippage of the annulus wall itself. Time will show.

 

 
     
 

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