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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.

 

 
 
 
 

03.  08-OCTOBER-2007  MUHAMED AHMED SAEED 55 YEARS  HUGE EXTRUDED DISC C5-6 WITH MILD STENOSIS C4-5 AND C6-7 AND RADICULO-MYELOPATHIC SYNDROME .

 

 
 

Anamnesis

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The patient came to the clinic 22-September-2007 complaining of right shoulder pain for 2 years. 4 months ago got numbness and weakness right hand and the last 2 months noticed weak and numb both lower limbs.

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MRI lumbar spine done 06-May-2007 showing huge extrusion C5-6 more the left side with elements of mild stenosis at C4-5 and C6-7 levels.

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On examination: the patient limping when walking  with severe atrophy of the interossii of the left hand. Hoffmann positive both sides. There is weak grip both hands 4/5  and extension both hands: right 4/5 and left- 3/5 with severe weak triceps muscles both upper limbs -3/5. There  weak dorsiflexion both feet and the guadriceps femoris: right 3/5 and left - 4/5. There is hypalgesia all volar surface right hand and ulnar side left hand.

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MRI cervical spine done 29-September-2007 showing the same data as in the previous MRI.

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Using Inomed Highline IOM, the operation was performed using TES-MEP protocol. Discectomy of C5-6 was performed and all the compressing elements were removed, including the bony elements.

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Smooth postoperative recovery and  improvement of the power of four limbs.

Comments:

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The patient has severe compression at C5-6 and mild stenosis above and below. It was decided to decompress the spinal cord at C5-6, leaving the other levels. If, in the remote future these findings became evident, then this will be corrected accordingly.

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The disc extrusion had a protracted course, which predict relatively persistent  pain in the long postoperative course.

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Inomed Highline IOM TES-MEP mode was used in this case.

 
     
 

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