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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.

 

 
 
 
 

08.  09-NOVEMBER-2007  RASHA BASHEER AL-QAYSI  27 YEARS  ACUTE EXTRUDED DISC L4-5  RIGHT SIDE.

 

 
 

Anamnesis

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The patient was admitted to the emergency of Al-Shmaisani hospital 3 days ago with agonizing left sciatica and inability to walk for 2 days.

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On examination, SLRS was 5 degrees in the right with drop and severe weak planterflexion right foot and analgesia of the right L5 and S1 roots.

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The patient performed MRI the next day confirming the presence of extruded disc L4-5 with occlusion of the right foramen.

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The patient was in pethidine and several pain-killers I/V root and without effect.

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Right L4-5 hemiflavotomy with right L5 root foraminotomy was performed and the extruded mobile disc was removed lateral to the axilla. The root was severely compressed, that no epidural fat was surrounding it.

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Meticulous cleaning of L4-5 disc space. The root was covered by epidural fat transferred from the surround. Routine closure.

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Smooth postoperative recovery.

Comments:

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The patient has moderate sized extrusion, but with agonizing pain and severe functional neurologic loss.

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It is not the size of the disc extrusion alone play role in selection of the patients for surgery, but the relation of the extrusion to neural tissues in combination with other factors lead to the decision of surgical intervention.

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The epidural fat was transferred to the root area to minimize the scar formation around critical areas.

 
     
 

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