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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.

 

 
 
 
 

8.  11-APRIL-2007  AHMAD MUSA AL-JALOUDY  43 YEARS  LCS L3-4, L4-5 WITH EXTRUDED DISC L3-4 LEFT SIDE

 
 

 
 

Anamnesis

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The patient came to the clinic  2 months ago complaining of LBP for 4 months with with left sciatica and weak dorsiflexion left foot  and hypalgesia of the left L4 territory.

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MRI lumbar spine done at that time showing extruded disc L3-4 with left downward migration and bulge L4-5 with segmental stenosis at these levels.

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The patient was given the opportunity to try conservative treatment, but he came 08-April-2007 confirming that his condition is deteriorating.

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On examination: The patient had scoliotic stance. He had SLRS 40 degrees both sides with shooting sciatica left side. He had severe weak dorsi and planterflexion both feet and hypalgesia both forelegs below the knee.

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Decompressive laminectomy L4 and partial of L3 and L5 with foraminotomy of both L4 and L5 roots left side.

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Inspection of the L3-4 disc showed extrusion, mandating removal of the extrusion from the left side with meticulous cleaning of disc space from the left side, after what the left L4 root became relaxed.

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The epidural fat was preserved during surgery to minimize postoperative scar formation.

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Smooth postoperative recovery and normalization of the power of both feet.

Comments:

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The patient in the first visit was in clinical status, that surgery could be avoided, for what surgical treatment was not decided at that time.

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The deteriorating clinical picture made it clear that surgery is indicated.

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The patient is a tall person and the spinous processii were abnormally long, requiring long incision.

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Preservation of the epidural fat and using it to cover the most mobile neural parts is the best solution to prevent scar formation and ease his pain in the long run.

 

 
     
 

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