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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.

 

 
 
 
 

06.  11-AUGUST-2007  AMNEH ABDEL-FATTAH AL-QANNAS  70 YEARS  RIGHT FAR-LATERAL DISC L4-5 WITH FORAMINAL STENOSIS AND SMALL EXTRUDED DISC L5-S1 COMPRESSING THE RIGHT S1 ROOT.

 

 
 

Anamnesis

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The patient came to the clinic 06-June-2007 complaining of right sciatica for 2 weeks with LBP for 5 years. Using crutches for 1 week and positive cough sign.

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MRI lumbar spine performed 31-May-2007  showed PLD L4-5 right far lateral with foraminal occlusion and small extrusion L5-S1 right side touching the right S1 root.

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On examination: SLRS 30 degrees in the right and 70 degrees in the left with hypalgesia right L5 territory and weak dorsiflexion right foot 3/5.

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The patient was advised to continue in conservative treatment, but she came 05-August-2007 confirming no improvement at all.

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On examination the hypalgesia is wide spread to involve the right L4-5 and S1 roots with weak dorsi 3/5 and planterflexion 4/5 of the right foot.

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Right hemilaminectomy of L5 with foraminotomy of both L5 and S1 right side was performed. Meticulous cleaning of L4-5 was performed from the right and the foramen was checked for patency and redundancy for the running root. Inspection of the right S1 root revealed a mobile small extrusion compressing the root. This extruded piece was removed without violating the L5-S1 disc space.

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Smooth postoperative recovery.

Comments:

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The patient before surgery had major problem at L4-5 level, which brought her to surgery. During surgery, the extruded small disc at L5-S1 was more convincing for her agonizing pain.

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The L5-S1 disc space was not violated, so as to make the postoperative course more easier and to limit the inflammatory process in case of possible involvement in the future, considering that the patient is a known diabetic.

 
     
 

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