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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.  13-FEBRUARY-2007  RANA MASH-HOOR AL-ASSAF  27 YEARS  EXTRUDED DISC L5-S1 WITH LEFT UPWARD AND RIGHT DOWNWARD MIGRATION.

 
 

 
 

Anamnesis

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The patient came to the clinic 03-February-2007 complaining of LBP with left sciatica for 2 months.

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MRI lumbar spine done 23-January-2007 showed prolapsed lumbar disc L5-S1  with bilateral extrusion with left upward and right downward migration.

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On examination: the patient had exaggerated scoliotic stance and limping during walk. SLRS was 30 degrees in the left with pain. Weak dorsiflexion all toes left foot.

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Bilateral foraminotomy of both S1 roots was performed and the left root was inspected and the extrusion was removed under the left axilla.

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The contralateral disc surface was checked for extrusion. There was still a huge extrusion, for what the extrusion was removed and bilateral cleaning of the disc space was performed meticulously. Epidural fat transfer to minimize postoperative scar formation and give the roots more natural anatomy.

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Routine closure with fat transfer and smooth postoperative recovery and normalization of the left foot power.

Comments:

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The disc space was wide and the disc material was removed meticulously. These factors make the incidence of recurrence around the average of 7%.

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Despite the fact, that the disc extrusion was migrating upward in the left, but for certain anatomical relationship, the removal was done from under the axilla. The right downward migrating part was removed lateral to the right axilla. This was done to minimize the surgical trauma with minimal traction of the roots during surgery.


 

 
     
 

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