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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.

 

 
 
 
 

4.  15-FEBRUARY-2007  MAJIDAH FAKHRY MARAQAH  71 YEARS  SEVERE LUMBAR CANAL STENOSIS L3-4 AND L4-5 WITH FORAMINAL STENOSIS BOTH SIDES.

 
 

 
 

Anamnesis

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The patient came to the clinic 30-October-2005 complaining of LBP with left sciatica for 1 week with numbness  of the left foot. The patient is a known hypertensive and in L-thyroxin for 30 years after thyroidectomy.

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MRI lumbar spine done 21-April-2005 showed lumbar canal stenosis L3-4 and L4-5.

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On examination: the patient could not walk than 5 meters and was limping with exaggerated scoliotic stance. She had weak dorsiflexion both feet  more in the left.

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The patient was sent for another MRI of the lumbar spine and she disappeared.

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The patient came 01-February-2007 with continuous numbness both feet  and bilateral sciatica. The scoliotic stance was inverted with weak dorsi and planterflexion both feet.

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The patient sent for MRI with MRMyelography, which confirmed the presence of more severe degree of lumbar canal stenosis at the above mentioned levels.

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Decompressive laminectomy of L4 and 2/3 of L3 and 1/3 of L5 was performed with foraminotomy of L4 and L5 roots both sides. There was no epidural fat and in some places the ligamentum flavum was adherent to the dura, which was transparent and very thin, that, it was possible to see the running roots inside the dura.

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Routine closure and smooth postoperative recovery and improvement of the power of both feet.

Comments:

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Lumbar canal stenosis is a progressive disease. When there are clinical manifestations , related to the pathologic process, the sooner to operate, the better the prognosis for recovery of the neural structures.

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Inspection of the foramina is important, so as to decompress the neural structures at the root level. For that a special probe must be applied to check the patency of the foramen.


 

 
     
 

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