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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.

 

 
 
 
 

15.  20-NOVEMBER-2007  NIHAD MAHMOUD ABU-HLAL  29 YEARS  PCD C6-7 WITH RIGHT FORAMINAL OCCLUSION.

 

 
 

Anamnesis

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The patient came to the clinic 27-October-2007  complaining of neck and right shoulder pain for 1 year after lifting heavy object. MRI cervical spine performed 14-April-2007 showed extruded disc C6-7 with left foraminal engorgement. The patient improved and deteriorated the last 3 weeks.

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On examination: the patient has neck movement when looking to the left and with limitation when looking up and down ( i.e.., moving the head).

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He had weak grip and extension of the right hand and the triceps of the right arm.

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The patient was sent for another MRI of the cervical spine, which revealed huge extrusion of the C6-7 disc with complete occlusion of the right foramen.

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Using Inomed Highline ISIS HSG KHBW scenario, discectomy of C6-7 was performed with removal of the extrusion and the osteophytic bone at that area.

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Routine closure of the wound and smooth postoperative recovery with improvement of the power of the right upper limb.

Inomed ISIS Highline with HSG KHBW Scenario.

Comments:

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Using IOM prevent possible complications during surgery, even in the remote sites of the CNS, as in this case the AEP was stable all the time and symmetrical from both sides and SEP with the medianus N20 and tibialis P40 were stable all the time from both sides during the surgery. MEP at times was recorded and it was acceptable. The successive EMG from both glossoph, thenar  facials and hypoglossi  both sides, were acceptable during the whole procedure.

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The preparation for setup for such iom protocol, is time-consuming and with time, the sense of normalcy and when to use such technology will grow and becoming established.

 
     
 

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