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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.  20-SEPTEMBER-2007  FIDA SALEEM AL-JAMAANI  34 YEARS  EXTRUDED RECURRENCE L5-S1 RIGHT SIDE.

 

 
 

Anamnesis

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The patient came to the clinic 18-September-2005 complaining of LBP and right sciatica after the surgery which was performed 19-July-2004 elsewhere for (PLD L4-5)?.

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The patient had bilateral sciatica more in the right with hypalgesia right L5 root and weak dorsi both feet and planterflexion right foot.

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The patient was sent for MRI lumbar spine which confirmed the presence of residual after discectomy of L5-S1. Conservative treatment was planned.

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The patient then came 26-August-2007 complaining of exacerbation of LBP with right sciatica with SLRS 40 degrees both sides with weak dorsiflexion both feet with stiff back. MRI lumbar spine was asked and performed 04-September-2007, demonstrating a huge recurrence of L5-S1 right side.

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Foraminotomy of right S1 root was performed and the root was foll0wed proximally and the massive scar was dissected sharply.

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The extruded recurrence was removed and the extruded annulus fibrosis was removed also from the right with right-sided cleaning of the disc space.

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

Comments:

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The patient came with information about wrong level of intervention, without MRI data reflecting the preoperative status.

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The patient got deterioration of her neurologic status after the first surgery, as she claimed, but the performed MRI showed no convincing data for surgical intervention during 2005 period.

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The patient then came recently with huge extrusion of L5-S1, requiring surgical intervention. The patient power improved after surgery.

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The disc space is shallow, which indicate, that the recurrence rate for this case is very low.

 
     
 

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