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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.

 

 
 
 
 

17.  22-NOVEMBER-2007  IMAD MUHAMED HABASH  36 YEARS  HUGE EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION.

 

 
 

Anamnesis

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The patient came to the clinic 21-November-2007  complaining of LBP with left sciatica for 4 months. MRI performed 19-November-2007 showing huge extruded disc L4-5 with left downward migration.

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On examination: the patient has exaggerated scoliotic stance, limping with SLRS 45 degrees in the right and 20 degrees in the left with pain.

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He had weak dorsi and planterflexion left foot and hypalgesia left L5 and S1 territories.

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Left L4-5 hemiflavotomy with left L5 root foraminotomy was performed. The extruded fragment was completely covered by the root and axilla, that it was impossible to remove it from both routes. It was necessary to decompress the disc space first, then to proceed with piece-meal removal of the extrusion, pulling it down to the disc space, after what the major part of the extrusion could be caught and removed, after what the root and the axilla regained relaxed appearance.

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Meticulous cleaning of the disc space from the left.

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Routine closure of the wound and smooth postoperative recovery with improvement of the power of the left foot.

Comments:

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If the extrusion is fixed by the root and the axilla, it is better to start decompressing the disc space, after what the tension over the neural structures decrease, permitting removal of the extrusion with minimal traction injury to the neural structures.

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The estimated recurrence rate in this case must be minimal, since the disc space height is minimal.

 
     
 

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