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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.

 

 
 
 
 

7.  24-FEBRUARY-2007  SUBHIYEH SAEED DARWEESH  61 YEARS  LUMBAR CANAL STENOSIS L3-4, L4-5.

 
 

 
 

Anamnesis

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The patient came to the clinic 11-June-2006 complaining of LBP with inability to walk for 1 year. She was complaining of LBP with bilateral sciatica  more the left for 2 years.

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MRI lumbar spine done 14-June-2006 showed severe lumbar canal stenosis L3-4 and L4-5.

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On examination: the patient was in agonizing pain with scoliotic stance with SLRS 5 degrees right side and 20 degrees left side. There was weak planterflexion and dorsiflexion both feet and hypalgesia right L5 root  and analgesia left S1 root territories.

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The patient came to the clinic another time 03-February-2007 with repeat MRI showing further escalation of her lumbar canal stenosis with clinical deterioration with bone scan demonstrating osteoporosis.

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Decompressive laminectomy of L4 and L5 with partial laminectomy of the 2/3 of the lower part of L3 lamina was achieved. Check for instability was performed and no overmobility was noted especially at the L4-5 level. The epidural fat was absent and the dura was very thin and transparent, that the running roots were under vision.

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Foraminotomy of L4, L5 roots was performed from both sides.

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

Comments:

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Lumbar canal stenosis is a progressive disease, which require surgery sooner or later.

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The sooner the intervention the better the outcome.

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Osteoporosis contribute in the escalation of the pathologic process but it's treatment cannot arrest the progression of the disease. The patient must receive osteoporosis treatment for long period of time.


 

 
     
 

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