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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.

 

 
 
 
 

14.  26-APRIL-2007  TAMAM MUSTAFA ISMAEEL  50 YEARS  ACUTE PROLAPSED DISC L3-4  WITH LEFT FORAMINAL COMPRESSION AND DROP LEFT FOOT.

 
 

 
 

Anamnesis

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The patient came to the emergency of Al-Shmaisani hospital 26-April-2007 with agonizing pain and inability to walk the last 10 days with shooting left sciatica.

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MRI performed yesterday, showing an extruded disc L3-4 with left foraminal compression.

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On examination, SLRS was 40 degrees in the left with pain and 50 degrees in the right. Almost drop left foot with weak planterflexion left foot. Hypalgesia of the left L5 and S1 territories.

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Left L3-4 hemiflavotomy with foraminotomy of the left L4 root was performed.  The extruded disc was removed lateral to the axilla and meticulous cleaning of the disc space from the left side was achieved. The left lateral mass was drilled from the medial side and the annulus fibrosis was widened laterally, so as to prevent pain in case of possible future recurrence.

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Routine closure of the wound after fat transfer and smooth postoperative recovery with normalization of the power.

Comments:

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Removal only the extrusion over the last three years increased the recurrence rate up to 30% with 7-10% requiring surgery.

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Meticulous cleaning also has its disadvantages. The new idea in this operation, is to provide some "free of bone space" around the root, laterally to minimize pain in case of recurrence and avoid second surgery in certain cases.

 
     
 

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