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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.

 

 
 
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7.  27-JANUARY-2007  MAWLOOD UMAR BOUR  75 YEARS  LCS L3-4. L4-5 WITH LATERAL RECESS SYNDROME AND DROP RIGHT FOOT.

 

 

Anamnesis

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The patient came to the clinic 13-January-2007  complaining of LBP with shooting right sciatica and inability to walk the last week. Mild LBP had for 2 months. MRI performed 10-January-2007 showing LCS L3-4 and L4-5.

On examination: the patient was unable to stand to see his scoliotic stance. SLRS was 70 degrees both sides. Sensation was intact, but he had drop both feet with planterflexion right foot 2/5 and 3/5 of the left foot. Both knee abduction was 2/5 with adduction 3/5 and quadriceps femores 4/5 both sides. He had normal micturition and defecation.

The patient is a known diabetic and hypertensive with bronchial asthma, for what cardio consultation was asked before the operation.

Decompressive laminectomy of L3, L4 and partial of L5 was done. The epidural fat was absent all over and the hypertrophied ligamentum flavum was inflamed in the left side and adherent to the dura. Using sharp dissection, these parts were removed.

Foraminotomy of right L4,5 and left L4 was achieved and the the foramina were checked for their patency.

Inspection of L3-4 and L4-5 disci confirmed their good alignment. They were kept intact.

Routine closure with smooth postoperative recovery with normalization of the power except the power of the right foot dorsiflexion.

Comments:

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The patient showed an abnormal course of lumbar canal stenosis: short duration and right sciatica. The weakness is more profound, than to be explained by the morphologic data. These hold the suspicion, that another provocative factor playing a role. The presence of ligamentitis of granulomatous behavior hold suspicion about sarcoidosis or other granulomatous disease.

The patient was complaining more from the right side and the pathological findings were in the left. This could be explained by the tiny structures of the nerve roots and severity of the compression. It is hard to tell, why such discrepancies taking place.

 

 
     
 

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