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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.

 

 
 
 
 

6.  27-MARCH-2007 ALLAA NAEEM RADWAN  28 YEARS  FLEXION FRACTURE OF C5

 
 

 
 

Anamnesis

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The patient was transferred from another hospital with falling down three days ago, during diving, during what he got flexion facture of the C5.

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MRI cervical spine performed 26-March-2007 showing the fracture of C5 without disc prolapse  and intact spinal cord.

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On examination: the patient  is neurologically free with collar  and cut wound of the scalp in the forehead.

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Considering that the fracture is an unstable one, reduction and stabilization was suggested. 

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Discectomy of C4-5 was performed to secure the process of reduction with distraction, using the Hallo ring with 8 Kg applied with slight hyperextension.

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Using three level 24 mm length Stryker cervical miniplate, fusion of C4-6 with 18 mm screws applied with divergent angulation, to aid the distraction and consequently the reduction. The most difficult part of surgery, was to insert the construct to the intended site, due to small incision. Several check X-rays demonstrated good alignment and reduction of the bony structures.

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Routine closure of the wound and smooth postoperative recovery with improvement of the motor power both feet.

Check X-ray 6 hours after surgery after ambulation of the patient.

Comments:

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Considering that the fracture is an unstable one and cannot stand load with severe angulation and decrease of the anterior height of the body of C5 less than 10% than normal, reduction and fusion of the fracture  one level above and one level below must be done.

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To avoid slippage of the fractured C5  during reduction and fixation, discectomy of C4-5 was performed and the body of C5 was left without screwing to prevent such possible complication. This was done with visual control through the discectomy site.

 
     
 

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