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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.

 

 
 
 
 

8.  28-FEBRUARY-2007  MUHAMED AHMAD BASALEEM  35 YEARS  SECOND RECURRENCE OF L5-S1 DISC RIGHT SIDED.

 
 

 
 

Anamnesis

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The patient was transferred from the airport arriving from YAR directly to Shmaisani hospital with agonizing right sciatica. The patient was operated for recurrence of huge disc L5-S1  27-October-2006 by me. The condition started 7 days ago, during lifting heavy object with rotational element.

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MRI performed 4 days ago showing small extrusion of L5-S1  compressing the right S1 root causing the agonizing sciatica, but with no neurological deficit.

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Considering that, he came from far with agonizing sciatica, it was decided to reoperate him. If he was a Jordanian citizen, then it was better to wait for 1-2 months to see if his extrusion shrinking, but due to socio-economic reasons, he was sent to the operating room.

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The old incision was refreshed and the right upper corner of the lamina was widened for 2 mm and the scar was removed, so as to expose the right S1 root. During this, the extrusion came out, before reaching the disc space. It was removed. The right S1 root was explored further down and inspection for more remnants revealed another small fresh pieces, which were removed.

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The disc space was so narrow, that only a tiny microswedish was able to be introduced to the disc space. A small sized pituitaries were unable to introduced to the disc space.

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The right S1 root hanging free. Routine closure of the wound.

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Immediate disappearance of the right sciatica after surgery.

Comments:

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In the previous second operation, the expectation for recurrence was minimal. But it happened 5 months later.

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During the second surgery the annulus was acceptable and the intradiscal space was not violated.

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If the disc space permit further cleaning of the intradiscal material, it is better retrospectively to perform cleaning, because even if the disc space is narrow, there could be pieces or fragments ready to slip later.

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It is still a dilemma , what exactly better for the patient to perform. Remove the extrusion without violating the disc space, or perform meticulous cleaning of the intradiscal space.

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There are cases with 5-8 time of recurrence and this phenomenon needs solution.


 

 
     
 

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