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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.

 

 
 
 
 

15.  30-APRIL-2007  AMAL MUHAMED AL-ATAWY  24 YEARS  WIDE-BASED EXTRUSION L5-S1 WITH LEFT SCIATICA AND WEAK BOTH FEET.

 
 

 
 

Anamnesis

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The patient came to the clinic 20-November-2006 complaining of left sciatica down to the S1 root territory.

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MRI performed 11-November-2006 showed wide-based huge extrusion of L5-S1 disc, more to the left. On examination, SLRS was 90 degrees both sides with only weak dorsiflexion left foot - 4/5.

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MRI repeated the same day and the disc extrusion is the same. The patient was advised to undergo surgery.

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The patient then came 02-April-2007 with new MRI  done the same day, showing the same extrusion. SLRS was 75 degrees in the left with pain and weak dorsi and planterflexion left foot.

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Bilateral L5-S1 flavotomy was done and the hard extrusion was removed from both sides and meticulous cleaning of the disc space was performed from both sides. All the rubbery extrusion with the calcified annulus were removed.

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Smooth postoperative recovery.

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. In this case it was necessary to remove all the extruded elements including the calcified annulus fibrosis to achieve adequate decompression.

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Fat was harvested from near by soft tissues and transferred to the roots.

 

 
     
 

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