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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.

 

 
 
 
 

18.  30-AUGUST-2007  NIDAL HASSUNEH YOUSEF  37 YEARS  EXTRUDED DISC L4-5 WITH RIGHT DOWNWARD MIGRATION.

 

 
 

Anamnesis

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The patient came to the clinic 03-June-2007 complaining of LBP with left sciatica for three days.

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On examination: he was limping and had exaggerated scoliotic stance with right sciatica  with SLRS was 30 degrees in the right with pain with weak dorsiflexion all toes right foot - 2/5. He was advised for surgery, but disappeared.

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The patient came 28-August-2007 urging for surgery.

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MRI performed 02-June-2007 showing huge extruded disc L4-5 more to the right.

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Right  1/3 L4-5 flavotomy with foraminotomy of right L5 root was performed. The extruded disc was pushing the right L5 root medially, for what it was attacked and removed lateral to the axilla. The migrated down piece was completely separate, for what it was sought behind the root and removed in two pieces. Meticulous cleaning of the extrusion and the disc space from the right side.

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Routine closure and smooth postoperative recovery and normalization of the power of both feet.

Comments:

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The patient had a separate migrated downward piece of disc material. Foraminotomy and exploration of the root and around the root is mandatory part of any disc surgery, so as not to miss a piece and to find the patient complaining after surgery.

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The epidural fat was preserved and reflected back to place around the root to prevent postoperative fibrosis.

 
     
 

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