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Multigen RF lesion generator .

03-APRIL-2002  SALEH ALI BAMETRIF  71 YEARS  PATHOLOGIC DESTRUCTION D1 AND THE RIGHT SIDE OF THE LAMINA WITH DENSE PARAPLEGIA AND ANESTHESIA.

Comments  

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The patient immediately start to show some recovery, but the atrophic condition of the muscles with rigidity, needs long time to recover partially. He was neglected and surgery must be done in the early stages, before irreversible changes took place.

Anamnesis

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The patient a Yemeni citizen came to Jordan with dense paraplegia and anesthesia below D1 for 12 months with gradual deterioration with incontinent for urine and defecation and atrophy of the muscles of both lower limbs, more pronounced in the right side. MRI done recently showing destruction of D1 with severe compression of the spinal cord with tumorous involvement of the body and right lateral mass and the right side of the lamina.

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On examination: The patient is bedridden with Foley's catheter. Dense plegia-anesthesia below D1. Spastic pattern both lower limbs and atrophy of the muscles. Cannot control defecation.

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Combined anterior and posterior approach was applied. Anterior approach was used to remove all the pathologic tumorous D1 vertebra and using large diameter Cloward instrumentation, an iliac graft was harvested and fixed to Scientx cervical plate and fusion of C7 and D2 was achieved. All stages of surgery were under C-arm guidance. The wound was closed and posterior approach was performed and all pathologic tumorous bone was removed and the right tumorous lateral mass was removed with preservation of the right running root. Using Luque rectangle, bended to accept the normal curve of the area with sublaminar wires, fixation of C6,7, and D2,3 was achieved. Practical radical removal of the tumor was achieved.  The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak.  Routine closure of the wound.

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Smooth postoperative recovery. The power of the legs improved. He was sent to the ward.

Follow Up

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The final histologic result was metastatic adenocarcinoma of gastrointestinal origin. The patient was in Yemen and by telephone communications and fax was advised to be seen by oncologist, but they told me that there is no oncologist there.

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As I understood from a fax 15-October-2002, that he is controlling his urination and defecation and walking with help and they told me that they want to go to Umra at Saudia, and I advised them to be seen there by oncologist.

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.


Inomed Riechert-Mundinger System, with three point fixation is the most accurate system in the market. The microdrive and its sensor gives feed back about the localization.


Inomed MER system

Leica HM500

Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

LooksCam II in the run.
LooksCam II Xenosys in the run  starting from  14-March-2021 with SheerVision TTL x4 magnification.

Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

WELCOME TO AL-SHMAISANI HOSPITAL

 


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