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Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit  neurosurgery.fr

 

 

02-AUGUST-2008 NAJAH BASSAM MUHAMED  50 YEARS  EXTRUDED DISC C6-7 WITH LEFT DOWNWARD MIGRATION.

Anamnesis:

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The patient came to the clinic 29-July-2008 complaining of severe neck and left upper limb pain for 24 days.

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MRI performed today 29-July-2008 showing huge extrusion C6-7 with left downward migration.

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The patient was operated by me 20-June-2007 for huge extruded disc L5-S1 with left downward migration.

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On examination: the patient in agonizing pain with pain when looking to left and down  with weak grip left hand 4/5 and extension of the fingers -4/5 and profound weak left triceps muscle 3/4 and hypalgesia all the left hand and medial side of the upper limb.

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Using image-intensifier, discectomy of C6-7 was performed. The disc material was calcified, but removable with pituitaries. After removal of the extruded inside disc material the weight applied to the Hallo traction was increased from 5 Kg to 15 Kg to augment the slipping of the extrusion. Further removal of the extrusion was achieved, until the dura was seen all over the field. The extruded disc was adherent to the dura.

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Routine closure of the wound with improvement of the power of the left upper limb.

Comments

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The patient  mostly had an old extrusion with de novo extrusion, because the extruded material was adherent to dura.  This factor could predict a protracted period of recovery.

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Recurrence in cervical disc surgery is zero.

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