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The patient was admitted to
Al-Shmaisani hospital with clinical picture of
paraplegia below C5 after suffering RTA
25-October-2008. The patient was sent to the ICU
to observe the vital functions. His breathing
pattern was affected, but tolerable, due to
absence of chest wall movements. He was
hypertensive and he showed rhythmic
bradycardia. The patient has hallucinations 15
years ago. He has fracture left clavicle.
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On examination: total
paraplegia of all muscles and sensation below
C5. |
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MRI
cervical spine was performed and showed
contusion of the spinal cord starting from C3
down to D3. The body of C6 was wedging and the
anterior osteophytes and the posterior calcified
longitudinal ligaments were fractured with huge
disc extrusion of the C5-6 compressing the
spinal cord. |
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Osteophytectomy was performed
over C5-6-7. The extruded disc C5-6 was removed.
There was no tear in the dura, but it was
contused. All the steps of the operation were
performed with traction 5 KG with slight
extension. Before applying fixation, it was
necessary to put the neck in flexion position to
bring the anatomical structures in acceptable
position, after what using Hybrid cervical
miniplate with 6 screws were used to fix C5-6-7. |
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All the steps of the
operation were guided with image-intensifier.
Smooth recovery with the same neurological
status. |
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The patient started to show
deterioration of his breathing pattern , for
what he was put in ventilator the morning of
30-October-2008. The patient was taken to the
operating room and tracheostomy and continuous
drainage of the lumbar CSF was achieved by
inserting tube subdurally in the lumbar spine,
using Touhy needle gauge 14. |
