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15-MARCH-2003 RIMA RATEB ABDEEN 42 YEARS OVERMOBILITY
OF C4-5.
Comments
The recurrence rate in cervical disc is
zero.
Fusion of one level could trigger
overmobility the adjacent near by level, which could have
place before the first surgery.
The upper right screw broke after 9
years.
Anamnesis
The patient came to the clinic 02-March-2003
complaining of neck pain with exacerbation the
last 20 days. She was operated in February-1999
for PCD C5-6. She was seen by cardiologist and
she was normal. Cervical X-ray done
01-March-2003 showing fusion of C5-6. She is a
known diabetic for 5 years in treatment and
receiving L-thyroxin for 2 years.
On examination: the patient in pain, has neck
pain exacerbated with turning the head to all
directions. There is weak grip and extension
left hand 3/5 and left triceps muscle.
The patient was sent for investigations. There
is small osteophyte at the left corner of C5-6.
Dynamic studies showing overmobility of C4-5.
Through the previous approach,
discectomy C4-5 was achieved under the control of
C-arm. Using drilling the C5-6 was created to
decompress the osteophyte of C5-6 left side. Using
Scientx 2 level construct with 6 screws fusion of
C4-5-6 was achieved and check by C-arm was
confirmed. Routine closure of
the wound
Smooth postoperative recovery.
The radicular pain decreased and the power of left
hand normalized. She was sent to the ward.
Follow Up
The patient came to the clinic 29-March-2003
with clean wound with improvement of the grip
and extension left hand, but still weak left
triceps muscle.
The patient then came 02-July-2003 with check
X-ray showing good alignment of the construct
and complaining of pain left elbow and weak left
triceps muscle.
She was treated conservatively.
The patient then came 06-July-2004 complaining
of LBP with right sciatica for 1 month down to
the L5 territory. Sent for MRI lumbar spine,
performed 10-July-2004 showing bulge D12-L1,
L1-2 and L4-5. She was treated conservatively.
The patient then came 10-November-2012 with
cervical X-ray showing fracture of the upper
right screw in half inside the bone and
outer part migrated down to the left. She was
sent for investigations and MRI cervical spine
performed 14-Novemebr-2002 showing gliosis
behind C5 level.
The patient then came 18-September-2019 and
31-August-2020 with manifestations of
arteriosclerosis and lacunar infarctions and
rheumatoid arthritis. She was treated
conservatively.
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
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Inomed MER system
Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
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 .
