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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.tv

 

 

02-DECEMBER-2006  ABDOH MUQBIL AL-WAJEH  63 YEARS  SEVERE CERVICAL CANAL STENOSIS C4-5 AND C5-6 WITH DENSE QUADRIPARESIS.

The patient came to the clinic 27-November-2006  complaining of neck pain for 2 years with right upper limb pain with spastic quadriparesis last 2 months with ataxic gait. MRI cervical spine performed 3 years ago showed stenosis at C4-5 level without malacia of the spinal cord.

On examination: the patient walking with help with Dupuytren's disease with OA both knees  and frozen right shoulder. The patient had hypalgesia of the radial side of the forearm and severe weak right arm. The patient was sent for MRI of the brain with MRA of the brain and carotids and MRI of the cervical spine with MR Myelography, which was performed 29-November-2006 confirming the escalation of his cervical canal stenosis at C4-5 and C5-6 with malacia of the spinal cord at the C4-5 level.

Discectomy of both C4-5 and C5-6 was performed with complete decompression of the dura at the C4-5 level and fixation of C4-5-6  using Stryker brand of miniplates and screws. The ossified anterior edges of the C4 were nibbled to have the construct fitting in acceptable position.  Smooth postoperative course.

Comments:

1.  CCS is a progressive disease and when the patient start to have progressive neurologic deterioration, surgery must be performed to prevent further deterioration.

2.  Anterior decompression is superior than posterior decompression, when the compressing agents are located anteriorly, as in this case. If decompression was performed at one level then fixation is not needed, but when multilevel decompression is performed, then fixation must follow.

 

 


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[2006] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved