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02-OCTOBER-2010  KHALDOON BAJES AL-KHZUZ  41 YEARS  PCD C4-5 AND C5-6  WITH QUADRIPARESIS.

Anamnesis

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The patient came to the clinic 23-September-2010 complaining of neck pain for 1 year with both upper limbs pain and numbness four limbs with exacerbation the last 2 weeks. Cath was done 2006.

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MRI cervical spine performed 20-September-2010 showing PCD C5-6 compressing the spinal cord and to lesser degree the C4-5 with left partial foraminal occlusion.

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On examination: The patient has severe pain and limitation of neck movement to all directions. The grip and extension and triceps of both upper limbs are 3/5. There is hypalgesia of the middle finger left hand. There is weak dorsiflexion both feet  and quadriceps muscles both lower limbs 4/5.

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Discectomy of C4-5 and C5-6 was performed until the dura was seen, so as not to miss any compression. Fidji cages 17X6.9X12 mm inserted to C4-5 level and 17X6.1X12 mm to C5-6 with Novabone. Trinica 44 mm 2 level cervical plate was used to obtain fusion of C4-5-6 with 6 screws 14X4.2 mm. All stages of surgery were performed under image-intensifier guidance. 

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Routine closure of the wound and smooth postoperative recovery and the power of all limbs became normal.


Comments

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The patient had tetraparesis, which resolved immediately after surgery. This means that parabiosis of the neural tissues was the leading factor for such neurological deficit.

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The fusion with cage implementation is the ideal option, because inserting 2 cervical disc systems, first it is costly and second: it has the disadvantage of possible slipping.

Please! wait for 3-5 min till the video start to load. It depends upon the internet connection.

Trinica Zimmer cervical miniplate

 

 


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