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
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04-OCTOBER-2008 ISSA SALMAN HADDAD 28 YEARS
UNSTABLE FRACTURE C6 AND C7 WITH PARAPLEGIA BELOW C6 AFTER RTA 02-OCTOBER-2008.
The patient came to the
emergency of Al-Shmaisani hospital
03-October-2008 after suffering RTA
02-October-2008 with clinical picture of
paraplegia at C6 level.
MRI of whole spine performed
today showing unstable fracture of C6 and
wedging of C7 with contusion and malacia of the
spinal cord at theses levels.
On examination: the patient
had complete paraplegia below D1 and severe
paresis below C5 and paraaneasthesia below D4
left side and D2 right side.
The patient was put under
observation for vital signs and massive dose of
decadron was started.
The next day before surgery
reevaluation confirmed improvement of the power
of upper limbs with the biceps 4/5 and grip of
the hands 3/5 and extension of the hands 3/5 and
triceps 2/5 both sides.
In supine position with halo
traction 5 Kg applied to the head, anterior
approach to C5 down to D1 was achieved.
Considering that the disci were in acceptable
position, it was decided not to violate them.
Check image-intensifier showed good reduction of
the fractured C6 and C7.
Using Hybrid miniplate 48 mm
length and 6 screws, fixation of C5, C7 and D1
was performed. The C6 was not included in screw
insertion to avoid bone dislodgment during screw
insertion. Serial check X-rays confirmed good
alignment and good positioning of the construct.
Routine closure of the wound.
The power of both upper limbs improved slightly
and the patient could feel the toes with crude
sensation better at the left side.
The patient has unstable
fracture of C6 with wedging of C7.
Reduction and fixation is mandatory to prevent
further trauma to the already traumatized spinal
The improvement of the
neurological deficit is drug induced and not
related with surgery.
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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 .