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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05-FEBRUARY-2012 SAAD SUOUD ABU-ZAYED 59 YEARS
SEVERE CERVICAL CANAL STENOSIS C4-5, C5-6 WITH MALACIA OF THE SPINAL CORD.
patient came to the clinic
26-January-2012 complaining of numbness both
hands more the right for 2 years and both
shoulder pain for 2 months. The patient
underwent right carpal tunnel release 10May-2010
without any improvement. The patient claiming
that his condition is deteriorating.
MRI cervical spine done 26-April-2011 showing
stenosis at C4-5 with malacia of the spinal cord
at the same level. MRI repeated 31-August-2011
showing progression of the malacia.
examination, the patient weak right upper limb
muscles -4/5 and the left triceps -4/5 with
hypalgesia of the entire right hand. Hoffmann
sign was positive in both sides. Babinski was
positive in both sides, more brisk in the right
side with weak dorsiflexion right foot -4/5 and
left foot 4/5. There was pronounced clonus both
MRI of the
cervical spine with myelography was performed 30-January-2012
showing small disci C4-5, C5-6 with stenosis at
these levels with malacia of the spinal cord.
In supine position, with the
head slightly flexed with Hallo traction with 5
Kg traction, laminectomy of C4,5 and partial of
C3 and C6 was achieved. There is missing
epidural fat at the compressed level.
closure of the wounds. Smooth postoperative
recovery with normalization of the power of four
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The patient has progressive cervical
canal stenosis with deterioration clinically and
morphologically over the time. Surgical intervention is the
only way to stop progression.
Why power recover immediately after
surgery, despite the presence of malacia is still
un-understandable, but parabiosis could have place, which
disappear after decompression.
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 .