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-JANUARY-2012 ABDALLAH NADA AL-ABDALY 58 YEARS
CERVICAL CANAL STENOSIS C3-4 AND C5-6 WITH SPINAL CORD MALACIA.
patient came to the clinic 26-December-2011
complaining of neck pain for 8 months and
numbness of the left side of the body for 1
month, sudden onset and both lower limbs with
ataxia. The patient is a known diabetic and had
episode of right VI nerve paresis 2 months ago,
which resolved within week. MRI of the brain
done 19-November-2011 almost normal. MRI
cervical spine showing severe cervical canal
stenosis C3-4 and C5-6 with malacia of the
spinal cord at these levels.
examination, the patient has
unstable stance with Romberg test falling to the
left. There is weak biceps muscle, grip and
extension of the hand 4/5. DTRs are exaggerated
in the left with Hoffmann sign positive in both
sides. DTRs are exaggerated in both lower limbs
and Babinski positive in both sides. There is
weak dorsiflexion left foot 4/5 with hypalgesia
left L5 root.
In prone position, with
slight flexion of the neck, decompressive
laminectomy of C3-4-5 and C6 was done wide up to
the border of the lateral masses. There was no
epidural fat at these levels and after the
decompression, the dura became wide and lax.
closure of the wounds. Smooth postoperative
recovery with improvement of the power of the
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The patient had cervical canal stenosis with the
compressing elements from behind. In this case,
posterior decompression is the logical solution
of the problem.
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 .