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05-MARCH-2011  BASIMA MUHAMED AL-HADDAD  58 YEARS  EXTRUDED DISC C3-4 WITH ELEMENTS OF SPONDYLOLISTHESIS.

Anamnesis

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The patient came to the clinic 13-May-2009 complaining of neck pain for 6 months with numbness both hands  with bilateral CTS for 5 years.

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On examination she had pain when turning the head to the right with weak grip 4/5 and extension 3/5 both hands and right triceps muscle 4/5. She had severe atrophy of both thenar muscles for 10 years with hypalgesia both median nerves distribution.

bullet MRI cervical spine done 16-May-2009 showed small extrusion of C3-4 and C4-5 with data confirming the presence of severe CTS both sides. She was advised to undergo CT-release, but she disappeared.
bullet The patient then came 24-February-2011 complaining of exacerbation of neck pain the last week with shooting pain to the right shoulder and right upper limb. She had severe limitation of neck movement with pain when looking up and to the right. The neurological deficit in comparison to the previous one was worse.
bullet

New MRI cervical spine performed and done 25-February-2011 showing huge PCD C3-4 with elements of spondylolisthesis at this level.

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Anterior discectomy C3-4 was performed with osteophytectomy. The dura was seen at the entire width of the disc space. After several trails, Fidji cervical cage 12X14X7.7 mm was inserted. Using cervical plate Zimmer Trinica 24 mm length one level  with screws 4.2X14 mm length, fusion of C3-4 was achieved.

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Routine closure of the wound. Smooth postoperative recovery with improvement of the power of both upper limbs.


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

Comments

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The patient progressed compression of the anterior spinal artery of the spinal cord at C3-4 level with elements of spondylolisthesis.

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Surgical decompression with fusion is the proper solution to prevent catastrophic possible sequel.

 


 

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