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06-APRIL-2011  HASAN MUSA AL-KOOZ  73 YEARS  PCD C4-5.5-6 AND C6-7 WITH MALACIA OF THE SPINAL CORD WITH TETRAPARESIS.

Anamnesis

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The patient came to the clinic 25-December-2006  complaining of neck and both shoulders pain for 2 weeks more the right. At that stage he had weak right hand and right triceps muscle 4/5.

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The patient then came 09-January-2007 with MRI of the cervical spine performed 26-December-2006 showing deformation of C4-5-6 with PCD C4-5 and C5-6 and malacia of the spinal cord and he was advised to undergo surgery, but he escaped.

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The patient then came 02-April-2011 with MRI of the cervical spine done 26-March-2011 showing PCD C4-5, 5-6 an 6-7 with malacia of the spinal cord.

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The patient underwent KABAG 2007 and CT-angio done 28-March-2011 was uneventful. The patient is a diabetic for 2 years in treatment.

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On examination: the patient walking bended with weak four limbs, more the left side. The weakness of both hands grip and extension is 4/5, both triceps 3/5. The lower limbs muscles are 4/5 except for profound weak dorsiflexion both feet 3/5.

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Discectomy C4-5. 5-6, 6-7 with osteophytectomy was done to eliminate all the compressive elements. Using Fidji cages 14x18x6.9 mm were inserted to C4-5 and C6-7 levels. A cage 14x17x6.9 mm was inserted to C5-6 level. Novabone was added to the cages. Trinica Zimmer cervical plate 3 level 54 mm length was applied with 8  cervical screws 4.2x16 mm length were used to fuse C4-5-6-7 bodies.

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Routine closure of the wound. Smooth postoperative recovery with improvement of the power of four 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 spinal cord compression is increasing over the time and the malacia which was present from the start with the clinical deterioration, all indicate that surgical decompression is the only solution to prevent further future deterioration.

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Fidji cages are superior among other cages, because their contour respect the normal alignment of the disc spaces, minimizing possible future sinking or dislodgment.

 


 

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