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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  neurosurgery.tv

 

06-SEPTEMBER-2006  KHADIJEH KHALED AWWAD  60 YEARS  PCD C3-4 AND C5-6 WITH INVERTED CURVATURE OF THE CERVICAL SPINE AND MALACIA OF THE SPINAL CORD AT THESE LEVELS.

The patient came 27-July-2003 complaining of LBP with bilateral sciatica with numbness of the right foot. She could not walk more than 100 meters. MRI lumbar spine performed 28-November-1995 showed LCS L2-3, L3-4 with spondylolisthesis L4-5 and L5-S1. On examination at that time, she had weak dorsi and planterflexion both feet. MRI of the lumbar spine with dynamic studies were requested and given medications and MRI showed spondylolisthesis L3-4 and L4-5 with isthmolysis. The patient was advised to undergo surgery for discectomy L3-4 and L4-5 with transpedicular fixation. The patient performed surgery elsewhere.

The patient came 29-August-2006 complaining of neck pain shooting to the left shoulder for one year with cephalic pain. She had numbness of the left ulnar distribution  with Hoffmann positive both sides with weak grip, extension left hand and left triceps muscle. She had hypalgesia of the left ulnar distribution with weak dorsiflexion right foot and hypalgesia right L5 territory. The patient was sent for MRI of the cervical spine, and it was done 30-August-2006 and showed PCD C3-4 and C5-6 with inverted curvature of the cervical spine with malacia of the spinal cord at these levels.

Considering that the malacia is due to dynamic repetitive injury of the spinal cord from the underlying causes, it was decided to undergo surgery.

Discectomy of C3-4 and C5-6 was performed and using Stryker three level miniplate with screws, fusion of the cervical spine between C3-6 was achieved.  Correction of the inverted curvature was noted after fusion. Routine closure and postoperative recovery.

Comments:

1. The previous case performed yesterday, has a lot of similarities, but the plan of surgery was different. That was because the patient's malalignment of the cervical spine played a major role in repetitive microtrauma to the spinal cord.  The aim of surgery was to reduce the alignment  to push away the bodies of C4 and C5 from the spinal cord, preventing by this means the repetitive trauma.


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[2006] [CNS CLINIC - NEUROSURGERY - JORDAN]. All rights reserved