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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

 
08-AUGUST-2006  SAWSAN AHMAD BAKEER  46 YEARS  EXTRUDED DISC C5-6 LEFT SIDE
The patient came 13-June-1999 complaining of neck pain for 5 years with numbness of both hands  with exacerbation of the pain in the left shoulder. MRI of the cervical spine was requested and the patient disappeared.  The patient then came another time 23-July-2006 with exacerbation of the pain of the left upper limb  for agonizing pain the last week.

On examination: the patient had weak grip and extension left hand with left triceps muscle. The deep reflexes diminished in the left  and hypalgesia left thumb. MRI cervical spine performed 24-July-2006 showed huge extrusion C5-6 left side.

The patient was operated and discectomy C5-6 was performed. The dura was as soap bubble thickness, that during dissection the CSF came to the field with no identifiable source, for what the dura was covered by 2 layers of muscle harvested from the SCMM  aided with surgicele. Valsalva maneuver confirmed no CSK leak. Routine closure of the wound with prompt postoperative recover.

Comments:

1. The long presence of the extrusion  in the cervical or the lumbar , not only decrease the outcome of surgery, but also destroy the natural tissues, as in this case. The dura was very thin, transparent, which was the cause of the leak. These elements increase the morbidity and possible complications during surgery. These factors must be taken seriously in the presurgical planning.


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