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13-MARCH-2008  MUHAMED SAEED AL-NOBANI  71 YEARS  SEVERE CERVICAL CANAL STENOSIS C2-3, 3-4, 4-5 AND C5-6.

Anamnesis:

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The patient came to the clinic 27-February-2008 complaining of numbness both hands with neck pain for 3 years. The last month progressed LBP with left sciatica and inability to walk.

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MRI lumbar spine done 25-February-2008 showed spondylolisthesis L4-5  with extruded disc L3-4 more to the right.

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On examination: the patient came in wheelchair. Weak flexion and extension of the right hand and right triceps muscle 4/5. There is weak dorsiflexion both feet 4/5. The patient was sent for MRI of the cervical spine.

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MRI cervical spine performed 01-March-2008  showing stenosis of the cervical spinal canal at C2-3, 3-4, 4-5 and C5-6, with malacia of the spinal cord.

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The patient is a known diabetic with hypertension with 2 stints inserted 2002 and 2005.

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Decompressive laminectomy of C3-4-5and 6 and lower 2/3 of C2 and upper third of C7 was done using the high speed drill. The epidural fat was absent at most of the levels. All compressing elements were eliminated.

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Routine closure of the wound with smooth postoperative recovery.

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Immediate recovery of the power of the three limbs.

Comments

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Posterior decompression of the cervical spine in CCS seems to be more acceptable than the anterior approaches, using the new modifications with the high-speed drilling. By this method surgical trauma becoming to zero.

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In the past, posterior decompression was associated with lot of complications due to surgical trauma by using the Smith-kerrisons and so on instrumentations.

 

 


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