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
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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.
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.
MRI lumbar spine done
25-February-2008 showed spondylolisthesis L4-5
with extruded disc L3-4 more to the right.
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.
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.
The patient is a known
diabetic with hypertension with 2 stints
inserted 2002 and 2005.
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.
Routine closure of the wound
with smooth postoperative recovery.
Immediate recovery of the
power of the three limbs.
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.
In the past, posterior
decompression was associated with lot of
complications due to surgical trauma by using
the Smith-kerrisons and so on instrumentations.