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17-APRIL-2008  SHAHNAZEER FAWZY AL-BAYRAQ  64 YEARS  SEVERE CERVICAL CANAL STENOSIS C3-4, 4-5 AND 5-6 WITH MALACIA OF THE SPINAL CORD AT C4-5.

Anamnesis:

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The patient came to the clinic 08-April-2008 complaining of both shoulders pain and neck and numbness both hands. The patient cannot sleep due to pain.

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On examination: the patient have limitation with pain when looking to both sides. The power of all muscles upper limbs were 3/5 except the right deltoid, which was 5/5. There was no sensory deficit nor pathologic reflexes.

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SLRS was 90 degrees both sides with weak dorsiflexion both feet 4/5.

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MRI of the lumbar spine performed 10-April-2008 showed severe cervical canal stenosis at C3-4, C4-5 and C5-6 with malacia of the spinal cord at C4-5 level.

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Decompressive laminectomy of C3-4 and 5 with partial of C2 and C6 was performed. All the bony and connective tissue compressive elements were removed, using the high-speed drill.

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Routine closure of the wound with smooth postoperative recovery.

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Mild improvement of the power of the four limbs.

Comments

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MRI of the cervical spine in transverse sections rarely show the compressive elements from posterior. It seems, that during motion and in the setting position the compressive elements play their role, but these compressive elements are dramatically noticed in the axial views and MRMyelography, as in this case.

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