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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

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Multigen RF lesion generator .

 

19-JUNE-2008  INTISAR ALI SALAH  38 YEARS  HUGE EXTRUDED DISC C5-6 RIGHT SIDE.

Anamnesis:

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The patient came to the clinic 13-October-2002 with LBP and left sciatica for 2 months and numbness of the left upper limb for 1 day with neck pain for 5 months.

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On examination: the patient had ganglion left wrist dorsal aspect with weak grip and extension left hand with hypalgesia left L5 and S1 territories and weak dorsi and planterflexion left foot.

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MRI lumbar spine performed 18-October-2002 was normal and MRI cervical spine showed PCD C5-6 central localization. The patient was advised to be treated conservatively.

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The patient then came 16-May-2008 complaining of severe neck pain with right radicular signs for the last three weeks. She had limitation of neck with pain when looking to left and up and downward. She had weak grip and extension right hand with weak right triceps muscle 3/5. There is also hypalgesia right median nerve distribution.

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MRI cervical spine performed 24-May-2008 showed huge PCD C5-6 with extrusion right side. She was advised to undergo surgery but the patient escaped.

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The patient then came with agonizing pain with inability to sleep for 4 days. She was afraid of surgery. She was planned for yesterday, but she did not come. She came the morning of this day asking for surgery.

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Using anterior approach and image-intensifier, discectomy of C5-6 was performed and the extruded disc was removed. The dura was inspected and the remnants of the extrusion were also followed and removed.

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Smooth postoperative recovery and the power of right upper limb improved dramatically.

Comments

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The recurrence rate in cervical disc surgery is zero.

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One level discectomy usually not require stabilization of insertion of artificial devices.

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Inspection of the remnants of the extrusion is the integral part of this surgery. Leaving such remnants could make the patient continue to complain.

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Notice: Not all operative activities can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also escaped from the plan .

     

  

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