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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

 

21-SEPTEMBER-2006  SAMI KAYYED AL-HINDAWY  52 YEARS  SEVERE CCS C3-4, 4-5 AND 5-6 WITH PCD AT THESE LEVELS  AND ASSIMILATION C2-3.

The patient  came to the clinic 17-September-2006 complaining of neck pain for 20 years. The last 7 months he progressed weakness of both lower limbs, then weak both upper limbs. MRI performed 06-September-2006 (bad quality) showed severe stenosis of C4-5, C5-6 and C6-7 with assimilation of of L3 and 4.

On examination: the patient is using crutches for 12 weeks. There is pain with limitation of neck movement for all directions with weak left deltoid and both biceps brachii, grip and extension both hands and triceps both upper limbs with weak quadriceps femoris right leg. abduction left knee and dorsiflexion both feet and planterflexion right foot. Hypalgesia entire lateral aspect of the right upper limb down to the median division of the right hand and the left C5 territory. He had SLRS 40 degrees both sides due to weakness and Babinski was positive bilaterally.

MRI of the cervical spine was requested and performed, which showed assimilation of C2-3 with PCD C3-4 and huge PCD C4-5 and C5-6 with malacia of the spinal cord at the last 2 levels.

Discectomy of C3-4, C4-5 and C5-6 was performed and fusion of the C3-6 was achieved. Routine closure and smooth postoperative recovery.

Comments:

1.  Despite the small PCD of C3-4 , it was decompressed and included in the fusion to prevent future escalation of problems, since the stress points will be increased several times at this level, if this was not performed.

2.  A lot of companies produce cervical miniplates, and this Zefeer brand, despite its low profile, has several disadvantages, among them, the inability to see the disc spaces properly. Anyhow, there is no perfect device and every one has its pros and cons.


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