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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 .

 

22-NOVEMBER-2008  KHALED BASHEER ALTOOD  71 YEARS  SEVERE CERVICAL STENOSIS C2-3, 3-4, 4-5 AND 5-6 WITH RADICULO-MYELOPATHIC SYNDROME.

Anamnesis:

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The patient came to the clinic 12-December-2004 complaining of LBP with left sciatica for one year. He has also pain right shoulder  with frozen shoulder for one year. He has hypertension for 15 years and underwent TUR 3 years ago.

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The patient sent for investigations and was operated elsewhere for lumbar canal stenosis.

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The patient then came 10-November-2008 with clinical picture of progressive weak both upper limbs and inability to use them with numbness both hands the last 2 months.

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On examination: the patient having difficulty in walking with weak both upper limbs more the right. The right hand grip and extension is 3/5 and biceps 4/5 and triceps right 4/5 with hypalgesia entire hand and medial aspect of the forearm.

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MRI cervical spine performed 18-November-2008 showed severe cervical canal stenosis at C2-3, 3-4, 4-5 and C5-6 with malacia of the spinal cord.

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Decompressive laminectomy of C3-4-5-6 and partial of C2 and C7. Drilling was used to make the laminae paper-like and they removed without exposing the spinal cord to operative trauma. The epidural fat was missing in all exposed levels.

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Smooth recovery with considerable improvement of the power of four limbs.


Comments

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The patient had signs of cervical canal stenosis from the first visit, but it mostly escalated the last 2 months.

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Since the major compressing elements are from behind the spinal cord, posterior decompression is the best solution of his problem.

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Using drilling of the laminae decrease the operative trauma to zero, which subsequently showing only positive changes immediately after surgery.

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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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