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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

 

 

23-DECEMBER-2006  KHALED ABDEL-KAREEM KHLEFAT  40 YEARS  DORSAL CANAL STENOSIS D10-11, D11-12, D12-L1

The patient came to the clinic 02-November-2006  in wheelchair complaining of LBP with numbness of the legs for 10 months  and numb both hands for 3 months. The condition is deteriorating with disturbance of micturition for 3 months.  MRI of the cervical spine performed 25.February-2006 showing huge disc C3-4  with malacia of the spinal cord at that level.

On examination: the patient has weak both upper limbs, more the hands 3/5 with hypalgesia palmar side of both hands. He has hypalgesia below the right L1 and left Th10 with dense analgesia both lower limbs. He has paraparesis -plegia of both lower limbs more the left. The patient was sent to perform MRI of the cervical and dorsal spine, which were done showing regression of the PCD C3-4 and severe dorsal canal stenosis D10-11, D11-12 and D12-L1 with malacia of the spinal cord at D11-12.

Decompressive laminectomy D11-12 and partial of D10 and L1 was performed. Drilling was used to avoid surgical trauma during decompression. There was no epidural fat all over and the dura was very thin and transparent. Inspection of D11-12 disc revealed that it is old and calcified and it was decided not violate it.

Smooth postoperative recovery.

Comments:

1.  Dorsal canal stenosis is a rare condition and as in this case he was treated for MS or amyotrophic lateral sclerosis.

2.  Drilling help minimize surgical trauma. The lamina were drilled so that they became paper-like and they crust by pressure from inside and the ligamenta flava bulged out  without using Smith-Kerrison rongours.

 

 


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