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
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23-FEBRUARY-2012 AYISHAH HUSSEIN MUHAMED 65 YEARS
SEVERE DORSAL CANAL STENOSIS D3-D6 AND D9-D11 WITH MALACIA OF THE SPINAL CORD AT
patient is a Libyan citizen came to the clinic
08-February-2012 complaining of difficult
walking after surgical intervention performed in
Libya 15-January-2009. Fixation of L4-5 and S1
was performed at that time. The patient
continued to deteriorate and MRI cervical spine
performed 06-October-2011 showing small disc
C6-7 , but dorsal MRI showing severe stenosis of
the canal at D4-5, D5-6, D10-11 and D11-12.
examination, the patient cannot walk with severe
atrophy of both lower limbs. There is profound
weak both lower limbs 3/5 of all muscles.
Babinski sign was positive both sides, but there
was no clonus. No sensory deficit.
patient was sent for further evaluation. MRI of
the brain performed 20-February-2012 showing
scattered lacunar infarctions both cerebral
hemispheres. MRI dorsal spine performed
13-February-2012 showing severe stenosis at the
above mentioned levels with malacia of the
spinal cord at these levels. The stenotic
elements were due to ligamentum flavum
In prone position,
skeletonization of D1 down to D5 was performed.
The patient has massive bleeding tendency. She
lost in this stage 750 ml blood. Considering her
age, it was decided to perform the upper part of
the surgery and laminectomy of D2-5 with partial
of D1 and D6. All the compressive elements were
eliminated. There was no epidural fat at the
area of exposure.
closure of the wound. Smooth postoperative
recovery with improvement of the power of both
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It was planned to perform the 2 surgeries, but
due to massive bleeding tendency, it was decided
to postpone the second surgery for several days.
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 .