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-MARCH-2009 JAMAL ALI HASAN 47 YEARS RTA 1
WEEK AGO WITH FRACTURE DISLOCATION D3 AND PARTIAL OF D2 AND D4.
The patient was transferred
from Saudi Arabia 21-March-2008 to Shmaisani
hospital after suffering RTA 5 days ago with a
history of LOC for several hours and when awaked
he was paraplegic below D2 both sides.
MRI whole spine performed
21-March-2009 showed fracture dislocation of D3
with partial fracture of D2 and D4 with
contusion and malacia of the spinal cord at
On examination the vital
signs were stable and the power of the upper
limbs were normal. He has dense plegia below Th2
level with anesthesia at that level to pin-brick
sensation. He had preserved sensation of
position sense of the left foot manifesting the
preservation of the left posterior funniculus of
the spinal cord functionally.
Exposure of the C7down to D5
laminae was performed with preservation of the
intraspinous ligament. There was no tear of the
Considering this, sublaminar
hooks medium size were inserted under the C7 and
D1 laminae, from the inferior border. Another
four hooks were inserted below the D4 and 5
laminae from the upper border. The 2 rods were
reconfigured so as to accept the normal
alignment of the area. Fixation with distraction
was applied to perform reduction of the bony
Smooth postoperative recovery
and the patient was sent back to the ICU.
The patient has more than 90%
of the spinal cord non-functioning at the
damaged level. Aggressive medical treatment was
started from the moment of admission and will be
continued for 18-24 months to rescue the still
surviving neural elements.
The aim of surgery is to
prevent further damage to the spinal cord and to
ambulate the patient as soon as possible. It has
no relation with the recovery of neural cells.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
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 .