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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

 
The patient came to the clinic 29-June-2006 complaining inability to fell the legs after parathyroidectomy  5 years ago. The condition continued to deteriorate the last year with inability to walk with intermittent claudication. She is using crutches the last 4 months. MRI of the spine done 29-May-2006 showing severe LCS L4-5 with lesser degree at L3-4 with mild right CTS. She is a known parkinsonian. She has micturition problems for the last 4 months.

On examination: SLRS was 45 degrees with pain in the right side with almost drop both feet  with weak planterflexion both feet and abduction and adduction of the knees and hypalgesia both feet above the ankle.

Decompressive laminectomy of L4 and partial of L3 and L5 was performed and foraminotomy of L4 and L5 was done both sides.

The power of both legs improved immediately after the operation and the sensation still the same.

Comments:

1. LCS when progressing, surgery give better results when the patient still not suffering from irreversible damage to the neural structures.

2. Parathyroidectomy provoked the sensory deficit as the patient mentioning, but it is unclear how the LCS playing role in this situation.


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