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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24-JANUARY-2008 ABDEL-KAREEM ISA SEMREEN 68 YEARS
SEVERE CERVICAL CANAL STENOSIS C3-4, 4-5, 5-6 WITH MALACIA OF THE SPINAL CORD.
The patient came to the
clinic 16-January complaining of sudden onset
neck pain 02-December-2007, after what he got
weak both upper limbs. The lower limbs remained
in good condition.
MRI cervical spine performed
12-December-2007 showed severe cervical canal
stenosis at C3-4, 4-5 and C5-6 with malacia of
the spinal cord with the major compression from
On examination: the power of
both deltoids and biceps brachii and the grip of
both hands were 4/5. The extension of both hands
and the triceps muscles were 3/5. The sensation
and the power of the lower limbs were intact.
Considering that the major
compressing elements were from behind, posterior
decompression was performed. The decompression
was modified, that the Laminae of C3-4-5 and 6
and lower 3/4 of the C2 were drilled in such a
way, that after removal of the spinous
processii, drilling was performed far-lateral of
the laminae abutting to the lateral masses until
the laminae were flail. The C3-4 and C4-5
compressing elements were eliminated, which were
bony and ligamentum flavum material. Midline
drilling was performed to be sure that the
laminae were were hanging free. We will call
this procedure a trilinear decompression of the
posterior cervical spine.
Routine closure of the wound
and smooth postoperative recovery.
In cervical canal stenosis
anterior decompression with fixation is the
preferred method, but when the compressing
elements originate from behind, posterior
decompression is the only solution remains.
decompression in cervical canal stenosis usually
causes dramatic deterioration of the patient. To
avoid such events modifications of the
decompression, to minimize the surgical trauma
to the already compressed spinal cord are
applied with the use of the high-speed drilling.
This presented modification bring the mechanical
and thermal injury to the cervical spine to
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After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014