Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity.

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
neurosurgery.art
neurosurgery.me
neurosurgery.mx
skullbase.surgery

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
ependymomas.com
gliomas.info
meningiomas.org
neurooncology.me
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com 

Neuroanatomical Sites
humanneuroanatomy.com 
microneuroanatomy.com

Neuroanesthesia Sites
neuro-anesthessia.org

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com

Neuroradiological Sites
neuroradiology.today

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com

Personal Sites
cns.clinic

Spine Surgery Sites
spine.surgery
spondylolisthesis.info
paraplegia.today

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

29-NOVEMBER-2017  AHMAD SAAD RAHAHLEH  51 YEARS  EXTRUDED DISC C4-5, C5-6 WITH MALACIA OF THE SPINAL CORD AT C5-6 WITH MORE COMPRESSION FROM THE RIGHT.

 
 

Anamnesis

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The patient came to the clinic 20-November-2017 complaining of numbness of the right upper and lower limbs, more from the right nipple downward for 7 years with numbness both hands. MRI cervical spine performed 08-November-2017 showing extruded disc C4-5, C5-6 with spinal cord compression more from the right side with malacia of the spinal cord at the C5-6 level. Lumbar MRI showed bulge L4-5 and L5-S1.

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On examination; the patient is not limping now, with weak extension of the hands and triceps both arms 4/5. Hoffmann positive both sides. There is hypalgesia for pin brick from 10 cm above the right nipple right side. 

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The patient was sent for investigation and cardio evaluation.

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Discectomy C4-5 and C5-6 until the dura was seen at both levels. Osteophytectomy of the C5-6 level. Cervical cages 7 x05 inserted to both levels. Using Precision Spine  ACDF 46 mm 2 level with 4 variable 4x16 mm to C4 and C6 and 2 fixed same dimensions to C5 were used to fix C4-5-6.  Routine closure of the wound.

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Smooth postoperative recovery. The power of the right upper limb normalized. The power of the left hand and left leg deteriorated immediately after surgery. He was sent to the ward.

Follow Up

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The patient showed full blown left sided Brown-Sequard syndrome, which over several hours started to recover. Control MRI done at 9.00 p.m. showed no compression and the spinal cord hanging free with the previous malacia, which will be morphologically permanent. The next day, the patient could walk with help and could move the upper and lower limbs. It was explained to the patient that, this phenomena can happen and it needs days to fully recover, but the sensory deficit, will partially recover over the years.

 

Comments  

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The patient having severe stenosis of the cervical spine with malacia of the spinal cord with progressive deterioration. Surgical decompression is the best solution to prevent further deterioration.

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Here the compression is from anterior, for what anterior approach is performed.

 

 

 

 

Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.


Inomed Riechert-Mundinger System, with three point fixation is the most accurate system in the market. The microdrive and its sensor gives feed back about the localization.


Inomed MER system

Leica HM500

Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

 


 

Back Up!

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 .

  

 

 

 

 

 

 

 

 

 

 

 

 

WELCOME TO AL-SHMAISANI HOSPITAL

 


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