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16-AUGUST-2003 AMIRA HASAN AL-ZUUBI 57
YEARS EXTRUDED DISC C4-5 WITH SEVERE COMPRESSION OF THE SPINAL CORD.
Anamnesis
The patient came to the clinic 29-April-2001
complaining of LBP for 5 years with left
sciatica last 15 days. There was hypalgesia both
L5 roots with weak dorsiflexion right foot. She
was sent for investigations and MRI lumbar spine
performed 09-May-2001 showed extruded disc L3-4
with left downward migration, for what she was
advised for surgery. She was operated by me
09-May-2001 and came to the clinic 24-May-2001
with clean wound with normalization of the
sensory and motor functions. The she came
21-July-2003 complaining of neck pain and
clumsiness both hands. She is now diabetic for 1
year in medication.
On examination, the patient has neck pain when
rotating the head to all directions. There is
weak grip, extension right hand 3/5 with weak
right triceps muscle 3/5. There
is hypalgesia median and ulnar distribution left
upper limb. Hoffman positive right side.
The patient was sent for investigation and MRI
cervical spine done 08-August-2003 showing huge extruded disc
C4-5 compressing the spinal cord more to the
right.
Through anterior approach,
the level of C4-5 was identified and meticulous
cleaning of the disc space was performed and
removal of the extruded disc and osteophytectomy was achieved until
the dura was seen lax at the bottom of the
removed disc cavity. Routine closure of the wound.
Smooth postoperative recovery.
The patient showed improvement of the power of
her right upper limb. She was sent to the ward.
FOLLOW UP
The patient
came to the clinic 26-August-2003 with clean wound.
There is no motor or sensory deficit.
The patient
then came several times for diabetic and rheumatoid
problems. Then came 14-February-2015 telling that
she was admitted to Islamic hospital for 2 weeks
with cardiomegaly and left hemiparesis. MRI cervical
spine done 01-February-2013 showing severe cervical
canal stenosis C3-4 and C4-5 with spondylolisthesis
L1-2 with infarction of the left
fronto-parietal lobes. She is in wheelchair the last
2 weeks.
Comments
This unlucky lady is suffering from many
problems, that requiring surgical intervention
at certain stages.
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
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
LooksCam II Xenosys in the run starting from 14-March-2021 with
SheerVision TTL x4 magnification.
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 .
