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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15-MARCH-2013 FARES LAFI AL-RWELY 20 YEARS
UNSTABLE FRACTURE DISLOCATION C2,C3 WITH TOTAL DESTRUCTION OF LEFT LATERAL MASS.
The patient came to the emergency of the
Shmaisani hospital from Saudi Arabia
14-March-2013 after suffering RTA the night of
13-March-2013 without loss of consciousness but
after that got severe neck pain and inability to
move it with severe pain in the left shoulder
with numbness of the left side of the neck.
CT-scan of the brain and neck done the same day
of bad quality and unreadable.
X-ray of the cervical spine showed dislocation
of C2-3 with chip of bones in the left C2-3
lateral mass. X-ray of the left shoulder is
normal. CT-scan of the neck repeated with thin
cuts and 3-D reconstruction confirming the
dislocation and complete destruction of the left
L2-3 lateral mass.
MRI cervical spine done 15-March-2013 showing
slight malacia of the spinal cord at the
fractured level, but the vertebral artery is in
relatively acceptable condition.
On examination: The patient with hard neck
collar with paresis of the left upper and lower
limbs with analgesia of the left side of the
neck. The patient claiming that he has severe
fainting when raising his head.
Considering that there is no
disc extrusion, using C-arm the C2-3 level was
identified and using Zimmer cervical plate one
level 24 mm length with 2 variable screws 14x4.2
mm inserted to C2. One variable screw 14x4.6 mm
inserted to the right side of C3 and
16x4.2 mm to the left side of C3. All stages of
surgery were done using C-arm control.
Routine closure of the wound.
Smooth postoperative recovery. The power of
the left side became normal.
The patient had unstable fracture of C2-3 with
complete destruction of the left C2-3 lateral
mass. To preserve the left vertebral artery and
avoid further deterioration of the spinal cord,
internal fixation is the only available best
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