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10-JANUARY-2018 JAMILEH IBRAHEEM AHMAD 73 YEARS HUGE
EXTRUDED DISC C4-5 WITH SPINAL CORD COMPRESSION.
Anamnesis
The patient came to the clinic 07-January-2018
complaining of neck pain for 2 weeks with weak
four limbs and inability to walk. MRI cervical
spine performed 04-January-2018 showing huge
extruded disc C4-5 with severe spinal cord
compression and old bulges C3-4, 5-6 with OPLL.
The patient is a known hypertensive in
medication for 8 years.
On examination; the patient in wheelchair with
weak left biceps -4/5, weak right hand flexion
3/5, left hand flexion 1/5, extension the right
hand 3/5, left hand extension 0/5. Right triceps
3/5. left -3/5. Both quadriceps 3/5 adduction
both knees 3/5, abduction left knee 3/5, right
knee 4/5 with weak dorsi and planterflexion both
feet 3/5. There is hypalgesia left upper limb
ulnar territory down and the right D1 down.
Hoffmann positive left side
The patient was sent for cardiac consultation.
Discectomy C4-5 until the dura was seen at both
sides. ON PLUS (EOS) Cervical
bladed cage 14x17 H7 with IN'OSS 2x0.5 ml inserted to C4-5 level. Routine closure of the
wound.
Smooth postoperative
recovery. The power of the right upper limb improved
dramatically. The power of both lower limbs
also, but the power of the left upper limb with
slight improvement. She was sent to the ward.
Comments
The patient has an extruded disc
which is not subsiding. Surgical decompression is the only
solution.
Since the catastrophic event is recent the
problem in the C4-5 is the cause of the neurologic problem. The
other levels were not violated, since they are long-standing and
not related with the recent event.
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
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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
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 .
