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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16-SEPTEMBER-2014 MAJIDA SAMI ANABTAWY 58 YEARS
TUMOR OF C7 WITH COMPLETE DESTRUCTION AND RIGHT PARASPINAL EXPANSION.
The patient came to the clinic 14-September-2014
complaining of neck and right upper limb pain
for 2 months with numbness all fingers right
hand for 2 weeks. The patient was operated 3
years for lymphnode biopsy, which was proved to
be Hodgkin disease for what radiation and
chemotherapy was performed. She was treated for
left kidney abscess 3 months ago with
On examination; the patient in agonizing pain
and cannot rotate the neck to all sides with
severe pain. There is weak grip right hand -3/5
and unable to extend the hand and weak right
triceps 1/5 and weak biceps 4/5. There is
hypalgesia of the Index finger right hand.
The patient was sent for MRI of the cervical
spine with contrast showing tumor of C7 with
complete destruction of the body with right
paraspinal growth toward the brachial plexus.
Bone scan done 15-September-2014 ruling out
scattered MTS picture.
There is no running crease in the neck to reach
the lesion and there is solid palpable mass 1 cm
above the sternoclavicular notch. For that an
incision was carried out along the medial border
of the right sternocliedomastoid muscle.
Dissection was started from above and the C6-7
and C7-D1 levels were identified. A mass was
identified in the right side of C7 pushing the
muscles antero-lateral, but not reaching the
sheath of the right CCA. The mass which was felt
before incision was a bony one in the right lobe
of thyroid not having any relation to the
pathological lesion. Discectomy C6-7 and C7-D1.
The disc material was not involved in the tumor.
The C7 body was destroyed by the tumor and it
was resected. The soft tissue component of the
tumor in the right side of the body was also
removed obtaining practical radical
resection of the tumor. Fresh frozen section
gave the answer of Hodgkin sarcoma of very
malignant behavior. Using Medulex expandable
cage 16 mm 40 with allograft 15 cc
was inserted at the bone defect between C6 and
D1. Using Reflex plate 2 level 30 mm plate and 4
fixed self drilling screws, fusion of C6 and D1
was achieved. Routine closure of
the wound. The histological specimens were sent
to separate pathological departments.
Smooth postoperative recovery. The power of the
right upper limb became normal and the agonizing
If the patient has Hodgkin sarcoma, then
it is very rare and it is not invading the disc material.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
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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 .