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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02-FEBRUARY-2013 MUNA MUHAMED SAEED 52 YEARS
EXTRUDED DISC C4-5, C5-6 WITH SEVERE SEGMENTAL STENOSIS.
The patient came to the clinic 29-January-2013
complaining of neck and right upper limb pain
for 3 years with exacerbation of the left
upper limb pain the last 45 days with numbness of
the left hand and cephalic pain. The patient
cannot sleep due to pain. The patient underwent
laminectomy for LCS 13 years ago and she is
hypertensive for 5 years.
On examination: The patient have weak grip left
hand 4/5, extension left hand 3/5, and left
triceps muscle 4/5. She has decreased hearing
with tinnitus left ear for three years. SLRS was
70 degrees with pain in the right with weak
dorsiflexion right foot 4/5.
The patient was sent to perform MRI of the
cervical and lumbar spine, which was done
29-January-2013 showing severe cervical canal
stenosis with extruded disc C4-5, 5-6 and to
lesser degree the C6-7. There is also severe LCS
L2-3, L3-4, L4-5 and L5-S1.
Discectomy C4-5 and C5-6 with total
cleaning until the dura was seen behind the
bodies of C4, C5 and C6. Fidji cervical cage
15x12x6.9 mm was inserted to C4-5 disc space and
12x15x6.1 mm to the C5-6 with NovaBone. Fusion
of C4-5-6 was done using Trinica cervical plate
42 mm length with 2 fixed screws 14x4.2 mm
length to C5 and variable to C4 and C6
same length. All stages of surgery
were done using C-arm.
Routine closure of the wound.
Smooth postoperative recovery.
The power of upper limbs became normal.
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The patient has extruded
disc C4-5 C5-6 with spinal cord compression,
more to the left. Decompression and fixation
must be achieved. It was decided not to violate
the C6-7 level.
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