Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity.

Functional Neurosurgery
functionalneuro.surgery
Functionalneurosurgery.net

IOM Sites
iomonitoring.org
operativemonitoring.com

Neurosurgical Sites
neurosurgery.art
neurosurgery.me
neurosurgery.mx
skullbase.surgery

Neurosurgical Encyclopedia
neurosurgicalencyclopedia.org

Neurooncological Sites
acousticschwannoma.com
craniopharyngiomas.com
ependymomas.com
gliomas.info
meningiomas.org
neurooncology.me
onconeurosurgery.com
pinealomas.com
pituitaryadenomas.com 

Neuroanatomical Sites
humanneuroanatomy.com 
microneuroanatomy.com

Neuroanesthesia Sites
neuro-anesthessia.org

Neuroendocrinologiacl Site
humanneuroendocrinology.com

Neurobiological Sites
humanneurobiology.com

Neurohistopathological
neurorhistopathology.com

Neuro ICU Site
neuroicu.info

Neuroophthalmological
neuroophthalmology.org

Neurophysiological Sites
humanneurophysiology.com

Neuroradiological Sites
neuroradiology.today

NeuroSience Sites
neuro.science

Neurovascular Sites
vascularneurosurgery.com

Personal Sites
cns.clinic

Spine Surgery Sites
spine.surgery
spondylolisthesis.info
paraplegia.today

Stem Cell Therapy Site
neurostemcell.com


Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

28-NOVEMBER-2017  MUSA ASSAD MUBARAK  70 YEARS  CERVICAL CANAL STENOSIS C3-4 WITH LESS AT C4-5.

 
 

Anamnesis

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The patient came to the clinic 21-November-2017 complaining of difficult walking for 1 years with ataxic gait. His relatives came first 27-September-2017 telling that he he has bilateral sciatica with "fainting attacks". MRI lumbar spine performed 19-October-2016 showing minimal spondylolisthesis L5-S1. Creatinine Kinase was 2365 U/L and ESR was 30 mm/h. EMG done 06-Novemebr-2016 demonstrating sensory  and motor axonal neuropathy. The patient in Kuwait. The sons of the patient were advised to be reevaluated there to rule out UMN disease. The patient then came with MRI of the brain performed 07-October-2017 showing mild brain atrophy compatible with age. MRI of the cervical spine showing as be extruded disc C3-4, 4-5 with severe spinal cord compression and malacia of the spinal cord at C3-4 level. There is assimilation of C6+7.  The patient is a known diabetic for 20 years with arterial hypertension for 10 years.

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On examination; the patient is walking with help and using crutches. There is weak both deltoid , biceps brachii 4/5. Flexion and extension both hands -4/5 with the right hand weaker then the left. Both triceps 3/5. The right quadriceps muscle power -4/5, the left 4/5. Abduction of the right Knee was 3/4, left -4/5. Adduction both knees 4/5. Drop both feet with weak planterflexion right foot -3/5 and left 4/5. Sensation for pin-brick was normal. Hoffmann was positive both sides with SLRS of the right side 60 degrees due weakness. The right KJ was exaggerated. 

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The patient was sent for investigation. MRI whole spine was performed 22-November-2017 and showed severe cervical stenosis C3-4  more from the posterior elements with malacia of the spinal cord and to lesser degree stenosis of the C4-5. There is assimilation of C4-5-6. Dorsal spine showed PDD D2-3. Lumbar spine showed stenosis of  L4-5 and L5-S1. Dynamic studies ruled out presence of overmobility. ESR was 95 mm/h and CRP was 20 mg/L. Zinnat 500 mg twice daily was started and the patient was sent for cardiac evaluation.

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Skeletonization of lower part ofC2, complete of C3,4 and upper part of C5. Decompressive laminectomy of C3 and C4 was performed after drilling of the bone until it became transparent and started to bulge out by itself. Routine closure of the wound.

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Smooth postoperative recovery. The power of the upper limb normalized and dramatic improvement of the lower limbs more the right, except the long standing bilateral drop feet. He was sent to the ward.

Comments  

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The patient having severe stenosis of the cervical spine with malacia of the spinal cord with progressive deterioration. Surgical decompression is the best solution to prevent further deterioration.

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The fist MRI showed as be the patient needs anterior approach, but the last MRI confirmed that the best option is posterior approach.

 

 

 

 

 

 

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

Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.

TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014

 


 

Back Up!

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 .

  

 

 

 

 

 

 

 

 

 

 

 

 

WELCOME TO AL-SHMAISANI HOSPITAL

 


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