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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04-MARCH-2010 SHIRIN ADNAN AL-HINDY 36 YEARS
PCD C4-5 WITH RIGHT FORAMINAL COMPRESSION AND PCD C5-6 OLD ONE.
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patient came to the clinic 28-May-2009
complaining of neck pain for 4 years with right
upper limb and cephalic pain. Exacerbation the
last 2 days. MRI done 30-May-2009 showing PCD
C5-6 and C4-5. The patient was advised to
continue in conservative treatment and in case
of deterioration to consider surgical treatment.
The patient then
came 21-February-2010 telling that her condition
became worse than before with weak grip
and extension of the right hand 3/5 and right
triceps muscle 3/5 with hypalgesia entire right
upper limb. Severe pain when rotating the neck
to all directions with limitation of movement.
MRI of the cervical
spine performed 24-February-2010 showing
progression of the PCD C4-5 with occlusion of
the right foramen with regression of C5-6 right
Total discectomy of C4-5 with
removal of the extrusion at the right foramen.
Check with contrast of the disc space revealed
that the root is free of any fragments. Through
tiny hole, intradiscal decompression of C5-6 was
performed to prevent future escalation of the
old extrusion of C5-6.
Routine closure of the wound.
recovery, and the power of right upper limb
performing 2-level discectomy of the cervical
spine, it is mandatory to apply fixation to
prevent instability. Some times it is possible
to cheat the rule by applying total discectomy
of the clinically manifesting level and
intradiscal decompression of the other level. In
this case it is not necessary to apply cervical
The surgery was
indicated for C4-5 and decompression of C5-6 was
precautionary to prevent near future escalation
of extrusion of C5-6 disc.
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 .