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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05-MAY-2009 MAYSOON SULAYMAN AL-WEHEDY 43 YEARS
OVERMOBILITY OF C4-5 WITH PCD C5-6.
The patient came to the
clinic 10-February-2009 with history of neck
pain for one year with cephalic syndrome. Two
months ago got upper limbs pain with left chest
pain and radiation to intrascapular region.
MRI cervical spine performed
08-February-2009 showing bulge C4-5 and
wide-based extruded disc C5-6.
On examination: the patient
has limitation of neck movements with pain all
directions with weak grip both hands 4/5 and
extension of the fingers 3/5 and both triceps
3/5. The patient was advised to undergo
conservative treatment, but she came
30-March-2009 with same clinical picture and
cervical X-ray demonstrated overmobitity of
C4-5. The patient is urging for surgery and she
was advised to wait for another month, but 2
days later she another time urged for surgery.
Discectomy of C4-5, and C5-6
was performed and using cervical miniplate
Hybrid with 6 screws 14 mm length
variable, fusion of C4-5-6 was achieved.
Smooth postoperative recovery
with normalization of the power of the upper
Routine dynamic study of the
cervical spine must be included in the
investigations to catch if there is overmobility
of some segments. In this case overmobility was
the major indication for surgery and discectomy
of C5-6 was performed to avoid future
progression of this disc extrusion, because
after fusion of C4-5, the stress points at this
adjacent level will increase, for what it was
included with fusion.
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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 .