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-OCTOBER-2010 KIFAH SAMI HAMMAD 40 YEARS PCD C6-7 WITH
COMPLETE OCCLUSION OF THE RIGHT FORAMEN.
to the clinic 03-October-2010 complaining of
agonizing neck and right upper limb pain with
numbness of the right hand for 2 weeks.
MRI cervical spine
performed 03-October-2010 showing extruded disc
C6-7 with complete occlusion of the right
On examination: The
patient was all the time holding her right upper
limb above the head. She was deprived of
sleeping for several days. There was horizontal
nystagmus when looking to both directions.
Romberg was stable. The biceps of the right
upper limb was weak -4/5, grip right hand 3/5,
extension of the hand 2/5 and the triceps was
2/5 also. She had hypalgesia of the right side
of the face and the entire right upper limb.
Movement of the neck to all direction was
painful and with limitation. There is weak
quadriceps right lower limb +3/5. It was
explained to the patient that the hypalgesia of
the right side of the face cannot be explained
by the extruded disc, but she insisted that she
CT-scan of the brain
was requested and done 04-October-2010 and it
Discectomy of the
C6-7 was performed. The extruded disc was
removed in one piece, after what massive
arterialized venous bleeding took place for 40
sec, which stopped by itself. Further inspection
for the extrusion.
Routine closure of
the wound and smooth postoperative recovery and
the power of the right upper limb dramatically
The patient was in agonizing
pain and several nights without sleep. She
exaggerated her clinical picture, that it was
necessary to perform brain CT-scan to rule out
The bleeding was mostly due
to compressed epidural vein. In case that the
vertebral artery is the source of bleeding, the
bleeding will take a lot of time and it will
need further measures to control it.
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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 .