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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16-MARCH-2008 ABDEL-QADER ISMAEEL MUHAMED 72 YEARS
SEVERE CERVICAL STENOSIS C2-3,3-4, 4-5, 5-6 AND MAXIMUM AT C5-6.
The patient came to the
clinic 08-March-2008 complaining of difficult
walking for three years and inability to walk
for 10 days with micturition problems for 15
years. The patient has decreased hearing left
ear for 20 years.
On examination: the patient
came in wheelchair. Weak flexion and extension
of both hands 2/5 and both triceps muscle 3/5.
There is complete analgesia for pain brick below
C7 with complete paraplegia below the same
MRI lumbar spine done
15-July-2007 showed severe lumbar canal stenosis
with pelvis X-ray showing bony fusion of both
MRI cervical spine performed
08-March-2008 showing stenosis of the
cervical spinal canal at C2-3, 3-4, 4-5 and
C6-7, with maximum compression at C5-6 with malacia of the spinal cord.
The patient is a known
diabetic with prostate hypertrophy in omnic for
Decompressive laminectomy of
C3-4-5-6 and 7 was done using the high speed drill. The
epidural fat was absent at most of the levels.
All compressing elements were eliminated. The
most compressed part at C5-6 was decompressed
last, to minimize the surgical trauma.
Routine closure of the wound
with smooth postoperative recovery.
Slight recovery of the power
of the upper limbs with no changes noted in the
Posterior decompression of
the cervical spine in CCS seems to be more
acceptable than the anterior approaches, using
the new modifications with the high-speed
drilling. By this method surgical trauma
becoming to zero.
In the past, posterior
decompression was associated with lot of
complications due to surgical trauma by using
the Smith-kerrisons and so on instrumentations.
The patient has bony fused
both hips, which means, that his paraplegia is
more protracted as he claim. This kind of
surgery will help him improve the power of the
upper limbs, but recovery of the lower limbs is