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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22-NOVEMBER-2008 KHALED BASHEER ALTOOD 71 YEARS
SEVERE CERVICAL STENOSIS C2-3, 3-4, 4-5 AND 5-6 WITH RADICULO-MYELOPATHIC
The patient came to the
clinic 12-December-2004 complaining of LBP with
left sciatica for one year. He has also pain
right shoulder with frozen shoulder for
one year. He has hypertension for 15 years and
underwent TUR 3 years ago.
The patient sent for
investigations and was operated elsewhere for
lumbar canal stenosis.
The patient then came
10-November-2008 with clinical picture of
progressive weak both upper limbs and inability
to use them with numbness both hands the last 2
On examination: the patient
having difficulty in walking with weak both
upper limbs more the right. The right hand grip
and extension is 3/5 and biceps 4/5 and triceps
right 4/5 with hypalgesia entire hand and medial
aspect of the forearm.
MRI cervical spine performed
18-November-2008 showed severe cervical canal
stenosis at C2-3, 3-4, 4-5 and C5-6 with malacia
of the spinal cord.
Decompressive laminectomy of
C3-4-5-6 and partial of C2 and C7. Drilling was
used to make the laminae paper-like and they
removed without exposing the spinal cord to
operative trauma. The epidural fat was missing
in all exposed levels.
Smooth recovery with
improvement of the power of four limbs.
The patient had signs of
cervical canal stenosis from the first visit,
but it mostly escalated the last 2 months.
Since the major compressing
elements are from behind the spinal cord,
posterior decompression is the best solution of
Using drilling of the laminae
decrease the operative trauma to zero, which
subsequently showing only positive changes
immediately after surgery.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
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 .