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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24-DECEMBER-2010 SUMAYA SALEM MUHAMED 36 YEARS
VERY HUGE EXTRUDED DISC C4-5 MORE TO THE RIGHT WITH ELEMENTS OF BROWN-SEQUARD
came to the clinic 22-December-2010 complaining
of LBP for 4 years with left sciatica for 4
numbness. Neck pain for one year with right
upper limb weakness for 2 months.
MRI of the
brain performed 20-December-2010 was normal, but
MRI cervical spine showed very huge extruded
disc C4-5 with severe compression of the spinal
cord more to the right.
examination: The patient is limping with
exaggerated scoliotic stance. SLRS was 85
degrees both sides without pain. There is pain
in the neck when looking up and down and bending
the head to the left shoulder. There is
hypalgesia of the entire right upper limb and
hypalgesia below the left nipple. The power of
the right hand grip was -3/5 and the extensors
/35 and the right triceps 4/5.
Anterior approach with discectomy of C4-5 was
performed. All the extruded disc was removed in
several pieces. The dura was seen in the entire
plane of the posterior longitudinal ligament.
closure of the wound. Smooth postoperative
recovery with normalization of the power of the
right upper limb.
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The patient has very huge extruded disc
C4-5 with elements of Brown-Sequard syndrome,
affecting more the sensory compartment. The
radicular manifestations prevailing.
The defect in the annulus
fibrosis was huge, that during intradiscal
decompression and traction, the extruded disc
returned to the intradiscal space and small
amount was needed to remove after that.
The recurrence rate after cervical
discectomy is zero.
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 .