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-JANUARY-2012 FATHIYEH MUSTAFA EL-SAYYED 55 YEARS
EXTRUDED DISC C5-6, 6-7 WITH COMPRESSION AND MALACIA OF THE SPINAL CORD
patient came 21-January-2012 complaining of neck
and LBP for 7 years with right upper and left
lower limbs pain. MRI cervical spine performed
07-July-2008 showing huge extruded disc C5-6,
C6-7 with malacia of the spinal cord. MRI lumbar
spine performed 14-December-2010 showing PLD
L4-5 with segmental stenosis. MRI cervical spine
repeated 06-January-2011 showing huge extruded
disc C5-6, C6-7 with malacia of the spinal cord.
examination, the patient is walking bended,
limping and cannot walk more than 10 meters.
There is pain when turning the head to all
direction, more to the right and upward. There
is weak grip right hand 4/5, extension the hand
3/5 and the right triceps power is 4/5. SLRS was
70 degrees with pain both sides. There is weak
dorsiflexion right foot -4/5 and left foot 4/5.
MRI of the
cervical and lumbar were repeated
22-January-2012 which confirmed the presence of
huge extrusion of C5-6 and C6-7 more to the
right with malacia of the spinal cord. There is
also stenosis at L4-5 with bulge L5-S1 disc. The
patient was advised to undergo surgery for
cervical problem first.
Using C-arm, discectomy of
C5-6, and C6-7 was performed with
osteophytectomy. The extruded disc C5-6 was
adherent to the dura in the right side.
Circumferential release was done and the hard
layer was thinned up to 0.01 mm thickness
leaving a shell with the dura so as not to
violate the integrity of the dura or cause
spinal cord injury. Fidji cervical plate
with NovaBone 12x15x6.1 mm inserted to the C5-6
level and 12x15x5.3 mm to the C6-7 level. Using
Trinica Zimmer 36 mm 2 level plate, fusion of
C5-6-7 was achieved with 2 variable screws
inserted to C5 and 2 screws 16x4.2 mm to
C7. Fixed 2 screws 16x4.2 mm were used to fix
the C5 body. Stepwise control with the C-arm.
closure of the wounds. Smooth postoperative
recovery with improvement of the power of the
right upper limb and both feet.
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The patient have problems in the cervical and
lumbar spine and both mostly needs surgical
intervention. The priority is given to the
compressed spinal cord at the cervical level.
The patient got improvement of the all involved
muscles, even the feet, confirming that the
weakness of the feet was partially due to spinal
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 .