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
Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
28-JANUARY-2012 AMAL MAHMOUD ABDEL-KAREEM 47 YEARS
HUGE EXTRUDED DISC C3-4, 4-5, 5-6 WITH MALACIA OF THE SPINAL CORD.
patient came to the clinic 25-December-2011 complaining of LBP
with agonizing left sciatica and numbness all
toes left foot for 7 months and exacerbation the
last 5 months. MRI lumbar spine performed
17-July-2011 showing huge extruded disc L4-5
with left downward migration.
examination, the patient is limping with
exaggerated scoliotic stance. SLRS
was 70 degrees with pain the left side. There is
left sided hemihypalgesia below C3 level with sight
weakness of the both upper limbs more the left and complete
drop left foot with weak planterflexion left
foot 3/5 and weak left quadriceps femoris 4/5.
There is Babinski positive in the left side with
exaggerated all deep reflexes and clonus both
feet more the left side.
MRI of the
brain done 17-January-2012 showing scattered
small lacunar infarctions of no clinical
significant and severe cervical canal stenosis
due to huge extruded disc C3-4, 4-5 and C5-6
with malacia of the spinal cord. It was decided
to perform cervical disc surgery first to avoid
catastrophic events, if lumbar spine surgery
with positioning were contemplated.
Discectomy C3-4, C4-5 and
C5-6. Osteophytectomy C3-4 and C4-5 until the
dura seen at the entire posterior aspect of the
disc spaces. Fidji cages with NovaBone 12x15x6.1
mm inserted to C3-4 and C4-5 levels. Another one
12x15x5.3 mm inserted to C5-6 level. Using
Zimmer Trinica cervical plate three level 54 mm
length fusion of C3-4-5-6 was achieved with
variable screws 16x4.6 mm inserted to C3 and
variable 16x4.2 mm inserted to C6 level. Fixed
14x4.2 mm screws used to C4 and C5. All the
stages of surgery were guided with C-arm.
closure of the wounds. Smooth postoperative
recovery with improvement of the power of three
limbs except the left foot.
Please! wait for 3-5 min till the
video start to load. It depends upon the internet
The patient having major problems in the
cervical and lumbar spine. Priority paid to the
The patient has huge PLD L4-5 with left
foraminal occlusion. Surgical treatment must be
performed after 10-20 days.
Zimmer Trinica cervical plate.
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 .