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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29-MAY-2010 SHARAL NAFETH ZHAEMAN 34 YEARS
EXTRUDED DISC C5-6 WITH LEFT UP AND DOWNWARD MIGRATION.
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to the clinic 25-May-2010 complaining of severe
neck pain for 5 days with left shoulder and
cephalic pain and numbness of the thumb right
MRI of the cervical
spine performed 25-May-2010 showing huge
extruded disc C5-6 with left up and downward
migration with malacia of the spinal cord with
occlusion of the left foramen.
there is pain and limitation of neck movement
when in flexion. The grip and extension of the
left hand is 3/5 with weak left triceps muscle
Discectomy of C5-6 was performed with removal of
the extruded parts of the disc. TES=MEP protocol
of IOM was used and C4-C3 with anode at C4 was
used. The current at 30 mA was producing
twitches of the left side of the face. Only
currents of 180 mA were necessary to achieve the
EMG response of the left thenar muscle. Prestige
LP cervical system 5X16 mm dimensions was used
and several checks using image-intensifier were
performed for the control of proper position and
function of the device.
Routine closure of the wound and smooth postoperative recovery with
improvement of the power of left upper limb.
The patient had large
extrusion with possibility to widen the
posterior edges of the lower part of C5 and
upper part of C6 so as not to escape the
In this case it is preferable
to use the cervical system such as the
Prestige-LP to regain the maximum more or less
normal movement of the segment, to prevent
future escalation of extruded disc above and
below the lesion.
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 .