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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04-MAY-2012 ABDALLA SALEM SAEED 38
YEARS 38 YEARS HUGE EXTRUDED DISC C6-7 WITH MALACIA OF
THE SPINAL CORD AND DEEP TETRAPARESIS.
came to the clinic 03-May-2012 in wheelchair and
inability to walk for 2 months . His condition
started after lifting athletic crossbar 7 months
ago, after what he got severe numbness of both
upper limbs. The patient then got intrascapular
pain after 4 months with heaviness of the right
lower limb. He is using wheelchair for 2 months.
MRI of the
whole spine was performed 03-May-2012 showing
very huge extruded disc C6-7 compressing the
spinal cord with malacia of the spinal cord.
examination, the patient in wheelchair, can walk
with assistant of 2 persons. The biceps brachii
are 5/5 but the grip of both hands are 3/5,
unable to extend the right hand and extension of
the left hand and both triceps muscles are weak
3/5. SLRS was 5 degrees both sides due to
weakness and there is exaggerated reflexes both
lower limbs with massive clonus. Babinski was
positive both sides. Weak proximal muscles both
lower limbs 4/5 and distal muscles 3/5. There is
sensory deficit, nor micturition or defecation
Discectomy of C6-7 with total
removal of the extruded disc inside the canal
with upward migration. The dura was seen at the
entire posterior aspect. Fidji 17x6.1x12 cage
with NovaBone was inserted to the C6-7 space.
Using Trinica cervical one level plate was used
with four fixed 16 mm length to fuse C6 and C7.
closure of the wound. Smooth postoperative
recovery. The power of the upper limbs
normalized and the power of the lower limbs
improved, but the clonus still having place.
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The patient has profound
quadriplegia-paresis, the sooner the
intervention, the better the outcome.
The recovery process will depend upon various
elements. The roots recover promptly, the motor
fibers of the spinal cord recover at lower
speed, but sensory deficits and fibers
responsible for spasticity and clonus recover
slowly and partially over months.
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 .