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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05-FEBRUARY-2014 AHMAD MUHAMED AL-MISRATY 75 YEARS
SEVERE CERVICAL CANAL STENOSIS C3-4, C5-6 AND C6-7 WITH MALACIA OF THE SPINAL
The patient came to the clinic 28-January-2014
complaining of inability to move the four limbs for
4 years with left sciatica with deterioration
the last 6 months. He underwent laminectomy L4-5
in UK 1977. Cardiac cath done 2010.
On examination; the patient is limping and
dragging the left leg with exaggerated scoliotic
stance. He has hypotrophy of
both interossii muscles both hands. The grip of
both hands 5/5, extension both hands 4/5. Triceps both upper limbs -3/5. Quadriceps both
lower limbs 5/5, dorsiflexion left foot 0/5,
right foot 4/5, dorsiflexion right foot 4/5 planterflexion
left foot -4/5. SLRS was 80 degrees without pain
The patient sent for MRI of the brain,
cervical, lumbar and dynamic X-ray of the lumbar spine
and done 28-January-2014 showing the small
scattered lacunar infarctions of both cerebral
hemisphere. MRI cervical spine showed severe
cervical canal stenosis at C3-4, C5-6 and C6-7 levels
with more compression from the posterior
elements with malacia of the spinal cord. There
is assimilation of C4 and C5. MRI lumbar
spine showing lumbar canal stenosis at L1-2,
2-3, 3-4 and L4-5.
Decompressive laminectomy of
C3,4,5,6 and upper 1/3 of C7 with preservation
of the spinous process of C7. There was no
epidural fat. Routine closure of the wound.
recovery. The patient showed dramatic
improvement of the power of four limbs.
The patient has progressive cervical canal
stenosis. The sooner the surgical intervention,
the better the postoperative outcome.
When there is stenosis of the cervical and
lumbar spine, the cervical pathology take
precedence in surgical treatment.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .