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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20-AUGUST-2013 AHMAD HASAN JIBARA 50 YEARS
SEVERE CERVICAL CANAL STENOSIS C4-5,5-6 AND C6-7 LEVELS.
The patient came 26-July-2012 complaining of LBP
with bilateral sciatica for 1 year. Had
difficult walking with ataxia for 1 week. MRI
lumbar spine done 07-March-2012 showed lumbar
canal stenosis L3-4 and L4-5. On examination at
that time, he was limping and dragging the right
lower limb. The patient was sent for further
investigations and disappeared.
The patient then came 15-August-2013 with
clinical deterioration and weak four limbs and
difficult walking and dragging the right lower
limb. The MRI of the brain requested in first
visit done 17-October-2012 showed small
scattered lacunar infarctions both cerebral
hemispheres and the brainstem. MRI cervical
spine bad quality showing cervical canal
stenosis C5-6, C6-7.
On examination the patient has weak grip left
hand 3/5 extension of both hands and triceps
both upper limbs -4/5. Weak right quadriceps
4/5, abduction and adduction of the right knee
4/5, dorsiflexion right foot -3/5, left foot
+3/5 and planterflexion right foot 4/5. SLRS was
60 degrees due to weak right lower limb and
exaggerated KJ more the right.
MRI cervical spine performed 15-August-2013
showing severe cervical canal stenosis C4-5,
C5-6 and C6-6 with old extruded disci C5-6,
C4,C5,C6 and C7. There was no epidural fat at
the exposed areas. There was slight overmobility
of the segments. The lateral masses was not
violated. Routine closure of the wound.
Cervical canal stenosis taking precedence over
the lumbar canal.
As mentioned above the patient has lacunar
infarctions of the brainstem and cerebral
hemispheres. Surgery in this case was advised
with such data to eliminate all the causes other
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