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10-JANUARY-2023 AZHARIYEH AMEEN ABU-SNENEH 83 YEARS
SEVERE CERVICAL CANAL STENOSIS C3-4, 5-6 WITH TETRAPARESIS AND MALACIA OF SPINAL
CORD.
Anamnesis
The patient's son came to the clinic
15-December-2022 telling that his mother
complaining of neck and both upper limbs pain,
more the left. MRI cervical spine done
15-November-2022 showing severe stenosis C3-4
and C5-6 with malacia of the spinal cord at
these levels. He was asked to perform dynamic
studies of the cervical spine with CXR to rule
out overmobility. She was seen by cardiologist
and pulmonary specialists. She is a known
diabetic and hypertensive for 1 year.
The patient was admitted 09-January-2023. On
examination, the patient is walking with help
with tetraparesis starting from both deltoids
3/4 down to feet with the right hand weaker than
the left- 2/3. There is hypalgesia from right C3
and left C4 with more dense loss of sensation in
the left side. All pathologic reflexes present,
but no clonus. She cannot elevate her right
upper limb above horizontal level. All deep
reflexes are exaggerated. Frozen right shoulder
and severe OA both knees, more the right with
pain and limitation of flexion.
Decompressive laminectomy
C4,5 and upper half of C6 and lower half of C3. The dura was
transparent that the spinal cord was seen
through it. There was no epidural fat, only at
the lower area of C6. Check for CSF leak was negative.
Routine closure of the wound. Smooth
post-operative recovery. The power of four limbs
moderately improved. She was sent to the ward.
FOLLOW UP
Too early now.
Comments
The stenosis is progressing in this case.
The sooner the decompression, the better the outcome.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Inomed Riechert-Mundinger System, with three point
fixation is the most accurate system in the market. The microdrive and
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Inomed MER system
Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
LooksCam II Xenosys in the run starting from 14-March-2021 with
SheerVision TTL x4 magnification.
Cios-Spin flat panel in the run.
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 .
