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The patient
came to the clinic 13-May-2009 complaining of
neck pain for 6 months with numbness both hands
with bilateral CTS for 5 years.
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On
examination she had pain when turning the head
to the right with weak grip 4/5 and extension
3/5 both hands and right triceps muscle 4/5. She
had severe atrophy of both thenar muscles for 10
years with hypalgesia both median nerves
distribution. |
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MRI cervical spine
done 16-May-2009 showed small extrusion of C3-4
and C4-5 with data confirming the presence of
severe CTS both sides. She was advised to
undergo CT-release, but she disappeared. |
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The patient then
came 24-February-2011 complaining of
exacerbation of neck pain the last week with
shooting pain to the right shoulder and right
upper limb. She had severe limitation of neck
movement with pain when looking up and to the
right. The neurological deficit in comparison to
the previous one was worse. |
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New MRI
cervical spine performed and done
25-February-2011 showing huge PCD C3-4 with
elements of spondylolisthesis at this level. |
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Anterior discectomy C3-4 was performed with
osteophytectomy. The dura was seen at the entire
width of the disc space. After several trails,
Fidji cervical cage 12X14X7.7 mm was inserted.
Using cervical plate Zimmer Trinica 24 mm length
one level with screws 4.2X14 mm length,
fusion of C3-4 was achieved. |
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Routine
closure of the wound. Smooth postoperative
recovery with improvement of the power of both
upper limbs. |
