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
neurosurgery.tv
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04-JUNE-2009 FARHAN SULAYMAN AWWAD 49 YEARS
BURST FRACTURE D11 WITH MILD COMPRESSION OF THE SPINAL CORD.
Anamnesis:
The patient suffered RTA
31-May-2009 with trivial head injury and
contusion of the kidneys and burst fracture of
D11 with minimal compression of the spinal cord
and linear fractures of the surrounding ribs.
The patient was transferred from another
hospital.
On examination: the patient
was neurologically free and he was bedridden
with corset at the lumbo-dorsal region.
MRI lumbar spine, which was
done 01-June-2009 which confirmed the diagnosis
and CT-scan of the abdomino-pelvic region and
the fractured D11 area were performed.
Using image-intensifier, the
D11 was identified. Skeletonization of D9-10 and
D12 and L1 was performed with preservation of
the interspinous ligament, which proved to be
intact. Using sublaminar hooks at the laminae of
D9, 10 and D12 and L1 and rods, reduction with
distraction and fixation was applied. The rods
were modeled and bended to imitate the normal
curvature of the area. Serial check X-rays were
performed to see to reduction of the deformed
vertebral body of D11.
Smooth postoperative recovery
with preservation of the neural functions.
Comments
The patient was planned in
the other hospital to undergo surgery with
corporectomy and cage replacement?? The best
policy is to achieve the best result with less
destructive surgery. In this case the
preservation of the interspinous ligament and
the anterior and posterior longitudinal
ligaments make the extreme plan for corporectomy
meaningless. The aim of surgery to reduce to
involved vertebra and decrease the degree of the
compression and most important the achieve
stability for early mobilization of the patient.
Please! wait for 3-5 min till the
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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 .