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Multigen RF lesion generator .
26-OCTOBER-2003 FATMEH UBAID AHMAD 70 YEARS
SEVERE CERVICAL STENOSIS C3-4, 4-5, 5-6 WITH MYELOPATHIC SYNDROME.
Anamnesis
The patient came to the clinic
03-September-2003 complaining of inability to
walk for 6 months. MRI lumbar done
06-August-2003 showing severe lumbar canal
stenosis L1-2, 2-3 and L4-5. The patient is
diabetic and hypertensive for 5 years under
treatment. Operated for lumbar canal stenosis
L3-4 and L4-5 15 years ago. Using crutches for 6
months.
On examination: the patient is in wheelchair and the power of all upper limbs muscles
are 3-4/5 more weak the left side. SLRS was 90
degrees both sides with Hoffman sign positive
both sides and Babinski positive right side.
Drop left foot.
The patient was sent for investigations and MRI
of the brain, cervical and dorsal spine done
22-October-2003 showing severe cervical stenosis
C3-4, 4-5 and C5-6 with myelopathic changes.
Discectomy with
osteophytectomy of C3-4, 4-5 and C5-6
was done until the dura was seen along all the
posterior aspects. Scientx cervical plate with 8
screws were used to fuse C3-4-5-6. All stages of surgery were
done under C-arm control.
Routine closure of the wound.
Smooth postoperative recovery. The power of the
four limbs moderately improved. She was sent
to the ward.
FOLLOW UP
The patient
came 05-November-2003 with clean wound and check
X-rays acceptable. The power of
the upper limbs 5/5 with no sensory deficit. The power
of the lower limbs became 5/5, except the right
quadriceps 4/5 and right foot dorsi and
planterflexion 4/5 and drop left foot.
The patient
then came 16-December-2003 walking with crutches
with full power of the right lower limb, but still
having hypalgesia below the left L2 level and right
L44 level with weak dorsi and planterflexion left
foot 1/5.
The patient
then came 12-June-2004 with some improvement of her
neurologic deficit and sent for investigations and
she disappeared.
Comments
Recurrence rate in cervical discectomy is zero.
The patient still needs surgical decompression
of her lumbar spine, but she disappeared.
In retrospective analysis of her plate, the
plate must be bended more to accept the natural
curve of the area. That is the reason that the
screws at the periphery of the construct were
difficult to penetrate the bone.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
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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.
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 .
