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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06-APRIL-2011 HASAN MUSA AL-KOOZ 73
YEARS PCD C4-5.5-6 AND C6-7 WITH MALACIA OF THE SPINAL CORD
WITH TETRAPARESIS.
Anamnesis
The patient
came to the clinic 25-December-2006 complaining of
neck and both shoulders pain for 2 weeks more
the right. At that stage he had weak right hand
and right triceps muscle 4/5.
The
patient then came 09-January-2007 with MRI of
the cervical spine performed 26-December-2006
showing deformation of C4-5-6 with PCD C4-5 and
C5-6 and malacia of the spinal cord and he was
advised to undergo surgery, but he escaped.
The
patient then came 02-April-2011 with MRI of the
cervical spine done 26-March-2011 showing PCD
C4-5, 5-6 an 6-7 with malacia of the spinal
cord.
The
patient underwent KABAG 2007 and CT-angio done
28-March-2011 was uneventful. The patient is a
diabetic for 2 years in treatment.
On
examination: the patient walking bended with
weak four limbs, more the left side. The
weakness of both hands grip and extension is
4/5, both triceps 3/5. The lower limbs muscles
are 4/5 except for profound weak dorsiflexion
both feet 3/5.
Discectomy C4-5. 5-6, 6-7 with osteophytectomy
was done to eliminate all the compressive
elements. Using Fidji cages 14x18x6.9 mm were
inserted to C4-5 and C6-7 levels. A cage
14x17x6.9 mm was inserted to C5-6 level.
Novabone was added to the cages. Trinica Zimmer
cervical plate 3 level 54 mm length was applied
with 8 cervical screws 4.2x16 mm length
were used to fuse C4-5-6-7 bodies.
Routine
closure of the wound. Smooth postoperative
recovery with improvement of the power of four
limbs.
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Comments
The spinal cord compression is increasing over
the time and the malacia which was present from
the start with the clinical deterioration, all
indicate that surgical decompression is the only
solution to prevent further future
deterioration.
Fidji cages are superior among other cages,
because their contour respect the normal
alignment of the disc spaces, minimizing
possible future sinking or dislodgment.
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 .