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19-JULY-2007 HUSNI HAMED AHMAD ABDEL-HADI 67 YEARS SPONDYLOLISTHESIS C4-5
AND C7-D1 WITH SEGMENTAL STENOSIS AT C4-5 LEVEL AND INVERTED CURVATURE OF THIS
SEGMENT.
Anamnesis
The patient is a known diabetic, came to the
clinic 13-June-2007, complaining of neck and
left ulnar distribution pain. The last 2 months
got right shoulder pain with numb right hand.
MRI of the cervical spine performed 06-May-2007
showing spondylolisthesis C4-5 and C7-D1 with
inverted curvature of the cervical alignment and
compression at C4-5.
On examination: all the muscles of both upper
limbs are weak 4/5 except the left triceps
muscle. The right biceps is more weak than other
muscles and the patient is unable to hold his
upper limbs above the shoulder level. There is
weak dorsiflexion both feet.
Discectomy of C4-5 and drilling the osteophytes
at C5-6 and C6-7 with discectomy of C7-D1 was
performed. Using 4 level cervical miniplate
fusion of C4 down to D1 was performed. It was
noticeable, that the C5 body was shifted down
and it was brought anteriorly with the screws.
So that the C6 body to resolve the inversion of
the curvature of the cervical spine and turn it
to acceptable alignment.
Routine closure of the wound and smooth
postoperative recovery.
The patient regained power of the muscles of the
upper limbs immediately after surgery.
Comments
The patient had not convincing compression of
the spinal cord in the MRI studies. The instability was most of
his problem, for what reduction and fixation was needed to
prevent dynamic compression and prevent repetitive trauma to the
spinal cord.
The motor fibers recover immediately after
the operation.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
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