Munir Elias 20-12-2013

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.fr

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Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses


Multigen RF lesion generator .

21-FEBRUARY-2014  IMAN ABDEL-RAHMAN FAREED  44 YEARS  HUGE EXTRUDED DISC C6-7 WITH LEFT FORAMINAL OCCLUSION AND BULGE C5-6.

 

Anamnesis

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The patient came to the clinic 18-February-2014 complaining of neck and left upper limb pain for 8 years. Exacerbation the last 6 days  with numbness of the II-IV fingers left hand. The patient performed MRI cervical spine 19-June-2013 showing extruded disc C6-7 more to the left with bulge C5-6. MRI lumbar spine was normal, brain -partial empty sella.

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On examination; the patient has severe pain and limitation of neck movement when looking to all directions. There is weak grip and extension left hand 3/5. The triceps left arm almost paralyzed 1/5.

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The patient sent for MRI of the cervical spine and done 18-February-2014, showing huge extruded disc C6-7 with left foraminal occlusion and bulge C5-6.

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Using C-arm, the level of C6-7 level identified. Discectomy of C6-7 with removal of the extrusion, which was occluding the left foramen, even with intradural expansion. The dural defect was about 1 mm. It was closed by piece of muscle. Intradiscal cleaning of C5-6. Using Vitatech (France) a cervical cage 6.5x16 with bone graft was inserted to C6-7 level and 5.5x16 mm to the C5-6 level. Cervical plate 2 level 41 mm length with 4 screws 4x18 mm applied to C5 and C6. 2 screws 4x16 mm were used to C7 level. Fusion of C5-6 and C7 was obtained. All stages of surgery were performed with C-arm guidance. Routine closure of the wound.

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Smooth postoperative recovery. The power of left hand became normal and the left triceps became 4/5. The radicular pain disappeared.

 

 

Comments  

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The patient had intradural penetration of the extruded disc material. A small piece of muscle was sufficient to resolve the problem.

 

Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and documentation.


Back Up!

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 .

WELCOME TO AL-SHMAISANI HOSPITAL

 


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