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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20-JANUARY-2013 JAMEEL AHMAD JAWASH 58 YEARS EXTRUDED
DISC C3-4, C4-5 WITH SEVERE SEGMENTAL STENOSIS AND MALACIA OF THE SPINAL CORD.
The patient came to the clinic 13-January-2013
complaining of both upper limbs pain and
numbness more the left hand for 2 months with
left lower limb pain and numbness. The patient
is a known diabetic for 10 years and underwent
CABG 7 years ago.
MRI cervical spine done 14-January-2013 showing
extruded disc C3-4, C4-5 with severe segmental
stenosis and malacia of the spinal cord with
elements of OPLL. MRI lumbar spine done
04-June-2012 was not significant.
On examination: the patient
using crutches for one month limping with
shuffling gait. There is pain when turning the
head to both sides more to the left and looking
upward. The left biceps muscle is weak 4/5. Grip
both hands 4/5, extension both hand 3/5, right
triceps -4/5 and left 2/5. There is hypalgesia
left hand and right die of the body below Th2
and the left leg below the knee. SLRS
was 70 degrees both sides. There is weak
dorsiflexion both feet 4/5 and the left
Discectomy of C3-4 and C4-5
with osteophytectomy until the dura was seen lax
at the whole entire posterior border of the
posterior edges of the bones. A Samarys cervical
cage 5x13x17 was inserted to the C3-4 level and
6x13x17 mm to the C4-5 level. Using Trestle
anterior cervical plate 30 mm length 2 level was
used to fuse C3-4 and 5. 2 variable screws 4x14
mm were used to the C3 body, 4x14 mm fixed to
the C5 body and 4x14 mm fixed to the right side
of C4 and 4.5x14 fixed to the left side of C4.
All stages of surgery were C-arm guided.
Routine closure of the wound.
Smooth postoperative recovery. The power of the
right upper limb and feet became normal.
Improvement of the power of the left upper limb.
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The patient has severe
cervical canal stenosis and extruded disc C3-4
and 4-5 with stenosis and elements of OPLL. The
condition is deteriorating and surgical
correction is the only solution to prevent
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