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.tv

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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 .

03-DECEMBER-2014  MAHMOUD ABDEL-AZIZ AL-UMARY  72 YEARS  SEVERE CERVICAL STENOSIS C2-3 DOWN TO C5-6 WITH MALACIA OF THE SPINAL CORD.

 

Anamnesis

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The patient came to the clinic 29-November-2014 in wheelchair for 22 days  with neck pain and difficult walking for 3 months with numbness four limbs more the left side. MRI of the brain done 18-November-2014 compatible with age and cervical showing severe stenosis from C2-3 down to C5-6. The patient underwent cath 2006 without stinting. He was operated for laryngeal mass 5 years ago.

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On examination, the patient examined in wheelchair. There is hypalgesia left side below the D2 level and below. He has pain in the neck when looking down, up and to the left. Both deltoid muscles 4/5, biceps 3/5, grip right hand 3/5, left hand 2/5, extension right hand 3/5, left hand 1/5, left triceps 3/5. The patient has drop left wrist. Complete drop left foot. Dorsiflexion right foot 3/5. Planterflexion right foot 4/5 and left foot 1/5. The right quadriceps femoris 4/5 and the left 3/5. Hoffmann positive both sides more brisk in the left. Babinski positive both sides. Loss of urinary control the last 3 days.

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The patient was sent for cervical X-ray with dynamic studies to rule out instability. MRI of the cervical spine performed the same day confirming the presence of the above mentioned levels with small recent disc at C5-6 left side. Cardio consultation approved his tolerance for surgery.

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Foley's catheter was inserted 3 days before surgery.

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Decompressive laminectomy of C3,4,5 and upper 3/4 of C6 and lower 3/4 of C2. There is no epidural fat and the dura was transparent at several places. The disc of C5-6 was inspected from the left. No major extrusion detected. Strict hemostasis. Routine closure of the wound.

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Smooth postoperative recovery. The power of four limbs improved slightly.

 

 

Comments  

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The patient has a progressive disease, the earlier the surgical decompression the better the recovery.

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Leica HM500

Leica HM500
The World's first and the only Headmounted Microscope.
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TRUMPF TruSystem 7500

After long years TRUMPF TruSystem 7500 is running with in the neurosuite at Shmaisani hospital starting from 23-March-2014


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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 .

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