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08-AUGUST-2007 MAHMOUD SALAMEH HUSSEIN 73 YEARS HUGE PCD C3-4
WITH FRACTURE OF THE OSSIFIED C3-4 DISC.
Anamnesis
The patient came to the clinic 14-April-2007
complaining of neck pain for 5 months with
quadriplegia.
MRI of the cervical spine performed
20-November-2006 showing huge PCD C3-4 with
malacia of the spinal cord at that level.
On examination: the patient is unable to walk
with quadriparesis 3/5 of all four limbs and
pathologic reflexes and exaggerated all deep
reflexes with quadrihypalgesia below C3.
Inspection of the anterior alignments of the
cervical column showed fracture of the ossified
C3-4 disc. Drilling of the anterior osteophytes
and discectomy of C3-4 with removal of all the
extrusion which was severely compressing the
dura. Further removal of the osteophytes
compressing the dura. Using Hybrid cervical
miniplate, fusion C3 and 4 was performed.
Smooth postoperative recovery. Some improvement
of the power of all four limbs.
Comments
The patient was quadriplegic for 9 months and
showed slight improvement with Nucleo-CMP, Somazina, Neurontine
and Neurobion. But this modality of treatment is not substitute
for surgery. It seems, that the patient was reluctant for
surgery, which could play a negative role in the degree of his
future improvement.
Fracture of the OPLL at the C3-4 level was
impossible to predict before surgery. The inspection during
surgery, confirmed the presence of such fracture with subsequent
extrusion of the disc material and severe compression of the
spinal cord.
The presence of huge anterior osteophytes are
an obstacle for discectomy and reduction. They must be drilled
off to have good alignment with proper positioning of the
miniplate.
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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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