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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28-MAY-2008 MUHAMED SADEQ AL-TAWEEL 68 YEARS
SEVERE CERVICAL CANAL STENOSIS C3-4 AND C4-5.
Anamnesis:
The patient came to the
clinic 28-April-2008 complaining of numbness
right upper and lower limbs for 1 month,
increasing the last three days.
On examination: Romberg sign
- stable with deep tendon reflexes D>S.
There was pain with Lhremitte sign when looking
upward. The power of muscles of the right upper
limb was 4/5, except for hand extension 3/4.
There was weak dorsiflexion both feet 4/5 and
planterflexion right foot 4/5. Hypalgesia
of the median nerve distribution right hand.
MRI cervical spine performed
20-May-2008 showed severe cervical canal
stenosis at C3-4 and C4-5 with malacia of the
spinal cord at these levels. There were also
scattered lacunar infarcts of cerebral
hemispheres of no clinical importance.
The patient has no
hypertension, nor diabetes mellitus and he
underwent cervical discectomy C5-6, and C6-7 15
years ago.
Decompressive laminectomy of
C3,4 and partial of C2 and C5 was achieved. The
epidural fat was missing all over.
Routine closure of the wound
with prompt recovery of the power of al limbs.
Comments
If the stenotic elements of
the cervical spine are equal from anterior and
posterior, it is preferable to decompress the
cervical spinal cord from behind.
Using the drilling, bring the
surgical trauma to zero.
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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 .