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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07-OCTOBER-2012 MUSTAFA YOUSEF AL-RAHAL 72 YEARS
PCD C4-5 AND C6-7 WITH MALACIA OF THE SPINAL CORD.
The patient came to the clinic 02-October-2012
complaining of neck pain for 1 year with
numbness left hand. 4 months ago started to
complain of numbness with heaviness both upper
limbs more the left with positive cough sign.
MRI of the cervical spine done 30-September-2012
showing huge extruded disc C4-5 and C6-7 with
malacia of the spinal cord behind C4-5 level.
On examination, the patient is walking with
ataxic gait with tendency to fall down. There is
mild scoliotic stance. There is pain when
looking to both sides more to the right. There
is pain associated with all neck movements.
There is weak grip, extension of the right hand
4/5 and left hand -4/5. Both triceps are mildly
weak 4/5. There is hypalgesia below the left Th5
level. The right quadriceps muscle is weak 4/5.
Discectomy of C4-5 with
removal of the extrusion until the dura was seen
at the entire space in the depth of the disc
cavity. The disc of C6-7 was cleaned internally.
Scientex Alphatec Spine Samarys cervical cage
4.5x17x13 mm was inserted to C4-5 level. Another
cage 5x17x13 mm was inserted to C6-7. Using
Trestle anterior plate 51 mm 3 level 51 mm
length was used to fuse C4-5-6-7. 4variable 4x14
mm screws were used to C4 and C7 bodies and 4
4x14 mm fixed screws to C5 and C6 bodies. Al
stages were done under C-arm control.
Routine closure of the wound. Smooth
postoperative recovery with dramatic recovery of
the power of both upper limbs.
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The patient had severe
compression of the spinal cord with malacia at
C4-5. Only surgical decompression was the only
solution. The other levels were included to
avoid future escalation of events from other
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