The patient came to the clinic 18-February-2013
complaining of severe weak four limbs after
falling down 40 days ago with feeling numbness
both hands with difficult moving of the hands
and right shoulder pain radiating to the right
MRI cervical spine done 16-January-2013 showing
severe cervical canal stenosis C3-4 with malacia
of the spinal cord at his level and stenosis to
lesser degree at C4-5 and C5-6 levels.
On examination: The patient is standing and
walking with help. There is weak both deltoid
muscles -4/5, both biceps brachii -3/5 more weak
at the right side and 2/5 grip both hands and
1/5 extension left hand and 0/5 right hand
and 2/5 of the right triceps muscle right upper
limb with good power of the left. There is weak
dorsiflexion both feet -4/5 more the left.
Hypalgesia both hands. Hoffmann positive
both sides more brisk in the right with
exaggerated deep reflexes all over.
C3,4,5 and upper half of C6. The ligamentum
flavum at C2-3 was calcified, for what it was
drilled out. The epidural fat was missing all
over due to severe compression. The dura start
to show good cardio-pulmonary pulsation.
Routine closure of the wound.
Smooth postoperative recovery. The power of
the feet became normal. The upper limbs still