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18-OCTOBER-2003 YOUSEF ABED UTHMAN 60 YEARS
EXTRUDED DISC C3-4 WITH QUADRIPARESIS.
Anamnesis
The patient came to the clinic
28-September-2003 complaining of weak four limbs
with subsequent hypotrophy and difficult walking
for 5 months started from the right upper and
lower limbs. The patient is in wheelchair with
Foley's catheter. MRI cervical done
21-September-2003 showing huge extruded disc
C3-4 with spinal cord compression.
On examination: the patient is in wheelchair and the power of all upper limbs muscles
are 2/5, except the right hand grip and
extension 1/5. The power of the lower limbs are
3/5 except the a flail right foot.
There is analgesia both upper limbs. Hoffman and Babinski were positive both sides.
Discectomy with
osteophytectomy of C3-4
was done until the dura was seen along all the
posterior aspects. All stages of surgery were
done under C-arm control.
Routine closure of the wound.
Smooth postoperative recovery. The power of the
four limbs dramatically improved. He was sent
to the ward.
FOLLOW UP
The patient
came 29-October-2003 with clean wound. The power of
the upper limbs 5/5, except the right hand flexion
and extension 2/5 with no sensory deficit. The power
of the lower limbs became 5/5, except the right
quadriceps 3/5 and right foot dorsi and
planterflexion 4/5.
The patient
then came 11-December-2003 walking without Foley's
catheter with the grip of the right hand still 3/5
and the dorsiflexion right foot 4/5.
The patient
then came 26-February-2006 telling that he got CVA 8
months ago and MRI workup showed stenosis right ICA
70% with scattered infarctions of the pons and
right parietal region. The patient was treated
conservatively.
The last time
seen 18-November-2006 with spastic left paresis. The
right side of the body is acceptable. He can urinate
and defecate. He was treated conservatively.
Comments
Recurrence rate in cervical discectomy is zero.
The patient suffered CVA and I do not know where
he was treated. Treating such event is time
sensitive and require interference within
minutes of hours, preferable less than 6 hours
from the start of the insult. He came to me 8
months later, when there is nothing to do.
Skyra MRI with all clinical applications in the run since 28-Novemeber-2013.
Inomed Riechert-Mundinger System, with three point
fixation is the most accurate system in the market. The microdrive and
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Inomed MER system
Leica HM500
The World's first and the only Head mounted Microscope.
Freedom combined with Outstanding Vision, but very bad video recording and
documentation.
After long years TRUMPF TruSystem 7500 is running with in the neurosuite at
Shmaisani hospital starting from 23-March-2014
LooksCam II Xenosys in the run starting from 14-March-2021 with
SheerVision TTL x4 magnification.
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 .
