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Malay's
Malay's
Malay's
Malay's
Spinal Cases
Cauda Equina Syndrome With Paralysis of Both Legs , Bladder and Bowel Invaded due to L5S1 Rupture Disk

Patient :
Sanjuli Basumatari - 21 Yrs Female
Kokrajhar, Assam

Treatment Done :
L5S1   Laminectomy
L5S1  Total Discectomy

Post Operative :
Both Legs Become Normal
Normal Bladder & Bowel Function
Pain Free
Can Walk Stand & Sit Easily

L5 - S1 Intra Vertebral Disc Herniation

Clinical Findings and Investigations

  • The patient presented with severe backache which increased in intensity from last 4-5 days. The patient also complained of radiating pain towards her right ankle. She had no bladder or bowel involvement or any other neuro deficit as such. She was asked to undergo a M.R.I. of the lumbo sacral spine the report of which suggested Lumbar spondylosis with marginal anterior osteophytosis and Right L5-S1 i.v. discal herniation with right L5-S1 nerve root and thecal sac compression.

Management

  • The patient was managed surgically for L5-S1 fenestration + Removal of disc + S1 root max. totally free. The surgery was done under G.A.
Pre Operative Images

 


Post Operative Images

   
Cervical Spondylysis with C5 - 66 Disc Rupture

Clinical Findings and Investigations

  • A 29 year old male patient presented with the history of a pulling sensation of the abdomen , chest and both upper limbs which became severe since 10-15 days. No h/o D.M. or H.T.N.
  • On examination his Pulse was - 82/min , B.P. - 140 / 80 mm of Hg
  • Chest : Clear , Abdomen : Soft
  • Patient was unable to walk and had difficulty in urination and had exagerrated jerks.
  • MRI of the cervical spine showed typical charecteristics of cervical spondylosis with degenerative discs. C3-4 i.v. disc showed right paracentral disc protrusion obliterating neural foramina.C5-6 disc also showed posterior tear in the annulus with herniation of disc posteriorly reducing the anterior subarachnoid space and causing cord compression.
  • The patient was treated surgically by C5 / 6 microdisccectomy with microscope and anterior approach under G.A. Post operative recovery was uneventful but finally the pt. became stable and was discharged.


Pre Operative Images


Post Operative Images

 
C5 - 66 Disc Heriation

Clinical Findings and Investigations

  • Patient presented with weakness in all four limbs----Quadriplegia
  • Pulse - 80 / min
  • B.P. - 100 / 60 mm of Hg
  • Abdomen - Soft and non tender
  • GCS – E4 V5 M6
  • No pupillary inequality
  • MRI report suggested anterior subluxation of C5 body with no marrow oedema.Posterior diffuse protrusion and herniation of C5-6 i.v. disc causing cord compression.

Management

  • Exploration done through anterior approach , hematoma removed and disc localisation done under C-ARM image intensifier and C5-6 discectomy done under microscope.


Pre Operative Images

 


Post Operative Images

 
Intradural Extramodullary Schwannoma

Clinical Findings and investigations

  • The patient a 35 year old gentleman presented with a severe neck pain and no other neuro deficit as such. He Had done a M.R.I. at Apollo hospital Chennai the report of which suggested intradural extramedullary S.O.L. at C2-3 level causing compressive myelopathy.------consistant with schwannoma / neurofibroma
  • Eventually when he came to us he was suggested a surgical treatment.

Management

  • Total removal of the SOL under G.A. The histopathology of the specimen suggested a Degenerate Schwannoma.
  • Differential diagnosis - Vascular Malformation


Pre Operative Images

 


Post Operative Images

     
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