Discusión entre pares / 63 yr male…quadriparetic…ASIA C…bowel/bladder involved..

63 yr male…quadriparetic…ASIA C…bowel/bladder involved…what will b adequate surgical decompr and stabilizn?
  • Sandeep Sonone Plan on radiological picture wud C4C5 corpectomy with C3 to C6 fusion .same stage or second stage post fusion fron C3 to C6 .
    10 horas · Me gusta · 1

  • Pravin Padalkar Sandeep Sonone why c4 c5 corpectomy. It is hardly causing any compression from front

  • Abhishek Ray Sandeep sir…was wondering whether to include C6…don’t want to see in post op CT that compression us still persisting…

  • Senthil T. Nathan I would do a c4/c5 corpectomy , c6/7decompression, ACDF c3-c7 , post fusion as stage 2

  • Abhishek Ray Senthil..just sceptical abt adding 2 more potential non union sites…tell me, would u use a fibula or cage?

  • Ali Öner C3-4 disc removal and decompression, c5 corpectomy or c5-6 disc removal and decompression. 

    Besides decompression surgery, The main goal should be re-arrangement of cervical lordosis, either by long plate (c3-c6), or if not possible, posterior instrumentation should be added.

    By this way, patient will need less corpectomy & Lilly have less chance of pseudoarthrosis.
    6 horas · Editado · Me gusta · 3

  • Niranjan Kavadi I think I would do C4 and 5 corpectomy and take that C6 superior osteophyte then cage and plate. C3 to C6 posterior same day or next couple of days depending on patient condition.

  • Deepak Joshi On this film I think Patient needs decompression at c3-4 and behind c 5 , hybrid construct with ACDF c3-4 and corpectomy c5 with plate c3-6 and then PSIF

  • Vedant Vaksha Patient is melopathic with signal changes & loss of CSF around cord at C3-4, but at the same time shows signal changes at C4-5 & C5-6 also. CSF is present at those levels, but I suspect that there may be dynamic stenosis with associated kyphosis at allVer más
    3 horas · Editado · Me gusta · 3

  • Swetabh Verma To b honest, this is a tough case to manage and with myelomalacic changes and asia c score, the prognosis is guarded..with respect to the mr image, there is more anterior compression at c3-4 and down c6-7 as seen by obliteration of csf sleeve..also as Ver más

  • Pravin Padalkar This spine need primarily correction of alignment and decompression at C34. I would prefer minimum possible to achive goal . C34 C45 ACDF C6 Corpectomy long plate in front And 2nd stage posterior instrumentation

  • Advance Lumbar Spine Technique Get dynamic xrays done. Also show parasagittal and axial T2 images at C3-4 to rule out facet effusion indicating instability.

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