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  • Hello, I'm doctor Ali Biden, a neurosurgeon specializing in

  • the treatment of spinal disorders at John Hopkins University.

  • I wanted to share with you a video presentation regarding a

  • common condition that we encounter quite frequently - cervical disc herniation.

  • Patients usually present with neck pain,

  • arm pain, difficulty with fine mtor movements

  • of the hand, weakness in the hand, gait and stability and urinary problems.

  • This particular patient was found to have a

  • large cervical discrimination which was compressing her spinal

  • cord that we treated via surgical removal using

  • a small incision in the neck and microscopic guidance.

  • Here is the intra operative video taken during surgery.

  • The patient in this illustration is lying, eh, on their back

  • and a small insertion has been performed in the neck.

  • The vertebral bodies are exposed and so is the disk.

  • You can see us here drilling through the disk.

  • The drilling continues until we encounter the bones or the

  • end plates on the other side of the disc, which is where the spinal cord would be.

  • And here's another illustration of where the

  • vertebral bodies are and where the disc is.

  • This procedure is done under microscopic guidance.

  • And here you can see that we are removing disc pieces

  • that have herniated through the annulus and are compressing the spinal cord.

  • And these are 2 small pieces, 2 medium sized pieces that we have removed

  • from there.

  • The decompression continues.

  • As you can see with the usage of multiple instruments,

  • and there we will keep on going until we see the spinal

  • chord which is the best measure of decompression of the spinal chord.

  • As we are trying to remove the

  • last pieces of disc we

  • encounter a piece that has

  • herniated

  • backwards and is causing compression of the spinal cord.

  • And with the use of a nerve hook,

  • we are going to tease out that last piece that has herniated.

  • And the nerve hook has not been brought to the

  • field yet, as we are still trying to remove the

  • last pieces of the annulus prior to going

  • for the large piece fragment that has herniated.

  • So this is an illustration of the large herniated

  • disc fragment which we can feel with our [UNKNOWN]

  • and here we are gonna go with the nerve hook and see if we can tease it out.

  • We will place the nerve hook right on the spinal cord and

  • see if we can remove that piece and here comes that piece.

  • It's a large piece of disc that was straight on

  • the spinal cord causing significant compression of the spinal cord.

  • Here's another couple of small pieces as well that are also coming out.

  • That's not uncommon for discs to come in fragments as you can see here.

  • The large piece has been removed and the small

  • pieces as well which were compressive have been removed.

  • Another piece

  • is discovered

  • and has been

  • teased off of the spinal cord.

  • And here goes another big one.

  • At this point you can see that the spinal cord has been decompressed.

  • You can see the spinal cord and its small vessel on top of it.

  • And it is completely decompressed and all the disk fragments have been removed.

  • And that's another illustration of the spinal

  • cord which is that white, glossy structure

  • and at the end we would place a bone graft followed by a titanium plate.

Hello, I'm doctor Ali Biden, a neurosurgeon specializing in

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Ali Bydon醫生進行ACDF手術。 (Dr. Ali Bydon Performs An ACDF Procedure)

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    masasama 發佈於 2021 年 01 月 14 日
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