Background:The role of laminectomy alone as an etiology of postoperative cervical instability is well known. Cervical sagittal malalignment of the spine has been linked to unfavorable functional outcome, so the effect of restoration of sagittal spinal alignment on functional outcomes and treatment effectiveness has recently gained attention.Objective:This is a prospective observational study aims to observe the possible relation between cervical sagittal alignment and functional outcomes following sub-axial cervical lateral mass screw fixation in patients with cervical spondylotic myelopathy.Patients and Methods:Thirty patients were included in this study all suffering from cervical spondylotic mylopathy (CSM) who underwent cervical laminectomy and screw-rod fixation and followed up over 6 months. Functional outcome accessed using Nurick myelopathy score and neck disability index (NDI)?. We also used the Cobb angle method (C2–C7) as a parameter for radiographic assessment of the cervical sagittal alignment which was measured preoperatively and postoperatively on lateral neutral views of cervical X-ray.Results:All the patients underwent cervical laminectomy and fixation in a range of 3–5 levels. Two intraoperative facet fractures and four facet joint violations were observed. All the patients were followed-up for at least 6 months. There were significant improvements of the motor power (88.5%), Nurick score (90%), and NDI (90%) postoperatively. The mean preoperative Cobb angle for all patients was −8.51° ± 14.07° standard deviation (SD) which changed to −10.29 ± 12.43 SD at the end of follow-up.Conclusion:Combing posterior decompression with lateral mass screw– rod in patients with CSM was effective in improving or at least maintaining cervical alignment with the good functional outcome.
Objective The aim of this study was to compare the radiological outcomes of long-segment fixation and short-segment fixation, including the fracture level in patients treated for thoracolumbar junction fractures.
Methods Data collected from records of patients with thoracolumbar junction fractures who were operated at our department. Neurological evaluation was done using American Spinal Injury Association classification score. Radiological parameters used were the Cobb's angle, vertebral body compression ratio, the anteroposterior spinal canal diameter, and the anterior and the posterior vertebral body heights. Patients were divided into two groups: group A included patients who underwent long-segment fixation and group B included patients who underwent short-segment fixation with inclusion of the fracture level.
Results The mean preoperative Cobb angle was 22.51 degrees in group A and 19.37 degrees in group B. Both groups showed improvement in the postoperative Cobb angle as the mean in group A was 14.17 degrees and in group B was 11.77 degrees. The mean preoperative compression ratio in group A was 82.8%, while in group B it was 76%. The postoperative mean in group A was 89.2%, while in group B, it was 84%. The mean preoperative anterior vertebral body height of the fractured vertebra in group A was 16.7 mm, while in group B, it was 15.18 mm. The mean preoperative posterior vertebral body height in group A was 16.33 mm and that of group B was 19.41 mm. The mean postoperative anterior vertebral body height in group A was 17.66 mm and that of group B was 17.10 mm. The mean postoperative posterior vertebral body height in group A was 17.11 mm and that of group B was 20.79 mm.
Conclusion Posterior short-segment fixation with additional screws at the fracture level provides similar—if not better—clinical and radiological outcomes to long-segment fixation in the treatment of thoracolumbar junction fractures.
Background: Traumatic brain injury (TBI) is considered the most common cause of death and disability among young individuals, Traumatic intracerebral hemorrhage (TICH) is a common complication of traumatic brain injury. It represents the leading cause of morbidity and mortality in individuals also it is known to be the most important determinant of outcome in polytraumatic patient. Objectives: Evaluation of the clinical and radiological outcomes in patients with traumatic intracerebral hemorrhage admitted to Neurosurgery department at Qena university hospitals. Patients and methods: This study was conducted by collecting data from the records of 37 patients with traumatic intracerebral hemorrhage admitted to Neurosurgery
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