Objective: The purpose of this study is to analyse the complication rate of endoscopic third ventriculostomy for obstructive hydrocephalus. Study Design: Descriptive study Place and Duration: This descriptive study was conducted at Dow International Medical College and Hospital OJHA Campus, Karachi in the period from May, 2022 to October, 2022. Methods: Total 97 male and female patients aged 1-30 presented. Patients had obstructive hydrocephalus were included. With consent, all patients provided age, sex, and BMI. CT and brain MRI were performed. In all reported instances, a third ventriculostomy was done under general anaesthesia after symptoms had become apparent. Two-week follow-up examined post-treatment efficacy and complications. SPSS 26.0 analyzed all data. Results: 66 (68.04%) of the 97 patients were male, while 31(31.96%) were female. The most frequent illness was aqueductal stenosis, which was seen in 64 (65.97%), followed by posterior fossa tumours in 15 (15.5%), blocked VP shunts in 13 (13.4%), and CSF ascites in 5 (5.2%) instances. Frequency of complication was found in 22 (22.7%) cases, most prevalent was CSF leak, followed by meningitis, seizures and bleeding. There were 3 deaths (3.1%) among all cases. Conclusion: In this research, we found that endoscopic third ventriculostomy reduced the risk of complications and death for patients with obstructive hydrocephalus. Keywords: Obstructive Hydrocephalus, Complications, Endoscopic Third Ventriculostomy, Mortality
For spinal injuries, thoracolumbar junction is common site in our population. Surgical management of unstable fractures and fracture dislocations of thoracolumbar spine is still controversial. This study was conducted to document efficacy of short segment fixation of thoracolumbar verterbral fractures. Objectives: To determine the outcome of short segment transpedicular fixation of thoracolumbar fractures. Study design: Descriptive cross-sectional study. Sampling technique: Non-probability purposive sampling. Material and Methods: A total of 103 study cases with thoracolumbar vertebral fractures were taken in this descriptive case series study which was conducted at department of Neurosurgery, Nishtar Hospital Multan from February 2014 to June 2015. Informed verbal consent was taken from each patient before participation in this study ensuring them confidentiality of the information and explaining them objectives and procedure of our study. Once registered, detailed history and clinical examination was done by a Neurosurgeon, investigations like X-ray dorsolumbar spine, CT scan and Magnetic resonance imaging (MRI) dorsolumbar spine were also done. Short segment transpedicular fixation was done and outcome of surgical management was assessed in terms of improvement in power, hardware failure and infection by consultant neurosurgeon. All the study cases were called for follow up visits after every month till 6 months to record final outcome of management. All the information were recorded in the study proforma. Data were entered and analyzed by SPSS version 22. Results: Out of these 103 study cases, 66 (64.1 %) were male patients and 37 (35.9 %) were female patients and male to female ratio was 1.85:1. Mean age of our study cases 33.92 ± 9.72 years ranging from 20 years to 54 years. Mean ages of male patients was 36.68 ± 10.37 years while in female patients it was 29.00 ± 5.89 years (p=0.000).Post-surgical management improvement in power was seen in 55 (53.4%) of our study cases, hardware failure in 11 (10.7%) and infection was observed in 20 (19.4%). Conclusion: According to our study short segment transpedicular fixation is safe & effective procedure providing efficient spinal stability. Short segment fixation is associated with minimum blood loss and trauma and leads to early mobilization of the patient and ease in physiotherapy. Transpedicular screw fixation is a useful choice for achieving better neurological recovery and good pain control in post-traumatic thoracolumbar fractures.
Objectives: To measure outcome of patients with cervical spine injury treatedwith and without surgical intervention. Study Design: Cross sectional study. Place andDuration of Study: 3years, Department of neurosurgery, Nishtar hospital Multan. Patients andMethods: Total 43 patients with cervical spine injury fulfilling the inclusion and exclusion criteriawere admitted from OPD and emergency department of Nishtar Hospital Multan. Patients wereexamined for motor loss at the time of admission and on follow after the assigned treatment.MRI neck was performed in all patients. Results: There were 43 patients in total. Males were31 (72%) while females were 13 (28%) with 2.5:1 ratio. Mean age was 33.92 ± 11.4. MeanPower grade was 2.2± 1.4 at the time of admission while on follow mean Grade of power was3.34±1.51 with P value of 0.00. Conclusion: Cervical spine injury patients are associated withImprovement in power with or without surgical intervention.
To measure outcome of patients with cervical spine injury treated with and without surgical intervention. Study Design: Cross sectional study. Place and Duration of Study: 3years, Department of neurosurgery, Nishtar hospital Multan. Patients and Methods: Total 43 patients with cervical spine injury fulfilling the inclusion and exclusion criteria were admitted from OPD and emergency department of Nishtar Hospital Multan. Patients were examined for motor loss at the time of admission and on follow after the assigned treatment. MRI neck was performed in all patients. Results: There were 43 patients in total. Males were 31 (72%) while females were 13 (28%) with 2.5:1 ratio. Mean age was 33.92 ± 11.4. Mean Power grade was 2.2± 1.4 at the time of admission while on follow mean Grade of power was 3.34±1.51 with P value of 0.00. Conclusion: Cervical spine injury patients are associated with Improvement in power with or without surgical intervention.
Material and Methods; A series of descriptive case was completed at Neurosurgery Department Nishtar Hospital Multan. The time period for this study was from November 2014- September 2016. After registering the patients, under the supervision of an expert neurosurgeon results of all the clinical examinations, and medical history were recorded. The medical record reported forty-one consecutive patients were treated with one-stage posterior debridement, transpedicular fixation suffering from monosegmental lumbar spinal tuberculosis, between December 2014-August 2016, were prospectively analyzed. Results; Forty one patients were observed for this procedure 25 (61%) were male patients and 16 (39%) of the patients were female with their mean age was 29.58 years ±2 years. The average time between follow-ups was 13.6 ±2.7 months. The average pain score preoperatively was 9.2 ± 2.13 on the VAS scale and postoperatively was 2.5 ± 1.32. This decrease in back pain was statistically significant (0.05142, P > 0.05) and Complication rate was 7.31 % in these patients Conclusion; Our results support one stage posterior fixation procedure with pedicle screw in adults with lumbar spinal tuberculosis as it is safe, effective and yields desired functional outcome. Keywords; Spinal Tuberculosis, Transpedicular screw fixation, posterior debridement.
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