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.
Background
Traumatic acute subdural haematoma occurs in about 10–20% of patients with severe head injuries. This study aims to investigate the relation between outcome and the age, Glasgow Coma Scale on admission as well as haematoma thickness upon admission CAT scan.
This is a prospective observational clinical trial study of 39 patients with isolated traumatic acute subdural haematomas treated with conservative or surgical procedures during a one-year study period.
Results
There was a statistically significant relation between Glasgow Outcome Score and both age of the patients and Glasgow Coma Scale upon admission. However, there was a non-statistically significant relationship between Glasgow Outcome Score and haematoma thickness upon admission CAT scan.
Conclusions
Age of the patients with traumatic acute subdural haematoma as well as Glasgow Coma Scale upon admission are essential predictors of the outcome.
Clinical trial registration details: Name of the registry: Traumatic Acute Subdural Haematoma: Management and Outcome. Trial registration number: NCT03971240. Date of registration: June 3, 2019. URL of trial registry record: https://clinicaltrials.gov/ct2/show/record/NCT03971240?term=Mohamed+Ahmed+Alghriany&draw=2&rank=1.
Background: The intracranial manipulation through the nose was already known to the ancient Egyptians. The transsphenoidal route is used for more than 95% of surgical indications in the sellar region due to its advantages. Aim: To evaluate the endoscopic trans-sphenoidal approach for resection of pituitary adenomas. Patients and methods: Retrospective and Prospective evaluation study of endoscopic transsphenoidal approach for the pituitary adenomas. This work was carried out on 30 patients during the period between May 2014 and October 2016. Results: Visual acuity and field improved in 75% of patients, endocrinal remission occurred in 62% of patients, gross removal was achieved in about 47% of patients. Conclusion: The advantages of the endoscopic transsphenoidal approach to pituitary adenomas include high incidence of total adenoma removal, high incidence of hormonal remission and low post-operative complications incidence.
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