Cerebrospinal fluid (CSF) leakage may develop when a defect is formed in dural layers by traumatic or iatrogenic processes. Traumatic CSF leakage was encountered in 2% of head injuries. CSF leakage is an associated feature of 12-30% of skull base fractures. Numerous treatment modalities are proposed for the management of CSF leaks. A closed lumbar drainage system (CLDS) is recommended as an alternative method to surgery for preventing complications related to leakage. In the present study, we report the clinical details of 46 patients who suffered from rhinorrhea/otorrhea (R/O), three of whom were urgently operated due to other causes like subdural hematoma and tension pneumocephalus. Leakage spontaneously ceased in 26 (60.4%) patients whereas CLDS insertion was found to be necessary in 17 patients. A prophylactic antibiotic regimen was started in the CLDS group and these patients were followed with daily CSF cell counts. Fifteen patients (88.2%) were successfully treated by CLDS, however meningitis developed in 2 patients (11.7%). Severe complications like meningitis could be avoided by a simple daily microbiological analysis of CSF.

This study shows that Catechin and its derivatives have a protective effect on peripheral nerve injury.

difficulties, especially the persistence and recurrence of symptoms. Failure of surgical treatment for LDH can be caused by the true recurrence of disc herniation, new disc herniation at a different disc level, epidural fibrosis, arachnoiditis, foraminal stenosis, and segmental instability (8, 21-23, 29, 30, 32). The overall rate of unsatisfactory discectomy results range from 5% to 20% of recurrent disc herniation and it is the major █ INTRODUCTIONLumbar discectomy is the most common surgical procedure performed by spine surgeons for patients complaining of back and leg pain. Numerous new techniques have been used to improve the efficacy of the surgical excision of herniated intervertebral discs but these procedures still include some AIM: Failure of surgery for lumbar disc herniation (LDH) can be commonly caused by recurrence. There are many debates regarding the risk factors of recurrent LDH (rLDH) and it is very difficult to define them because many clinical and complicated biomechanical parameters are involved. The purpose of study was to evaluate the long term result of re-discectomy for LDH at the same level and adjacent segments. MATERIAL and METHODS:Between 1999 and 2009, 1898 cases were operated and 142 (6.4%) patients underwent re-discectomy following initial operation. The study included 65 patients who were operated for single level discectomy, and their charts were analyzed retrospectively. RESULTS:There were 33 (50.8%) women and mean age was 45.5 years (24-73 years). rLDH was diagnosed at the initial level in 40 (61.5%) but adjacent and/or opposite level herniation (with or without the first level) was found in the remaining 25 cases (39.1%). Recurrence at the same level (SLG) and adjacent level groups (ALG) were similar according to the clinical outcomes in follow-up (mean 34.1 months). Admission period after initial operation was also parallel in SLG and ALG (54.7 and 53.1 months, respectively). However, the mean age of ALG (49.4 years) was significantly higher (p≤0.05) than SLG (42.8 years). CONCLUSION:After discectomy, collapsed discs are biomechanically more stable than those with preserved disc heights, and responses to axial compression on intervertebral disc pressure produced deformations of adjacent levels despite limitations.Altered biomechanical loading next to a fusion resulted in ongoing degeneration with aging at the affected entire lumbar spine.

Objectives: Post-laminectomy syndrome due to epidural fibrosis (EF) is a common cause of persistent low back pain after lumbar spinal surgery and is challenging for both surgeons and patients. The current experimental study aimed to investigate the effect of dehydrated human amnion/chorion membrane (dHACM) allograft for preventing EF formation following lumbar laminectomy. Methods: Sixteen Sprague-Dawley rats equally divided into two groups underwent lumbar laminectomy. Group A, the control group, underwent lumbar laminectomy with standard closure. Group B, the experimental group, additionally received epidural dHACM allografts during the procedure. After 45 days of follow-up, the rats were sacrificed, and the harvested tissues were histopathologically evaluated for EF. Results: Compared with Group A, Group B showed significantly less EF generation (p < 0.001), implying that dHACM allografts effectively prevent EF. Conclusions: This study demonstrated that dHACM can effectively reduce EF formation after spinal laminectomy in rats.

Cotinine, a main metabolite of nicotine, has harmful effects on SCI via GFAP and CNP expression. The findings of the present study support the hypothesis that tobacco causes neuronal degeneration via cotinine.

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Aim: Cigarette smoking is a common addictive manner and one of the greatest threats to health. Nicotine is one of the main components of cigarette. The aim of this study was to reveal the effect of cotinine which is an active metabolite of nicotine, on peripheral nerve injury in rats. Material and Methods: We studied 42 male adult albino-Wistar rats that were divided into three groups with simple randomization method. Group 1 were given Cotinine® (C-5923sigma) intraperitoneally, at a dose of 0.3 mg/kg/day for 21 days. Group 2 were given ethyl alcohol, the solvent of Cotinine in the same way, dose and period. Group 3 were subjected to sciatic nerve compression injury by a clip, which has a closing pressure of 50 gr/cm 2 . Group 1 and 2 were subjected to the same type of injury at the end of 21 days. Four weeks later after trauma, both three groups were sacrificed and injured sciatic nerve sections are taken for histopathological analysis. Results: It was observed that cotinine aggravated the traumatic degeneration and as privileged caused to fibrosis. In the Schwann cells of thick-myelinated fibers exhibited higher grades of degeneration and mitochondrial augmentation. According to the multiple comparison results, the number of Wallerian degenerations in the trauma group was significantly lower than in both the drug-control (p=0.016) and drug (p<0.001) groups. This situation was estimated as a response to oxidative stress. Conclusion:This study reveals that peripheral nerve regeneration after traumatic injury may be affected negatively in smokers.

AIM: To compare the histological and angiographic measurements of the basilar artery in an experimental rabbit subarachnoid hemorrhage model. MATERIAL and METHODS: The basilar artery was measured using both histological and angiographic methods in experimental subarachnoid hemorrhage (SAH) and vasospasm rabbit models. New Zealand white rabbits were randomly categorized into two groups: control and SAH groups. The SAH group rabbits were operated on to create an experimental SAH. Both groups were examined angiographic and histological methods. RESULTS: On comparing the two methods, angiographic and histopathological measurements of the basilar artery were similar in the control group. However, in the SAH group, the difference between the angiographic and histopathological measurement methods was significant. Histopathological measurements of the basilar artery were lower than angiographic measurements, and the difference was statistically significant. In the angiographic method, although there was a marked decrease in basilar artery measurements in the SAH group, the differences between the groups was not statistically significant. However, in the histopathological method, measurement differences between the control and SAH groups were statistically significant. CONCLUSION: Histopathological measurements were shown to be more sensitive than angiographic methods in demonstrating cerebral vasopasm in experimental SAH rabbit models.