Background Data: Open lumbar microdiscectomy has been considered the gold standard in the management of lumbar disc herniation (LDH) because of its favorable outcomes in long-term follow up. Nowadays, minimally invasive discectomy is gaining recognition due to its advantages. The advantages endoscopic lumbar discectomy includes clear visualization, less injury to the paraspinal muscle, protection of spinal stiffness and dynamic structure better cosmetic effect, and less postoperative symptoms and open surgeryrelated complications with subsequent earlier return to work. Purpose: This study was conducted to evaluate the efficacy of transforaminal and interlaminar endoscopic lumbar discectomy in the treatment of lumbar disc prolapse. Study Design: A prospective descriptive case series study. Patients and Methods: A prospective descriptive case series study was carried out on 42 patients who had lumbar disc herniation not responding to medical treatment for 6 months. Patients included from those attending the neurosurgical

Background Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign, but the locally aggressive, vascular tumor that occurs almost exclusively in young men. Although this tumor accounts for only about 0.5% of head and neck tumors, it is by far the most common benign nasopharyngeal neoplasm. It is presented typically with epistaxis, obstructive symptoms, and chronic otomastoiditis. The examination of this tumor reveals pale reddish-blue mass. The tumor is seen on imaging as vividly augmenting soft-tissue mass centered on the sphenopalatine foramen. The treatment of choice is usually surgical resection; either open or endoscopic. Pre-operative embolization is usually done to help with hemostasis. We aim to address the efficiency and the safety of endovascular modality in JNA. Methods In the period between January 2012 to December 2017, 20 male patients with age ranging from 6 to 20 years were referred to the Endovascular Unit, at Departments of Neurosurgery in Sohag, Alexandria, and Tanta University Hospitals with JNF. Preoperative trans-arterial embolization was done, followed by endoscopic surgical resection by our ENT surgeons. All patients were subjected to clinical and radiological Imaging evaluation pre embolization, post embolization, and post endoscopic resection. All patients had clinical and radiological follow-ups for at least 1 year. Results 20 male patients with JNA underwent preoperative super-selective trans-arterial embolization. The average age at presentation was 13 years. All patients underwent successful embolization with total obliteration of vascular blush of the tumor in 15 patients, and near-total obliteration of blush in 5 patients. The dramatic effect of preoperative embolization was observed on limiting intraoperative blood loss (average 200 ml) and decreasing the time of surgery (average 2.5 h). There was no permanent morbidity or mortality related to either embolization or endoscopic resection in all patients. Conclusions Trans-arterial embolization is strongly recommended in patients with JNA, it offers a good assist to the surgeon, reduces blood loss, decreases the amount of transfusion, improves the degree of resection, reduces operative time, and decreases the incidence of recurrence.

Background Data: The most frequent treatable vascular abnormality of the spinal canal is spinal dural arteriovenous fistulae (SDAVFs), which cause progressive para-or quadriplegia mostly affecting elderly males. SDAVFs are present in the thoracolumbar region. The main goal of treatment must be to obliterate the shunting zone via superselective embolization with the usage of a liquid embolic agent.Purpose: This study aims to evaluate endovascular technique as a safe and efficient approach for the treatment SDAVFs, especially with long-term follow-up clinical outcomes. Study Design: A retrospective clinical case study. Patients and Methods: From May 2010 to May 2017, 15 patients who had symptoms attributed to SDAVFs underwent the operation in the

No abstract

No abstract

Background Data: Incidence of sacroiliac dysfunction in a population suffering from low back pain (LBP) after lumbosacral (LS) fusion is unknown. The underlying pathophysiology of SIJ pain may be increased by mechanical load, iliac crest bone grafting, or a misdiagnosis of SIJ syndrome. Purpose: To evaluate the incidence of SIJ pain and the accuracy of diagnostic tools with utility of different therapeutic modalities after lumbosacral fusion. Study design: Prospective Cohort study. Patients and Methods:We prospectively studied all the patients operated with postero-lateral fusion for the incidence and management of pain originating from SIJ joint in Neurosurgery Department, Sohag University between December 2011 and December 2015. The total number of patients was 205 patients. Indications, levels, techniques of fusion, and Postoperative course (improvement of symptoms, and complications such as infection, peudoarthrosis, metal failure, adjacent segment diseases) all were assessed. Inclusion and exclusion parameters were selected. In addition two management modalities were addressed. Results: Out of 205 patients, 21 patients (10%) missed in follow up, 117 patients (57%) revealed complete clinical improvement in their manifestations, while 67 patients (32.6%) revealed postoperative pain. 67 patients (32.6%) revealed postoperative pain, (low back pain only in 12 patients 20%, lower limb pain only in 9 patients 13.5%, and both in 46 patients 66.5%).44 patients who form the basis for this report. Nine patients (20.5%) improved by medical treatment. Thirty-five patients (79.5%) improved by local injection of glucocorticoids, and local anesthetic.

No abstract

No abstract