Anterior decompression, fusion and plating in cervical spine injury: our early experience

To evaluate the efficacy of anterior cervical decompression, fusion and titanium plate fixation in sub axial cervical spine injuries in respect of neurological outcome, postoperative stability and early rehabilitation. The Descriptive case series study was conducted at Department of Neurosurgery, Liaquat University Hospital, Jamshoro, Sindh Pakistan during year 2005 to 2007. Patients with cervical spine injuries were admitted during study period were included in this study. All cases were evaluated for their clinical features. During initial phase, level and degree of neurological injury was assessed using ASIA impairment scale. Cervical traction was applied to all patients. Operative and post operative record with x-rays and MRI were maintained. Patients with Injury to C3-6 underwent decompression, fusion and local titanium plate implant fixation by anterior approach. The follow-up ranged from 6 to 12 months with clinical and radiological assessment. 37 cases of sub axial cervical spine injuries included in this study during year 2005 to 2007. Out of these, 28 [75.67%] were males and 9 [24.32%] females. Age range was 8-60 years mean [32-40%]. Common mode of injury was fall. Post operative follow up showed good clinical and radiological outcome, bony fusion and favour early rehabilitation. No immediate complication found except temporary dysphagia. Anterior decompression, fusion and titanium plate fixation is an effective method with good neurological and radiological outcome

Timings of surgery for acute spinal injury

Early surgical management of spinal injury is commonly considered the treatment of choice for spinal injuries particularly cervical. Recently many reports do not agree strictly to criteria of emergency surgery. In our hospital this was chance study due to 15 km wide distance of fully equipped unit from casuality neuro surgical unit. It has been eventually delayed for few days until patient was other-wise stable and transportable to other unit. A retrospective study was undertaken to see the impact of this policy on the prognosis of neurological deficit postoperative complications and hospital stay. It included 27 patients undergoing surgery for spinal injuries from March-99 to Oct-2000 [21 months study]. Patients were divided into two groups. Group-A included 8 patients who were operated within 24 hours of admission and Group-B included 19[70.37 percent] patients operated during 1-2 weeks of trauma. In Group-A patients had grade power +3. In Group-B 16 patients has +3 power. In Group-A mortality was 3 [37.5 percent] and complication rate 5/8 [62.5 percent]. In Group-B morality was 2/19[10.52 percent] and complication rate 4/19 [21.05 percent]. The mean hospital stay was compared in both groups it was 9 days average in group-A while 19 days in group-B. This data concluded that circumstantial delay, initial refusal by relative or unsuitable environmental delay in surgery of spine is safe without worsening of neurological recovery and without increased rate of complications

Percutaneous Radiofrequency retrogasserian rhizotomy for trigeminal neuralgia

One hundred and twenty-seven patients with trigeminal neuralgia were treated by percutaneous radiofrequency rhizotomy after the drug treatment had failed or various side effects were noted. Majority of patients were in the age group of 51-60 years and predominantly males. Pain was on the right side in 89 and on the left in 38 patients. Sixty-three percent of cases had pain in the distribution of maxillary and mandibular division. The procedure was done under local anaesthesia with a success rate of 86%.This is an excellent procedure with a low cost, fewer complications [16.5%], low morbidity and no mortality