ABSTRACT
Dural sac tear is an infrequent, but well recognized complication of spine surgery in which the thin layer over the spinal cord is cut by the neurosurgeon during lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra- and postoperative management. This study included 134 patients who were operated for recurrences over two years interval. Intraoperative dural fissures were repaired through suture, by applying muscle and fat grafts. One case presented a cerebrospinal fluid [CSF] fistula which was repaired at reintervention. Dural tears occurred in 10 cases representing 67.7% of all cases. Risk factors include older age, female sex, obesity, surgeon's experience, previous operation at the same level. All incidental dural fissures during operations for degenerative lumbar disorders must be diagnosed and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased costs of the treatment. Dural sac tears can be prevented, identified and treated, respecting a precise surgical technique and a standardized treatment protocol. Unintended durotomies were associated with fewer complications than previously reported in open spinal operations
ABSTRACT
The effect of some environmental factors namely: temperature and hydration on thyroid activity was studied in an experimental model using albino rat. The parameters used for the assessment of such an activity were: protein bound iodine [PBI], free thyroxine [T[4]] and total cholesterol in serum. The levels of PBI and T[4] in serum were higher in winter than in summer and this demonstrates clearly the role of the thethyroid gland in calorigenesia. PBI and T[4] levels were also higher with hydration. Cholesterol levels were higher in summer than in winter and on dehydration than hydration. The increase in T[4] was accompanied by a decrease in cholesterol levels in serum and vice versa. T[4] seems to play a role in sterol removal from blood. This investigation demonstrates the importance of environmental factors in evaluating thyroid activity and the present data may be useful as a standard for further studies on this animal