Surgical outcome of tethered cord syndrome

Objective: surgical outcome of tethered cord syndrome

Study Design: retrospective descriptive

Period and Place of study: Neurosurgery Department Allied Hospital Faisalabad over 6 months from October 1, 2014 to March 28, 2015

Materials and Methods: forty patients were selected at Neurosurgical Department, Allied Hospital, Faisalabad with age ranging from 2 months to 27 years[average 2.58 years]. These were assessed clinically and their orthopedic and urological aspects were also assessed. MRI of relevant area was advised. Counselling was done regarding surgery under general anesthesia and its outcome. Laminectomy or laminotomy was done. Cord was detethered from its attachments from dura, and, in case of lipomeningocele, from its extradural component. In case of diastometomyelia, bony spur was extirpated and dura- plasty was done. Tight filum terminale was divided. Surgery was done using microsurgery techniques. Postoperative assessment was done immediately at the time of discharge, at 6 and 12 months

Results: a total of 40 patients, M:F ratio was5:3. Average age was 2.58 years.Age was ranging from 2 months to 27 years. Power improved in 44 % to grade 5/5 and 37% in grade 4/5 at one year. There was 65 % improvement in anal sphincters and 71% improvement in urinary sphincters at one year

Conclusion: our clinical and neurological evaluation showed satisfactory outcome after surgery, particularly when performed before the onset of irreversible deficit. Neurological status prior to surgery has profound impact on the outcome

Neurosurgical outcome of aute traumatic EDH. Based on GCS

Objective: Assessment of Neurosurgical Outcome of Acute Traumatic Extramural Hematoma based on GCS

Study Design: Clinical Trial

Place and Duration: Neurosurgery Department Allied Hospital Faisalabad, 20 Months from July 31-2011 to 28-2-2013

Clinical Material and Method: One hundred and thirty patients were selected for study. CT scan brain was done of every patient. The size of EDH was assessed. GCS was assessed. Patients were grouped in three groups A [GCS >8, EDH volume <30 ml], B [GCS <8, EDH volume > 30 ml] and C [GCS > 8, EDH volume > 30 ml]. Outcome was assessed according to Glasgow outcome scale

Conclusion: Patients with group A [EDH < 30ml and GCS > 8] can be managed conservatively. Their outcome was comparable with operated patients EDH > 30ml. However group B has mortality of 4.3% and outcome was different from group A and C which have no mortality