Preoperative myelographic evaluation of lower spinal lesions

One hundred patients underwent myeolgraphy for low back pain. Twelve had normal myelograms. The accuracy of myelography in predicting diagnosis of different causes of low back pain was evaluated in 88 patients. These patients later underwent surgical procedure and final diagnosis was made at operation. On myelography the prolapsed intervertebral disc [PID] was suspected in 59 [67.1%], spinal stenosis [SS] in 15 [17.0%], tumour in 12 [13.6%] and abscess in 2 [2.3%] cases, while at surgery PID was found in 51 [57.9%], SS in 18 [20.5%], tumour in 14 [15.9%] and abscess in 5 [5.7%]. In 8 false positive cases for PID, 3 were spinal stenosis, 2 were tumour and 3 were abscesses. Accuracy rate of myelogram was 88% and sensitivity for PID, SS, Tumour and abscess were 86.4%, 83.3%, 85.7% and 40% respectively. Myelography seems to be a safe and fairly accurate test in diagnosing the different causes of low back pain

Cerebrovascular accident pattern and distribution of different types based on computed tomography

This study was undertaken to determine the pattern and distribution of various types of C. V.As in 110 patients who underwent C.T. for suspected C.V.A. The percentage of all C.V.A. by pathological type was: Ischaemic cerebral infarction [I.C.I.] 55.4% localized primary intracerebral haemorrhage [P.l.C.H.] - 37.3% generalized subarachnoid haemorrhage [S.A.H.] 5.5% and cerebellar haematoma 1.8%. Right side was affected in 33 patients [30%] and left in 52 [47.2%]. Seventeen patients [14.6%] had multiple areas involved. It was also noted that ischaemic stroke was common in older age group [70-85%]. The most common area of brain involved for all types of C. V.A. was internal capsule and basal ganglia 31 [28.1%] followed by parietal region 17 [15.4%]. frontal region 7 [6.36%], frontotemporal 3 [2.7%], frontoparietal 12 [10.9%], temporal 4 [3.6%], temporoparivtal 10 [9%], parietooccipital 8 [7.2%] and occipital 2 [1.8%]. We recommend C.T. scan of all patients with C.V.A. for proper assessment. A national project to determine its incidence, risk factors, pattern and complications should be undertaken

Degenerative lumbar spinal stenosis; Results after surgery

50 patients with degenerative lumbar spinal stenosis underwent decompressive laminectomy, 18 with one level, 9 with two level and 23 more than 2 levels. The average age was 57 years [45-65]. Male to female ratio was 3:2. 5 patients were lost in follow up. Out of 45 patients 23 had excellent improvement, 14 had fair recovery, 6 remained unchanged, 2 deteriorated as compared to pre-operative status. No patient had revision surgery. There were two dural leaks which healed spontaneously. Decompressive laminectomy is safe and effective procedure for degenerative spinal stenosis