Sagittal diameter of the lumbar spinal canal and canal/body ratio in normal adult Saudis

The determination of normal sagittal diameter of the lumbar spinal canal in normal adult Saudis, and as to whether there are any racial difference in the morphometry of the lumbar spinal canal which are essential in a reliable evaluation of patients with symptoms of lumbar canal stenosis or low back pain. A retrospective study over a period of 5 years [June 2001 - May 2006] utilizing the computer system [magic web] which saves all x-ray images where computed tomography measurements of the mid-sagittal diameter of the lower three lumbar vertebral canal were made in 170 adults. For the sake of consistency, all measurements were taken by one observer and results were recorded as the mean of two measurements. To evaluate the significance obtained, Student t-test were carried out. The measurements showed that the mean mid-sagittal diameter of the lumbar spinal canal in the Saudi population was smilar to Caucasian and wider than the Far Eastern Asian or African. The mean male mid-sagittal diameters were slightly wider than those of the female but the differences were not statistically significant. The ratio is increased steadily as we go from L3 - L5, especially in the females. The mid-sagittal body/canal ratio is higher in the female in this population, which indicates that the lumbar canal is more capacious in females than that of the males. In age group over 60 years, the mid-sagittal diameters were smaller than those of younger generations at all levels. The mid-sagittal diameter of the lumbar spinal canal among Saudis is similar to the measurement in the Caucasian population; the radiological criteria of spinal canal stenosis should be identical between these two populations

Novel shunt device for intrauterine treatment of hydrocephalus

Hydrocephalus is one of the most common congenital anomalies, especially in developing countries, for several reasons including prohibition of abortion in many countries. The technological advances in methods of intrauterine diagnosis of congenital malformations such as ultrasonography and magnetic resonance imaging made it possible to detect early enlargement of the ventricles and diagnose hydrocephalus as early as fifteen weeks gestational age. Many trials of intrauterine shunting proved unsuccessful, mainly because of complications such as intra or extracranial shunt migration, obstruction, infection, and malposition. To overcome these complications, the author has developed a special ventriculo-uterine shunt device as a first step in treating congenital hydrocephalus. This one-way valve, designed to prevent amniotic fluid backflow during uterine contraction stages, is easy to implant and has special wings to prevent intra or extracranial migration. The risk of infection is reduced because of minimal exposure to the extemal environment. Furthermore, the relatively short and wide design may reduce the possibility of malfunction. Details of the device will be discussed

the patient's age, sex and weight affect microdiscectomy for a single lumbar disc prolapse?

Clinical experience maintains that there is a great variability in the ease of performing lumbar microdiscectomy, in particular while instructing trainee surgeons. This study was conducted to determine the role of patient's age, sex and weight on influencing the procedure of lumbar microdiscectomy for a single lumbar disc prolapse. A prospective study of 82 patients with a single-level lumbar disc prolapse included the analysis and correlation of patient's age, sex, and weight to the intraoperative findings of epidural vein dilatation, degree of fibrosis and the duration of operation. The data were subjected to detailed analysis by using the statistical package of Social Science [SPSS/PC] Release 10. Thirty-two percent of patients had significantly dilated epidural veins, which were influenced by the patient's age and sex. A third [34%] of the patients had appreciable fibrosis at the surgical site, although mainly in elderly and heavier patients. In 37% of patients, blood loss was in excess of 100 ml, seen in patients with a profile similar to those with significant fibrosis. The procedure of microdiscectomy lasted longer than 120 minutes in 34% of patients, which was influenced significantly by the patient's weight. The patient's age, sex and weight can affect the microsurgical procedure. Microdiscectomy is likely to be a difficult and tedious procedure in the elderly, obese and female patients