Prevalence of neuropathic pain among patients suffering from chronic low back pain in Saudi Arabia

The aim of this study was to assess the prevalence of neuropathic pain among patients suffering from chronic low back pain using the Leeds assessment of neuropathic symptoms and signs [LANSS] pain scale. This was a pilot study collected from 10 centers in the Middle East Region, with each center enrolling 10 patients between November 2004 and January 2004. In total, 100 patients with chronic low back pain were included in the study. The LANSS clinical assessment score was used to assess the presence of neuropathic pain. Patients with score >/= 12 were considered to have neuropathic pain, while patients with score a less than 12 were considered as having nociceptive pain. We found that 41% of the chronic low back pain patients had neuropathic pain and 59% had nociceptive pain. The ability to identify neuropathic pain mechanisms should lead to individualized treatment resulting in improved pain control in this group of patients with chronic low back pain

Freiberg's disease treatment by extraarticular dorsal closing-wedge osteotomy

A prospective study on 12 feet suffering from Freiberg's disease was conducted. The mean age of patients was 23 years [19 to 37]. The second metatarsal was affected in ten feet and the third metatarsal in two feet. All patients underwent surgery in the form of extra- articular dorsal closing wedge osteotomy after failure of conservative treatment. Patients were evaluated clinically and radiologically after an average follow-up duration of 2.3 years. The procedure gave excellent results in seven feet, good results in four and fair in one. There was a minimal loss of metatarsophalangeal motion and an average radiological metatarsal shortening of 2.4 mm. This procedure appeared to be a reasonable treatment for symptomatic Freiberg's disease

Dorsal closing wedge osteotomy for treatment of intractable plantar keratosis

This prospective study was conducted on 22 non-rheumatoid patients, suffering from intractable plantar keratosis. Their mean age was 43 years [31-67]. All patients had dorsal closing wedge osteotomy at the metatarsal neck after failure of conservative treatment. Only the affected metatarsal was addressed during surgery. The osteotomy was carried out on 35 metatarsals in 26 feet. Pinning using two crossing Kirschner wires was done in all cases. The overall results were good in 21 feet, fair in 2 and poor in 3. There was union in all feet, but transfer metatarsalgia developed in three. Dorsal closing wedge osteotomy at the metatarsal neck for intractable plantar keratosis was successful both clinically and radiologically in most patients

Outcome of anterior cervical decopression and fusion using the atlants anterior cervical plate system

The study was conducted on 45 patients suffering from degenerative disease of the cervical spine that was resistant to conservative treatment. Patients with either single-level or two-level cervical disc affection only were included. Radiculopathy was diagnosed in 41 patients and myelopathy in 10. The mean age was 43.2 years [range 34-66 years]. The patients were randomly divided into two groups: Group I [23 patients] had the Atlantis plate system to stabilize the grafted discs, while, group II [22 patients] had the same procedure without plating. It was concluded that, the Atlantis anterior cervical plate system provides the additional benefits of fixed, variable and hybrid constructs. In addition to being safe and easily implanted, its use appears to yield equal or better results than other established anterior plate systems, particularly with two-level fusion. Further studies and longer follow up should be carried out

subvastus approach for primary total knee replacement: does it affect the early results?

This prospective study compared the early results of the subvastus arthrotomy to the medial parapatellar approach in 87 consecutive primary total knee arthroplasties. The mean age was 65.8 years. Patients were divided randomly into two groups, group I composed of 47 patients who had the knee arthroplasty via the medial PPA while group II was formed of 40 patients who had their arthroplasty through the subvastus approach. The patient outcomes were evaluated at 3, 6 and 12 months based on clinical and radiological measures, the need to perform lateral retinacular release, and the incidence of postoperative patellar subluxation. The subvastus arthrotomy did not add to the operating time significantly and it led to less postoperative pain along with a quicker rehabilitation time. The subvastus approach resulted in an earlier recovery in the quadriceps muscle strength both at one week and one month postoperatively but the difference was insignificant by the third month. Improved patellar tracking was noticed using the subvastus approach, with less number of knees requiring lateral retinacular release. There was no significant difference at the final follow-up with respect to the range of knee movements, the knee score or the incidence of complications

Primary amyloidosis of the upper respiratory tract mainly involving the larynx: case report

A case of primary amyloidosis involving the larynx in a 9-year-old girl is reported. The clinico-pathological features, the difficulties encountered in diagnosis, the therapeutic measures adopted, the prognostic outlook and the literature are reviewed