RESUMO
Background: This retrospective study was performed toassess the radiological and clinical outcome of patients whounderwent transforaminal lumbar interbody fusion (TLIF) withan interbody cage for spondylolisthesis.Methods: Forty five consecutive patients of spondylolisthesiswho underwent transforaminal lumbar interbody fusion (TLIF)during the period from July 2016 to June 2018 were reviewedretrospectively. Clinical data and radiological data werecollected and analysed. Twenty seven male and eighteenfemale patients underwent the TLIF procedure with a meanage of 48.6 years (24–66 years). The primary pathology was alytic listhesis in 28 patients and degenerative listhesis in 17.There was no multilevel fixation. Two cases were revisionsurgery. The mean blood loss was 290 ml and mean operativetime 160 minutes. No patient need to stay in ICU or HDU.Hospital stay was 4-5 days. Radiological outcome wasassessed by observing the presence of fusion mass at biplanarradiography whereas clinical outcomes were assessed bymeans of the Parker Visual Analog scale (VAS).Results wereclassified into three categories (excellent and good, fair, andpoor) using the Parker criteria. Pain was recorded by usingVisual Analog Scale.Results: There were no intra-operative complications. Twopatients developed neurological deficit in the form of partial footdrop. There were statistically significant improvements frompreoperative VAS to post-operative VAS. Fusion couldbe assessed in all patients. Anterior interbody fusion wasachieved in 78.3% of cases and posterior lateral fusion wasachieved in 69.6%.Four patients showed no fusion at the endof 6 months post operatively.Conclusions: Transforaminal lumbar interbody fusion is a safeand effective method to achieve circumferential fusion. It istechnically challenging and needs to be proficient in thetechnique to avoid catastrophic complications. Clinical scoringconfirmed that satisfactory overall outcome. Complicationsresulting from the procedure is uncommon and generally minorand transient.
RESUMO
Aging is a biological process affecting mammalian tissues and organs at different rates. The present work was done to study the effect of melatonin as anti-aging therapy on the structure of the testis and the pars distalis. A total number of 25 male albino rats were used. The animals were divided into three groups: group [I] served as a control adult group [6 months age], group [II] was the control aged group [20-months age] and group [III] was treated with melatonin. The specimens of the testis and pituitary glands were prepared for light and electron microscopy. Histological and immunohistochemical techniques were used to examine these organs. It was found that age-related changes occur in the histological immunohistochemistry and ultrastructure of the testis and pituitary gland. Also, treatment with melatonin as anti-oxidant and free radical scavenger caused improvement of these changes in the pituitary gland as well as the testis. The age-related changes that occurred in the testis included progressive involution and germ cells depletion in the seminiferous tubules which contained only Sertoli cells. Ultrastructural apoptotic changes of germ cells increased with aging and abnormal morphology of the resulting sperms were found. This might result in decapacitating sperm function increase in interstitial tissue. Leydig cells exhibited ultrastructural changes which might lead to a decrease in their activity and testosterone production. As regard the pituitary gland; different utrastructural changes occurred in the somatotrophs or GH cells. The ultrastructrual and immunohistochemical studies of gonadotrophs or LH/FSH cells showed marked deterioration with progression of age. Treatment with melatonin from the adult state improved the morphological and ultrastructural changes that occurred with aging