Magnetic resonance imaging of normal lumbar intervertebral foraminal width

Objectives: To study the pattern and changes of lumbar intervertebral foraminal width in asymptomatic Jordanian sample in relation to age, sex and level

Methods: A total of 153 asymptomatic patients [87 males and 66 females] were selected during the study period between June 1999 to June 2000, at Jordan University Hospital and Faculty of medicine, University of Jordan, Amman, Jordan. Measurements of intervertebral foraminal width at all lumbar levels were done on parasagittal magnetic resonance images. Values were analyzed and significant differences in the means of foraminal width at different levels in every age group and among age groups were determined

Results: The mean foraminal width measured was 10.2 + 0.9mm with a range of 8.5 - 12.4mm. As related to level, values increased in both genders to reach their maximum at L2/3 and L3/4 especially in older age groups. As related to age, foraminal widths in females increased significantly only at L3/4 and L4/5 and reached their maximum values in the 6[th] decade followed by a general decrease especially at upper lumbar levels. In males, foramina] widths exhibited a significant decrease up to the 5[th] decade at upper lumbar levels

Conclusion: As an entirety, the presented baseline data of lumbar FW and FH can serve as a reference for future studies on normal and degenerative spine and is essential to identify Jordanian population at risk of lumbar nerve root entrapment. It may also provide clinicians with a fundamental channel for refining the excellence of their diagnosis and management

New scoring system for diabetic foot ulcers

To review the management and outcome of diabetic foot ulcers based on a novel scoring system for ulcers depending on the Phase of the ulcer [P], Extent of the ulcer [E], Degree of infection [D], Associated problems [A]. This scoring system is called PEDA score. Design: A prospective study. Setting: Jordan University Hospital The database of 80 diabetic patients seen at Jordan University Hospital with foot lesions between September 97 to April 2000 were studied prospectively. Data for gender, age, nature of foot lesions, presence of peripheral vascular disease, peripheral neuropathy, associated bone deformity, types of surgical procedure, morbidity and mortality were reviewed. Eighty patients with foot infections were seen at the hospital during the period from Sept 97 to April 2000. Patients were followed up from 1 month to 30 months. Mean age of the patients was 55 years ranging between 17-90 years. They were 50 males [62.5%] and 30 females [37.5%] Peripheral neuropathy was documented in 52 patients [65%]. Distal pulses were not present in 18 patients [22.5%]. Twenty four patients with superficial cellulitis without ulcers were excluded from the study. Twenty two patients [39%] had Low grade ulcers [PEDA score <6] all had complete healing of their original ulcers in 4-6 weeks, twenty patients [36%] had moderate grade ulcers [PEDA score7-9], sixteen patients from this group had complete healing in 6-12 weeks. Fourteen patient [25%] had high-grade ulcers [PEDA score 10-12], two patients had ulcers in association with Charcot joints, and another two with hallux valgus deformity. Local bone excision was performed on these patients and all had good results. Ten patients had significant peripheral vascular disease, one patient had a successful reconstruction, and the remainder required amputation at different levels. Patients with high-grade ulcers required in hospital management in excess of 12 weeks. Diabetic foot ulcers inflect a huge cost to society and disrupt the quality of life. We have developed a new scoring system [FED A] that allows categorization of diabetic foot ulcers into three groups depending on severity; low, moderate and high grade ulcers. The goal of this system is to optimize local ulcer care, provide an idea about the place, duration and the outcome of management. According to this score 75% of diabetic foot ulcers will fit the low and moderate grade ulcers with 90% success rate of ulcer healing in 2-3 months

Analysis of 130 hospitalized patients with hand injuries at Jordan University Hospital

One hundred and thirty patients with hand injuries who were admitted to Jordan University Hospital from May 1983 to May 1985 were analysed to describe the patterns of trauma to the hand; in many aspects findings were comparable to findings in other developing and developed countries. This study points out the need for establishing an advisory committee In order to reduce the incidence of hand injuries and specialized centres for treatment of hand injuries In Jordan