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Article
TETHERED SPINAL CORD: REVIEW OF LITERATURE

Authors: Mohamed El Husseini --- Hussein Mouawia --- Adnan Mrad --- Taghrid Chaaban
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2018 Volume: 24 Issue: 2 Pages: 81-85
Publisher: Basrah University جامعة البصرة

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Abstract

Mohamed El Husseini*, Hussein Mouawia#, Adnan Mrad# & Taghrid Chaaban@*MD, PhD, Neurosurgeon, Hôpital Libano Français, Zahle, Lebanon, #Director, Lebanese University, 4th Branch, Lebanon. #Dean, Islamic University of Beirut, @Vice dean, Islamic University of Beirut, LebanonAbstract Tethered cord syndrome is a stretch-induced functional disorder associated with the fixation (tethering) effect of inelastic tissue on the caudal spinal cord, limiting its movement. This abnormal attachment is associated with progressive stretching and increased tension of the spinal cord as a child ages, potentially resulting in a variety of neurological and other symptoms. The condition is closely linked to spina bifida, and such presentation in childhood may accompanied with the cutaneous stigmata of dysraphism (hairy patch, dimple, subcutaneous lipoma). There may be associated foot and spinal deformities, leg weakness, low back pain, scoliosis and incontinence.The condition may go undiagnosed until adulthood with the development of sensory and motor problems and loss of bowel and bladder control.


Article
Findings of magnetic resonance imaging of lumbosacral spine in chronic lower back pain

Authors: Jabir Hasan Obaid Al.Shami جاب حسن عبيد الشامي --- Amjaad Majeed Hameed أمجاد مجيد حميد
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2015 Volume: 11 Issue: 20 Pages: 98-104
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background :Magnetic resonance imaging (MRI) of the lumbar spine is a safe and painless scan that uses a magnetic field and radio waves to produce detailed pictures of the lumbar spine (the bones, disks, and other structures in the lower back), MRI of the lumbar spine can be useful in evaluating symptoms such as lower back pain, leg pain, numbness, tingling or weakness or problems with bladder and bowel control. It can also help to diagnose tumors, bleeding, swelling, developmental or structural abnormalities and infections or inflammatory conditions in the vertebrae or surrounding tissues.Aim of study :To detect the cause of chronic lower back pain in patients referring from different departments in our hospital like Orthopaedics, Rheumatology , Surgery & neurology.*Patients & method : About 50 patients selected from February 2011 to December 2011 all of them are complaining from chronic lower back pain referring from different departments. Average age from 23 to 70 year, 31 were male &19 were female, the patients were classified according to their age, sex, occupation, past history of trauma, medical disease & previous surgery.*Results Twenty sex of patients (52%) were diagnosed as a PIVD (prolapsed intervertebral discs) at the level of L4-5 & L5-S1, ten(20%) of them diagnosed as degenerative disease of the discs, five patients (10%) diagnosed as Straitening of Spine ( Muscular Spasm), 2 (4%) of them diagnosed as secondary metastases in L1& 2 vertebral bodies, 3 (6%) of them diagnosed as infected disk with gibbus deformity in lower dorsal spines & 4 (8%) had normal lumbosacral spine .*Conclusion:1.High incidence of abnormal MRI study in patients with chronic low back pain . 2.Highest percent of patients with chronic back pain had disc herniation follow by other pathology .

يعتبر الرنين المغناطيسي من الفحوصات المهمة والدفيفة لتشخيص أسباب الآم الظهر وذلك لإظهاره التفاصيل المتعلقة بالفقرات والغضاريف والعضلات المتعذرة حصولها في الأشعة السينية او المفراس الحلزوني إضافة انه امين وغير مؤذ ولا يعتمد على الأشعة ولكن باستخدام المجال المغناطيسي والموجات الرادويةهدف الدراسة: لمعرفة أسباب آلام الظهر المزمن عند المرضى المحالين من استشاريات المفاصل والكسور والجملة العصبية والجراحةالمرضى والطرق: تضمنت الدراسة اخذ عينة 50 مريض من مختلف الاستشاريات احيلو الى وحدة الرنين المغناطيسي في م. الديوانية التعليمي اعتبارا من شباط الى كانون الاول 2011يعانون من الم الظهر ومعدل عمر 15-70 سنة ,31 من الرجال 19 من النساء وصنفوا المرضى حسب العمر والجنس والمهنة والحوادث ومختلف الأمراض ا لأخرى.النتائج : اظهرت الدراسة ان 26 مريض (52%) شخصوا انزلاق غضروفي قطني بين الفقرات القطنية الرابعة والخامسة والعجزية الاولى ,10 من المرضى(20%) شخصوا من تغيرات انحطاطية في الغضروف والفقرات , 5 من المرضى (10%) شخصوا تشنج عضلي ,2 من المرضى (4%) شخصوا انتشار ثانوي من اورام اولية , 3 من المرضى (6%) التهاب فقري, 4 (8%) كانت نتائج الرنين طبعيه. الاستنتاجات : .نسبه عاليه من المرضى اللذين لديهم آلام الظهر المزمن لديهم ايجادات ايجابيه في فحص الرنين


Article
A study of 22 Cases of Dorsal Inter-Vertebral Disc Prolapse treated by Thoracic Laminectomy

Author: Ali K. AL-Shalchy
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 4 Pages: 414-415
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: dorsal spine intervertebral disc prolapse (IVDP) not a very common entity compared with cervical & lumbar region usually treated surgically.
Patients & method: 22 patients studied in the specialized surgical hospital neurosurgical department from Jan 2002 till Jan. 2006. the study included age, gender, cases. clinical features, diagnoses & surgical management.
Results: 22 patients were studied 76% of the patients are at the age of 30-60 with slight male predominance, all diagnosed by MRI & or CT scan, all managed surgically by laminectomy the results are compared with other studies.
Conclusion: posterior thoracic laminectomy at the dorsal region is a safe, simple procedure with good results if done early & meticolous.


Article
The Stress Distribution on the Zygapophyseal Joint of Lumbar Vertebra by ANSYS Program
توزيع الأجهاد على مفصل النامية المقرنية للفقرة القطنية من قبل برنامج ANSYS

Authors: Summer S. M. Mukhtar سمر سرمد محمود مختار --- Sadiq J. Abass صادق جعفر عباس --- Akram A. Jaffar اكرم عبود جعفر
Journal: Al-Khwarizmi Engineering Journal مجلة الخوارزمي الهندسية ISSN: 18181171 23120789 Year: 2010 Volume: 6 Issue: 3 Pages: 85-91
Publisher: Baghdad University جامعة بغداد

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Abstract

Zygapophyseal joints (or facet joints), are a plane synovial joint which located between the articular facet processes of the vertebral arch which is freely guided movable joints. Ten dried vertebrae were used for the lumbar region and taking (L4) as a sample to reveal stress pathways across the joints by using ANSYS program under different loading conditions which used Finite Elements Analysis model. Results obtained from the ANSYS program are important in understanding the boundary conditions for load analysis and the points of stress concentration which explained from the anatomical point of view and linked to muscle and ligament attachments. This model used as a computational tool to joint biomechanics and to prosthetic implant analysis.

مفاصل النامية المقرنية او (مفاصل الظهر) هو مفصل زلالي مستوي يحدد مكانه بين نتوءات المظهر المفصلية للتقوس الفقري وهي عبارة عن مفاصل متحركة بحرية. استعملت عشر فقرات مجففة للمنطقة القطنية واخذت (الفقرة القطنية الرابعة) كعينة لكشف ممرات الأجهاد عبر المفاصل بأستعمال برنامج ANSYS تحت شروط التحميل المختلفة والتي استعملت لها نموذج تحليل العناصر المحدود. النتائج التي حصلت من برنامج ANSYS مهم في فهم الشروط الحدية لتحليل الحمل ونقاط تركيز الأجهاد الذي وضحا من وجهة النظر التشريحية والاتباط العضلات والأربطة المتصلة. هذا النموذج استعمل كاداة حسابية لربط علم الميكانيك الحيوي مع تحليل الزرع البديلي.


Article
Incidental Finding during MRI Evaluation of Lumbosacral Disc Prolapse in Adults in Al- Hilla Teaching Hospital

Authors: Hadeel Abdul-Sattar Qasim --- Hassaneen Al-Bayati --- Nashwan Aziz Mahmood
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2017 Volume: 14 Issue: 3 Pages: 537 -549
Publisher: Babylon University جامعة بابل

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Abstract

Due to increasing number of MRI imaging , detection of incidental findings not related to main complain of patient were elevated. Aim of study to find the frequency and types of spinal and extra spinal incidental findings of lumbosacral spine MRI in adult patient with suspected intervertebral disc prolapse. Across sectional study conducted from 2016 – 2017 in Al-Hilla teaching general hospital on 805 adult patients with female–male ratio 460: 345, age range 18-90 years undergone lumbosacral spine MRI due to suspected intervertebral disc prolapse using 1.5 T MRI unit. Incidental finding not related to patient symptoms, evaluated by radiologist, Chi square test was used to find the relation between incidental finding and patient characteristics. Incidental findings found in 275 patients out of total 805 age range 18-90 years with percentage 34.2%. among this vertebral haemangioma was commonest forming (27%), then tarlov cyst forming (2.7%), ovarian cysts (0.87%), perineural cysts (0.74%), each one of intraspinal mass, renal cysts and nabothian cyst found (0.5%) for each , bone lesion form (0.37%), uterine masss form (0.37%), arachnoid cyst form (0.25 %) and meningocele formed (0.125%). There was significant correlation between occurance of these incidental findings in regard with patient’s age and sex, P-value < 0.001. So Incidental findings is common in clinical practice and increasing. Majorities are benign and it is associated with patient age and sex. Providing information on these findings help to manage and deal with them and it can affect patient health.


Article
Effects of Backpack Loads on Kids Posture

Authors: Sadiq Jafer Abbass --- Duha Qais Abd-ul-Amir
Journal: AL-NAHRAIN JOURNAL FOR ENGINEERING SCIENCES مجلة النهرين للعلوم الهندسية ISSN: 25219154 / eISSN 25219162 Year: 2017 Volume: 20 Issue: 4 Pages: 876-886
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Kids carrying heavy loads as a part of everyday activity may be related to bend their trunks forward to maintain body posture and balance while walking. This study was to determine a correlation between the weight of a child's backpack, their body weight, and certain features of their body posture. The study group consisted of 6 children, in age of primary school. The anthropometry (age, length, weight) were taken for each volunteers. A school backpack was specially built for the present study. Walking gait was filmed in three cases: (zero kg, 3 kg and 6 kg) backpack.Posture was analyzed by using (Kenova and MATLAB) computer programs.The results show that the forward inclination of the trunk increases when the load and the walking distance are increased, this forward inclination segment may impose greater stress over the vertebral column (ligaments and intervertebral disks) and increase the risk of back problems. Spine and back health may be adversely affected by load carriage and it may be important to use spinal curvature as a measure of posture for load carriage. This study shows that the backpack load cause a lumbar asymmetry by 10 to 20 degree according to the load which has a significant amount of back pain in kids.

الاطفال اللذين يحملون أحمال ثقيلة كجزء من نشاطاتهم اليومية من الممكن ان تؤدي الى إنحناء ابدانهم الى الأمام للمحافظة على هيئة الجسم والتوازن اثناء المشي. هذه الدراسة كانت لتحديد العلاقة المتبادلة بين وزن حقيبة الظهر للأطفال، مع وزن أجسامهم وتعيين الملامح لوضعية أجسامهم. تمت الدراسة بالاستعانة بستة أطفال متطوعين طبيعيين في مرحلة الدراسة الابتدائية، تم حساب الانثروبومترية (العمر والطول والوزن) للمتطوعين. تم اختيار حقيبة الظهر المدرسية لهذه الدراسة. تم تصوير خطوات المشي من المستوي الجانبي لثلاث حالات هي (صفر كغم و3 كغم و6 كغم) لحقيبة الظهر. تم تحليل وضعية الجسم باستخدام برنامجي الحاسوب (كينوفا وماتلاب). أظهرت النتائج زيادة في الأنحناء للأمام لجذع الجسم عند ازدياد الثقل ومسافة المشي، وهذا الأنحناء يفرض إجهاد عالي على العمود الفقري (الأربطة والأقراص الفقرية) والتي بدورها تزيد من خطر الإصابة بمشاكل الظهر. بينت الدراسة أن حمل الثقل يؤثر سلباً على العمود الفقري وصحة الظهر، ومن المهم استخدام انحناءات العمود الفقري لقياس وضعية

Keywords

posture --- spine --- gait analysis --- back pain --- kids.


Article
Conservative Treatment of Tuberculosis of the Spine in Patients with no Neurological Deficits

Author: 1Bassam M. Flamerz ,2Moneer K. Faraj , 3Ahmed H.Ibrahim
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2018 Volume: 14 Issue: 2 Pages: 54-63
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Patients who have both neurological impairment and kyphotic deformity can be treated medically, and this treatment can be achieved with anti-tuberculous drugs alone.Objective: To evaluate conservative medical management of patients with tuberculosis of the spine (Pott disease). The prognostic significance of various clinical, radiological, and long-term follow-up findings in these patients was also evaluated. Methods: Between January 2009 and January 2018 data were collected prospectively at The Neurosciences Hospital/ Baghdad/ Iraq in 44 patients with Pott disease in the thoracic and lumbar spine. These patients had no major neurological deficits or severe spinal deformities. The study population consisted of 21 male (48%) and 23 female (52%) patients, with a mean age of 42.1 years (range 10–70 years). The most common region of Pott disease was the thoracolumbar junction (18 cases; 41%), followed by the thoracic (16 cases; 36%) and lumbar (10 cases; 23%) regions. With the exception of two cases, all had kyphotic angles less than 30°. At presentation, 20 patients had neurological signs of spinal cord compression during clinical examination. Clinical , radiological, and laboratory investigations findings were used in all cases for diagnosis. All patients were treated with anti-tuberculous drugs, and the disease in only two (4.5%) was resistant to the regimen. The follow up period was 24 months.Forty-two (95.4%) of the 44 patients were successfully treated with conservative medical management and attained acceptable spinal deformity angles, and none of these patients had any residual instability, radiculopathy, or neurological compromise. Only 4.5% of the patients experienced residual spine deformity (as much as a 30° kyphotic angle), which was clinically obvious but biomechanically stable.Conclusions: Patients with Pott disease in the lumbar and thoracic regions, without neurological deficits or kyphosis, can be treated conservatively in the vast majority of cases. Indications for surgery need to be redefined given these new data.


Article
ANTHROPOMETRIC STUDY OF PUBIC TUBERCLE AND ITS CLINICAL IMPLICATIONS

Author: Thaer M Farhan ثائر محمود فرحان
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2011 Volume: 9 Issue: 4 Pages: 308-311
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

BackgroundAbdominal wall is the site of opposing physical forces that may eventually result in the appearance of the hernias. The external abdominal hernias are the most common forms, the inguinal hernia being the commonly encountered type [75% of the abdominal hernia]. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. Few of the previous studies have concluded that the low lying pubic tubercle is associated with the development of the inguinal hernia.ObjectivesThis study was designed to investigate the distance between the anterior superior iliac spines and the perpendicular distance of the pubic tubercle from the interspinal line.Methods50 males with inguinal hernia compared with the control group comprising of 60 adult healthy males.ResultsThis study revealed that both parameters (interspinal SS distance and the pubic tubercle height ST) in the study group were significantly greater than that in the control group. The distance from mid inguinal point to the superficial inguinal ring was also measured in both the study and control groups and the results show that the distance is shorter in the individuals with the inguinal hernia. Identification of the structural characteristics of inguinal region enables the surgeon to perform the surgical technique appropriately.ConclusionThe low pubic tubercle group of cases has more tendencies for herniation. The unusual origin of internal oblique muscle in group II with low lying tubercle is far away, from the external half of the inguinal ligament, leaving the internal ring unprotected during abdominal muscle contraction, which is another causation of hernia development.Key words Inguinal hernia, pubic tubercle, inguinal canal, anterior superior iliac spine


Article
Traumatic dorso lumbar spine fractures and its management

Author: Musaed Hekmat Al Dahhan مساعد حكمت الدهان
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2011 Volume: 7 Issue: 12 Pages: 220-231
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

The dorsolumbar segment is an unstable zone between fixed dorsal and mobile spine. The posterior approach with interpedicular screws and rods for segment stabilization was found appropriate method.Forty eight consecutive patients of dorso-lumbar spine injuries with or without neurological deficit ranged from 18-55 years were included in this study. LI vertebra was fractured in 32 cases, D12 in 12 cases l 1 in 3 cases and D10 in one case.21 patients presented with unstable fractures, 12 of them presented with complete paraplegia while 9 presented with incomplete neurological deficit. 16 patients with stable fractures treated conservatively while 32 patients treated surgically by decompression of the cord (Laminectomy) at the site of injury with stabilization by interpedicular screws and rods. All sixteen patients without neurological deficit and stable fractures treated conservatively and return to the work within 3 weeks of injury, 9 patients presented with partial neurological deficit showed significant improvement after surgery, while those 12 patients who presented with complete paraplegia showed no any significant improvement. The anterior wedge compression angle decreased postoperatively and there is improvement in kyphosis and decrease in severity of the pain. Transpedicular screws fixation with rods is the method of choice in treatment of dorsolumbar spine injury for stabilization and decompression to allow improvement of neurological deficit and early rehabilitation.

تعد إصابات العمود الفقري بمستوى الفقرات الصدرية القطنية من الإصابات الشائعة والخطرة في أن واحد بسبب الانتقال من مستوى الفقرات الصدرية الثابتة إلى مستوى الفقرات القطنية المتحركة والتي بدورها تكون سهلة الانكسار أو الخلع تم دراسة ثمانية وأربعون حالة أدخلت جميعها خلال الأسبوع الأول من الإصابة . كانت أعمار المرضى بين (18-55) سنة وسبب الإصابات أما السقوط من علو أو حوادث السيارات . كان هناك ستة عشرة مريض إصاباتهم مستقرة عولجوا تحفظيا بيما كان هناك اثنان وثلاثون مريضا عولجوا جراحيا بواسطة تثبيت العمود الفقري باستعمال براغي وقضبان من مادة التينانيوم بعد إن أجريت عملية فتح الفقرات وتحرير النخاع ألشوكي من الضغط الحاصل بسبب انكسار جسم الفقرة ورجوعه إلى الخلف وضغطة على النخاع ألشوكي . تحسنت حالة المرضى الذين كانوا يعانون من ضرر عصبي جزئي بينما لم نلاحظ أي تحسن على المرضى الذين يعانون من شلل الإطراف السفلى الكامل .تحسن حالة تقوس العمود الفقري ما بعد العملية بالإضافة إلى تراجع حدة الألم المصاحبة للكسر


Article
Co-Existence of Fibromyalgia and Radiological Cervical Spine Degeneration: Preliminary Report
الترابط بين مرض الالتهاب الليفي العضلي المتعدد والتغيرات الشعاعية السوفانية للفقرات العنقية

Authors: Riyadh A. Sakeni رياض عبد الكريم الساكني --- Marwan S.M. Al-Nimer د. مروان النمر --- Rafid A. Alkhuzuie رافد الخزاعي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2013 Volume: 26 Issue: 2 Pages: 137-140
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

AbstractObjectives: The study is aimed to prove that clinical presentation of fibromyalgia is not attributed to the radiological degenerative changes of cervical spine that accompanied it. Methods: A total number of 89 patients (71 females and 18 males) clinically diagnosed as fibromyalgia with a mean duration of 2 years and 97 healthy subjects (83 females and 14 males) were enrolled in our study at Al-Yarmouk Teaching hospital in Baghdad, Iraq. Results: Degenerative changes in term of narrowing disc space in absence or presence of spondylophytes were found in 25 (28.1%) and 28 (31%) out of 89 patients compared to 9 (9.3%) and 30 (30.1%) out of 97 healthy subjects respectively. These radiological changes were significantly reported in patients who had family history of fibromyalgia and those with psychosomatic symptoms of irritable bowel syndrome. Conclusions: We conclude that degenerative changes of cervical spine in patients with fibromyalgia are not related to the age while family history of fibromyalgia is strongly relatedKey words: Fibromyalgia, cervical spine, radiological changes

خلفية البحث:أن التهاب الليف العضلي المتعدد له أسباب متعددة ولا زال لحد ألان قيد البحث عن مسبباته والعوامل المشتركة مع الإمراض الأخرى في هذه الدراسة نحاول الربط بين العلامات السريرية لالتهاب الليفي العضلي المتعدد والتغيرات الشعاعية السوفانية للفقرات العنقية حيث شملت الدراسة 89 مريضاً (71 مريضة ، 17 مريض) شُخصوا سريرياً لإصابتهم بالالتهاب الليفي العضلي لمدة عامين ومقارنتهم مع 97 مريضاً من عينة متشابهة في مستشفى اليرموك التعليمي وتبين من نتائج الدراسة أن هنالك ترابط بين التغيرات السوفانية للفقرات العنقية ومرض الليفي العضلي المتعدد بدون الترابط مع العمر أو التاريخ المرضي العائليالكلمات المفتاحية: الالتهاب الليفي العضلي، الفقرات العنقية.

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