3 research outputs found
Frequency of Misplacement of Percutaneously Placed Pedicle Screws in Thoracolumbar Fractures
No full textof thoracolumbar fractures.
Material and Methods: A descriptive case series was conducted at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore. The study comprised all individuals who had minimally invasive percutaneously implanted thoracic or lumbar pedicle screws placed. CT scans were conducted on the patient 24 hours after surgery as part of their usual post-operative care to capture axial pictures to find Pedicular cortical breaches in any direction.
Results: Mean age of the patients was 32 years. 82.7% were male whereas 17.3% were females. We found that the frequency of misplacement was 10.9% in the management of thoracolumbar fractures. 110 patients received 600 pedicle screws placed percutaneously. Of these, 534 screws (89.1%) were ideally placed inside the pedicle. 7% showed minor pedicle penetration, 3.6% showed moderate pedicle penetration and only 0.3% showed severe penetration. Out of misplaced screws (10.9%), 7.3% of patients were between 15 – 40 years, and 3.6% were between 41 – 50 years. Out of misplaced screws (10.9%), 9.7% were male patients and 1.3% were female patients. For thoracic injury, 4.5% of patients suffered from misplaced screws, and for lumbar injury, 6.5% of patients were observed for misplaced screws (p-value: 0.008).
Conclusion: The frequency of misplacement was 10.9% in the management of thoracolumbar fractures. The misplacement rate of the percutaneously placed screw is low. Therefore, we concluded that the percutaneously placed screw is safe to use.
 
Long-Term Outcomes of Aneurysm Management in Elderly Patients with Subarachnoid Hemorrhage
No full textObjective: To analyze the long-term outcomes of patients with poor-grade aneurysm management of elderly patients with subarachnoid hemorrhage (aSAH).
Materials & Methods: A prospective study was conducted at Shahida Islam Medical College and Hospital, Lodhran, Pakistan from March 2023 to February 2024. The study enrolled patients aged 65-85 years who were admitted to the hospital with a diagnosis of poor-grade aneurysmal subarachnoid hemorrhage. Evaluations involved clinical examinations, imaging studies, and standardized outcome measures such as the modified Rankin Scale (mRS) to assess neurological and functional outcomes.
Results: At the 3-month follow-up, 23.8% of patients had an mRS score of ? 3, while 76.2% had an mRS score of > 3. Among those with an mRS score of ? 3, 44.8% were aged 65-75 years, and 55.2% were aged 76-85 years. Similarly, at the 12-month follow-up, 26.2% of patients had an mRS score of ? 3, and 73.8% had an mRS score of > 3. Among patients with mRS score of ? 3, 37.5% were aged 65-75 years. Among those with an mRS score of > 3, 43.3% were in the 65-75-year age group and 56.7% were in the 76-85-year age group.
Conclusion: Long-term outcomes gradually improved even among elderly patients with severe subarachnoid hemorrhage (SAH) if they were provided with aneurysm repair as surgical management. Patients with older age having SAH should not be ignored for surgical management based on their age
Double encephalocele in a four-year-old girl: A case report with literature review
No full textEncephalocele is a congenital neural tube defect (NTD). The pathophysiology of the NTDs is exceedingly complex. Numerous explanations have been proposed to explain it. Double encephaloceles are highly unusual. There have only been fifteen previously reported cases of double encephalocele in the medical literature, with this index case being the oldest and first from Pakistan. A four-year-old girl presented with two occipital scalp swellings from infancy. The occipital swelling measured about 7x5x3 cm, while the suboccipital swelling measured about 7x9x5 cm. The skin over both the swellings was intact. Following a thorough history, physical examination, and radiological investigations, surgical excision and repair was performed. Postoperative recovery was uneventful. She did not develop hydrocephalus until the three month follow-up.Double encephalocele is a rare entity. The multisite closure theory appears to be the most plausible explanation for the development of multiple NTDs. The management of double encephalocele requires a case based approach
