Medicine and Health Sciences Commons^™

Endoscopic Lumbar Stenosis Decompression Through Uniportal Bilateral Approach, Yosouf Barakat, Magdy Asaad El-Hawary, Usama Mohamed El Shokhaiby, Ahmed Kamal Abdel-Aaty Abdou

Al-Azhar International Medical Journal

Background: Percutaneous endoscopic stenosis lumbar decompression (PESLD) is regarded as a noteworthy therapeutic option for lumber spinal stenosis (LSS), particularly on the contralateral side, in a satisfactory manner. Objective: To evaluate the efficacy and efficiency of PESLD of LSS through a uniportal-contralateral approach. Subjective: This was a prospective observational study. The patients were admitted to the Neurosurgery Department, Damanhour Educational Hospital, El-Behira Governorate, and Al Hussain Hospital Al Azhar University in Cairo. All patients underwent PESLD through a uniportal-contralateral approach.. Results: The pre-operative visual analogue scale (VAS) was 7.3 ± 0.9 and decreased significantly post-operative to 2.4±1.0. Intraoperative data showed …

Comparative Study Of Dynamic Cervical Implant Versus Cervical Interbody Cage Fusion In Management Of Degenerative Cervical Disc Disease, Salah Mohammed Mereka, Mohammed Al Sayed Saleh, Ibraheem Gameel Ewis

Al-Azhar International Medical Journal

Background: Cervical radiculopathy occurs when a herniated disc cause pressure on a nerve root, resulting in dysfunction of the sensory, motor, or reflex pathways served by that nerve root. This trial aimed to evaluate the effectiveness of a dynamic cervical implant against a cervical interbody cage fusion for the treatment of a single degenerative disc in the cervical spine. Methods: This prospective randomized trial was carried out on 30 patients aged from 30 to 50 years old, both sexes, suffering from single degenerative cervical discs who were surgically treated by anterior cervical discectomy, intervertebral disc herniation from C3 to C7. …

An Endoscopic Journey To The Center Of The Skull Base For Novice Neurosurgeons: From Cadaver To Theater, Alhusain Nagm, Mohammed Hamadah, Kamal Elbaz, Ibrahim Ewiss

Al-Azhar International Medical Journal

Background: For novice neurosurgeons (nNS), it is important to determine the safety of extended-endoscopic endonasal approaches (eEEA) by analyzing/eliminating surgical drawbacks. Aim: To evaluate the impact of cadaveric training for nNS on reducing obstacles/complication rates in the operative theater.

Subjects and Methods: This unique study has two parts: first; the lab/cadaveric part included a checklist scoring system to estimate the ability of nNS to dissect/identify basic and complex anatomical landmarks (BCAL) (n=50) via eEEA for the center of the skull base (CSB) using 2 formalin-fixed heads and a dry skull for tumor simulation. Second; theater/clinical part included 28 cases with …

Role Of Conventional And Pulsed Radiofrequency In Treatment Of Low Back Pain And Sciatica, Maamoun Mohammed Abo Shosha, Mohammed Ahmed Ellabbad, Mostafa Soliman Elmaghraby, Ahmed Maher Ahmed Ibrahim

Al-Azhar International Medical Journal

Background: Low back pain is a feeling of discomfort, stiffness, or muscle tension below the costal border in the upper part of the back of the thigh, above the lower gluteal folds. Sciatica can occur with low back pain. The two most common techniques are pulsed radiofrequency (PRF) and conventional radiofrequency (CRF). Both techniques employ heat produced by particle vibration to cause a lesion. PRF employs intermittent high-frequency current injection to diffuse heat into nearby tissues and prevent temperatures from rising beyond 42 °C, known as the neuronal injury threshold.

Aim of the study: To assess the efficacy of PRF …

Skull Base Reconstruction After Endoscopic Endonasal Skull Base Surgery, Mostafa El-Sayed Mohammed, Hany Hafez Sherif, Islam Mohammed Alaghory, Ahmed Nossir Abd El-Khalek Mobarak

Al-Azhar International Medical Journal

Background: CSF leakage following surgery is a known potential complication associated with substantial morbidity & mortality. Numerous techniques for prevention & treatment after endoscopic skull-base surgery are described. These include lumbar drain, autologous grafts like fat, muscle and fascia and synthetic materials like a polyester-silicon dural substitute. But these grafts alone were associated with a high failure rate, particularly in large defects. The application of vascularized flaps promotes more rapid and complete healing and was associated with a sharp decrease in CSF leaks. These vascularized flaps include nasoseptal, inferior turbinate and peri-cranial flaps. The most common nasoseptal flap (NSF) is …

Anterior Cervical Discectomy And Fusion Using Cages Versus Cages And Plating, Hamdy Mohamed Behiry, Mansour Ali Hendawy, Mahmoud Mohammed Bayoumi

Al-Azhar International Medical Journal

Background: The anterior column receives rapid load bearing support, the disc space height is restored, foraminal decompression occurs, and interbody fusion is facilitated by cervical intervertebral disc replacement with cage. Aim: Aim of work was to assess the interbody fusion rate and to assess incidence of complications of 20 consecutive patients for degenerative one or more level anterior cervical disc utilizing cage/s versus cage/s and plate. Patients and Methods: A comparative research of 20 patients with degenerated cervical discs managed by an anterior cervical discectomy procedure and fusion (ACDF) using either cage alone (ACDF-CA) or cage and anterior plating (ACDF-CPC). …

Assessment The Efficacy Of Stent Assisted Techniques For Endovascular Management Of Complex Anterior Circulation Cerebral Aneurysm, Ahmed Mohamed Farid Alsayed, Ali Khodair Ali Khodair, Mohamed Abdalaziz Elbily

Al-Azhar International Medical Journal

Background: Stent-assisted coiling is an established treatment option for intracranial aneurysms, particularly, wide neck aneurysms with complex anatomy.

Aim of the work: To assess safety, efficacy, and outcome of stent-assisted endovascular management of complex anterior circulation cerebral aneurysm.

Patient and methods: In a prospective and retrospective study, 15 patients diagnosed clinically and radiologically to have unruptured complex anterior circulation cerebral aneurysm and underwent endovascular stent assisted techniques at the Neurosurgical Intervention Unit at AL Hussein University Hospital were recruited in the period from beginning of Feb 2022 to the end of Feb 2023. Efficacy was assessed immediately post-procedure using Raymond−Roy …

Cages Alone Versus Plate Fixation With Cages After Four Levels Anterior Cervical Discectomy, Karim Mohamed Mohamed Elshafei, Ibrahim Gamel Ewaiss, Taha Mohamed Adel Fawi, Hamdi Nabawi Mostafa

Al-Azhar International Medical Journal

Purpose: This study assessed clinical and radiological outcomes to support the surgical decision of ACDF using cages alone versus cage-with-plate fixation in patients with four-level spondylotic myelopathy of the cervical spine.

Methods: This study enrolled 30 patients with four levels of cervical spondylotic myelopathy. The C Group (n=15) was subjected to ACDF using four cages, and the C&P Group (n=15) had additional plate fixation. They were followed up clinically and radiologically for at least 12 months. Scheduled for surgical intervention in the neurosurgery department of Misr University and hospitals of Al Azhar University and Nasr Institute from October 2020 to …

Transforaminal Endoscopic Lumbar Discectomy, Elsayed Abdelrahman Elmor, Abdelbaset Ali Saleh, Abdelelah Nazeer Yasin, Abdelreheem Mahmoud Mohamed, Ezz Eldeen Elsayed Mohammed Ibrahim

Al-Azhar International Medical Journal

Background: Clinical problems might result from the structural and morphological changes brought on by lumbar degenerative disc degeneration. The medical costs and lost productivity that result from treating lumbar disc herniation (LDH) are a major burden on families, communities, and nations.Lumbar Discectomy for Prolapsed Intervertebral Disc associated with radicular symptoms in lower limb is probably the most widely performed spinal intervention. Aim: Percutaneous transforaminal endoscopic lumbar discectomy is a less invasive approach for treating LDH, and the purpose of this study is to assess its efficacy. Subject and method: This study was conducted at the neurosurgery department, Ibn Sina hospital …

Outcome Of Lumbar Discectomy By Using Endoscopic Interlaminar Approach, Ibrahim Gamil Ewaiss, Mostafa Mahmoud El Sayed Aboelkhir, Abelgelel Ragab Abdelgelel Atta

Al-Azhar International Medical Journal

Background: Lumbar degenerative disc disease is a condition which causes anatomical and morphological changes leading to clinical complaints. Lumbar disc herniation (LDH) is a common neurosurgical disease which causes economic and medical burdens to families, society and country. Aim: This study sought to assess the effectiveness of interlaminar endoscopic lumbar discectomy as a minimally invasive method for treating lumbar disc herniation in Al-Azhar university hospitals. Patients and Methods: This study, which included both prospective data, involved 25 patients between February 2021 to October 2022 who had lumber disc prolapse and were treated with endoscopic lumbar discectomy using the EasyGo system …

Assessment Of Lateral Orbitotomy Approach In Management Of Extraconal Orbital Lesions, Samy Ibrahim, Mohammed Hassan, Shymaa Adel Ismael

Al-Azhar International Medical Journal

Background: A variety of tumors and pseudotumors can occur in the orbital region, requiring distinct surgical approaches based on lesion characteristics.

Aim of the work: To evaluate the effectiveness of the lateral orbitotomy approach in the surgical management of extraconal orbital lesions.

Patients and Methods: A retrospective review of 14 patients who underwent lateral orbitotomy for extraconal orbital lesions at Al Azhar University Hospitals and Al Salam Specialized Hospital between July 2019 and July 2022. The main outcomes measured included postoperative complications and symptom resolution.

Results: A total of 14 patients were included (7 males, 7 females), with a mean …

Clinical Outcome Of Corpus Callosotmy For Management Of Drug Resistant Epilepsy, Islam Magdy Ali Ibrahim, Mamoun Abo Shosha, Mohamed Meligy Rabea Hamed

Al-Azhar International Medical Journal

Background: One of most common chronic neurologic disorders is epilepsy. incapability of significantly reduce percentage of studied cases resistant to all available antiepileptic treatments without producing unacceptable side effects is particularly frustrating. Aim & objectives: Aim of research was to investigate seizure result following corpus callosotomy in relation to extent of resection in pediatric studied cases with Symptomatic generalized epilepsy with normal preoperative brain imaging on MRI Brain. Studied cases & Methods: Research entails prospective analysis of data from 20 pediatric patients who were treated for intractable symptomatic generalized epilepsy by corpus callosotomy. Results: In our patient series, 13 patient …

Endovascular Management For Carotid Artery Stenosis With Or Without Using Of Distal Protection Device, Mostafa Y. Ali, Mohammed Abdulaziz Albialy, Magdy A. El Hawary

Al-Azhar International Medical Journal

Background: Transient ischemic episodes and ischemic strokes are frequently brought on by internal carotid artery atherosclerotic stenosis. Carotid artery stenosis can be treated with medicine, surgery, endovascular therapy, stenting, or a combination of these methods.

Aim of the work: Analyzing the various endovascular treatment options for carotid artery stenosis with and without filters.

Patients and Methods: This is a prospective and retrospective study, was conducted on 30 patients with carotid artery stenosis; 13 with filter and 17 without filter undergoing different endovascular techniques.

Results: In this study we found that in group A, mean age of patients 65.85 (±7.29) while …

Outcome Of Epilepsy Surgery In Pediatrics, Mohammed Refaat Mohammed Hammouda, Shehab M. El Khadrawy, Mohamed Hasan Mansour, Alaa Rashad Ibrahim Hassan, Alazzazi Rabei

Al-Azhar International Medical Journal

Background: Epilepsy is a brain disorder characterized by recurrent attacks of seizures. A seizure is a sudden change of behavior due to a transient alteration in the electrical pattern of the brain. Since despite appropriate drug treatment, one-third of patients continue to have seizures, other treatment must be considered. Aim: This study aims at emphasizing the importance of epilepsy surgery in pediatrics by assessing surgical outcome as regard seizure freedom and surgical morbidity & mortality at Al-Azhar university hospitals.

Patients and Methods: Prospective and retrospective study on 27 pediatric patients diagnosed as drug resistant epilepsy, with 6 months to 1 …

Conservative Versus Surgical Management Of Cranial Pediatric Epidural Hemorrhage, Shehab M. Elkhadrawy, Mohamed Hasan Mansour, Wael F. Sanad

Al-Azhar International Medical Journal

No Abstract

Stereotactic Ablative Surgery For Movement Disordres, Ahmed Jamal Awad Al Demiry, El Sayed Abdel Rahman El Mor, Alaa Rashad Ibrahim

Al-Azhar International Medical Journal

Background: Since its inception in the early 1950s, the radiofrequency (RF) ablative technique has served a crucial function in the treatment of movement problems. Ablative surgery is encouraging since it doesn't require substantial perioperative care, doesn't run the risk of hardware issues, and it expenses less than deep brain stimulation. Aim of the work: This study is to evaluate the efficacy and safety of RF ablative surgery for medically intractable movement disorders. Patients and Methods: This study was conducted retrospectively on 20 patients with medically refractory movement disorders who had undergone macrostimulation-guided RF ablative surgery in the institutions affiliated with …

A Primer On Cognitive Errors Illustrated Through The Lens Of A Neurosurgical Practice, Jeffrey Evan Florman, Lisa Almeder, Robert Trowbridge

Journal of Maine Medical Center

Problem Statement:

Diagnostic error is often attributed to cognitive errors, including biased thinking patterns, rather than knowledge or data limitations, and education on cognitive bias deserves review in all spheres of practice.

Background:

The cognitive biases of practitioners create an inherent fallibility in recognizing and treating medical conditions. Awareness of cognitive errors is valuable for mitigating risk of diagnostic error.

The impact of cognitive error is substantial in the management of neurosurgically relevant disease. Remarkably broad differential diagnoses often accompany neurologic symptoms. Both focal and non-focal symptoms lend themselves to diagnostic inertia that contributes to errors. Further, initial diagnostic direction …

A Feasibility Study Of Lavender Aromatherapy In An Awake Craniotomy Environment, Kailah Cathey, Nichole Gunyon, Nancy Chung, Nancy Conway, Diane Ames, Maharaj Singh, Amin B. Kassam, Richard A. Rovin

Journal of Patient-Centered Research and Reviews

Purpose: Integrative medicine interventions are needed for awake craniotomies, as many patients experience anxiety. Lavender aromatherapy significantly reduces anxiety or pain in a variety of surgical procedures. This feasibility study used lavender aromatherapy during awake craniotomies to determine the number of patients who would consent and complete the study, the technicality of lavender aromatherapy use, and acceptance by operating room (OR) staff.

Methods: We approached 40 consecutive patients (≥18 years old). Exclusion criteria were pulmonary issues or sensitivity to lavender. Outcome measures in consented patients were enrollment and completion rates, anxiety and pain as measured by the Visual Analog Scale …