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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 206 - 206
1 May 2009
Shalaby S Shenouda E Rizkalla K Morgan G Amini A Hughes S Crock H
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Introduction: The purpose of the study was to evaluate the outcome of multiple spinal operations by an expert spinal surgeon HV Crock.

Materials and Methods: A retrospective review of 169 patients who had multiple spinal surgery including spinal Fusion and spinal decompression was undertaken. A special Questionnaire form was designed and sent to each patient to answer with an appointment for the patient to be seen and assessed in the spinal assessment clinic where data from the questionnaire, clinical notes and thorough clinical examinations were recorded in a spinal data base which covered the following sections:

Patients Symptoms

Treatment received

Spinal Operations

Body Diagram for shading the site of pain

Final outcome

Patient Satisfaction

Results:

– 76 patients 66% of the patients who replied “were satisfied” with the surgery.

– 38 patients 33% of the patients who replied were not satisfied.

– 58 patients did not reply as they were not interviewed.

There were no significant post-operative neurogenic complications, such as cauada equina syndrome or severe leg weakness interfering with standing and walking retirement. There was always a temporary relief followed by deterioration of symptoms after a period ranging between 1–2 years.

Conclusions: Overall, patients with failed back syndrome need to be evaluated and treated in a multidisciplinary setting, where a group of Health Care Professionals from various fields, such as Physiotherapy, Pain Management and Clinical Psychologist work together, towards the common goal for the benefit of the patient


Orthopaedic Proceedings
Vol. 87-B, Issue SUPP_III | Pages 240 - 240
1 Sep 2005
Shenouda E Al-Delami E Germon T
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Study Design: Retrospective outcome measurement study.

Objective: To study the functional outcome of surgery for patients presenting with severe extradural spinal cord compression.

Subjects: All patients who: 1) were surgically treated for spinal cord compression between January 2001 and December 2003, 2) presented with Frankel grade A, B or C, 3) had extradural spinal cord compression secondary to tumour or infection, and 4) were operated on by a single surgeon.

Outcome: Pre- and post-operative functional assessment was made by medical staff, a physiotherapist or both, using the Frankel grading. Frankel grade at 3 months was taken as the end point, unless death had occurred before this time, in which case the best postoperative Frankel’s grade was used.

Results: The records of 41 patients with spinal extradural tumour or infection were reviewed. Fourteen patients had Frankel grade A, B, or C. Four were female and 10 male. The median age of the group was 63.5 (range 36 to 73 years). Two had infection and 12 had tumour. The surgical objective was to decompress the neural elements and to restore and maintain the alignment of the vertebral column. One patient had multiple laminotomies alone. Ten had posterior decompression and fusion. Three had anterior and posterior decompression and fusion. Twelve immobile patients became mobile (Frankel grade D and E) and two remained unchanged. Complications were; two superficial wound infection treated with antibiotics, one deep-seated infection requiring open drainage and one extradural haematoma requiring evacuation.

Conclusions: Appropriate spinal cord decompression and reconstruction of the spinal column has a very good chance of restoring spinal cord function despite the severity of the presenting neurological deficit.