The axis is anatomically, developmentally and biomechanically unique from the five lower cervical vertebrae as well as the axis above it. The pars interarticularis is a transitional structure and a thin tube of cortical bone with small amount of cancellous bone. The canal-to-cord ratio is extremely large, hence the minimal risk of neurological deficit after injury. To report long-term, minimum 5 years, clinical and radiological outcome of our series of patients with traumatic spondylolysthesis of the axis managed non-operatively Thirty patients had traumatic spondylolysthesis of the axis over a period of five years (January 2005 to December 2010). There were 22 males and eight females with an average age of 36 years. Plain X-rays and CT scans were obtained to evaluate the injury. All patients were managed non-operatively.Objective:
Method and material:
HIV and musculoskeletal trauma have reached epidemic proportions in the developing world especially in sub Saharan Africa. The epidemic has adversely affected health care delivery in limited resource settings. We assessed the outcome of HIV+ patients following spinal surgery for fractures and dislocations. Forty seven HIV+ patients were treated surgically over the past three years. The mean age was 32 years (19–53 years) and included 39 males. The dorsolumbar region was affected in 28 patients and the cervical spine in 19. Motor vehicle collisions (34) accounted for 72% of the injuries. Neurology occurred in 49% of patients (23). The mean CD4 count was 426 (range 98–742). The albumen was 29 gm/d? (range 26–34) and the lymphocyte count was 1.6c/cumm range 1.4–1.9). Twenty eight patients had generalized lymphadenopathy and recent weight loss was noted in 11 patients. Fifteen patients were treated for pulmonary TB and seven patients were on ARVs. The dislocations at the cervical spine commonly occurred at C5/6 (8). Three patients required a posterior cervical release with facetectomy prior to anterior cervical plating which was performed in all patients. The dislocations and unstable burst fractures of the dorsolumbar spine were treated by a one/two level posterior fusion. Post-operative sepsis due to S. aureus occurred in 8 (17%) patients. In four patients with deep infection vacuum dressings were used to clear the sepsis. Post-operative sepsis is best avoided by optimization of patients and meticulous surgery.
The incidence of MRSA infection is increasing worldwide. Costs incurred in treating MRSA infection are over twice that of normal patients, and the duration of hospital stay is up to 10 times longer. Risk factors are age, previous MRSA infection, prolonged hospitalization, patients from convalescent homes, immunocompromised states, vascular and pulmonary disease. A retrospective chart review was conducted on 14 patients who developed MRSA infection in our unit, over a period of six years. Data included: age, gender, neurological status, length of hospital and ICU admission, type of procedure performed, HIV status, co-morbidities, nutritional status, haemoglobin, sensitivities and treatment. Age ranged from 2 to 52 (mean 15.75 years) and included four males, six females, and four children. Of the thirteen patients who developed Surgical Site Infection (SSI), nine were posterior surgical wounds. Two patients were HIV positive. Mean albumin and lymphocyte count was 34.88 and 2.37 respectively. The average wait to surgery was 23.8 hospital days, average length of ICU admission was 5.01 days. Signs of SSI developed at 11.75 days on average. Four cases showed sensitivity to Vancomycin, while ten were sensitive to Clindamycin. Patients were treated for a total of six weeks with antimicrobial therapy. Five patients required debridement, two required implant removal for chronic infection. Infection subsequently resolved in all patients.Methods.
Results.
The reported prevalence of sciatica ranges from 1.2% to 43%. Epidural injections are the most commonly performed interventions for sciatica A provincial based spinal unitBackground:
Setting:
To determine the incidence, distribution and associated organ damage in patients that sustained multilevel spinal injuries presenting to a level 1 trauma unit. Is the standard trauma series adequate? A retrospective, chart review of all spinal injury patients that were admitted to the spinal unit from March 2007 to May 2011 was performed. Patients with multilevel spinal injuries were isolated from paediatric, single level, and gunshot injuries. All Trauma unit patients undergo a full body C.T scan with angiography. Using the radiologist's reports the incidence, mechanism of injury, distribution patterns and associated organ damage sustained by this subset of patients was tabulated and reported on.Objective
Methodology
