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The success rate of such procedures depends on the clinicians\' understanding of the discrepancy in the sacral hiatus.

It was observed that the inverted U shape of sacral hiatus was common in both males (n=24) and females (n=26). There was one female sacrum with complete dorsal wall agenesis. In males, the length of the apex of sacral hiatus from 1st sacral spine was 5.82 cm ± 1.27 and in females, it was 6.02 cm±1.08. Sacral hiatus depth in males was 0.56 cm±0.16 and in females 0.54 cm±0.14. The width of sacral hiatus at the cornua in males was 1.42 cm± 0.29 and in females, it was 1.46 cm±0.38 Conclusion Knowledge of incidences of variations in the morphology and morphometry of the sacral hiatus across various population groups is paramount for the success and reliability of epidural anesthesia. The success rate of such procedures depends on the clinicians\' understanding of the discrepancy in the sacral hiatus.Subdural hematomas constitute rare causes of secondary Parkinsonism in elderly. Subacute or chronic subdural hematomas occur in the elderly following minor head trauma or even without a remarkable history of trauma. Leukadherin-1 A 69-year-old woman admitted with a rapidly progressive acute-onset hemiparkinsonism on the left side of her body. She denied any precipitating event before the onset of her symptoms, and her medical history was unremarkable. The anti-Parkinsonian therapy showed no benefit, but gradually worsening of the symptoms was observed. Her brain magnetic resonance imaging revealed a large subacute-chronic subdural hematoma on the right side with a mass effect on the basal ganglia structures, contralateral to her symptomatology. On thorough questioning, she confessed to having fallen out of the bed at night almost four weeks ago, three-weeks before the onset of her symptomatology. She had no complications associated with this fall and merely remembered this event. She denied any history of rapid eye movements (REM) sleep behavior disorder. The anti-Parkinsonian treatment was discontinued; the subdural hematoma was evacuated via burr hole drainage surgery. Her symptoms disappeared instantly after the surgery, with a normal neurologic examination one week after the surgery.

Pedicle screw instrumentation has been used widely for the treatment of unstable spine fractures and degenerative spinal disorders. Screw loosening is one of the major complications of this technique. We hypothesized that adding an extra anchoring point to the construct, by passing the crosslink through a hole in the spinous process (trans-spinous crosslink technique), may prevent screw loosening by increasing the pull-out strength.

Twenty-four fresh-frozen single lumbar sheep vertebrae were instrumented with pedicle screws bilaterally, and they are connected to each other with a crosslink. All vertebrae were assigned randomly to either the experiment (trans-spinous crosslink) group or the control group. In the experiment group, the crosslink was passed through a hole within the spinous process. In the control group, the posterior part of the hole was removed. The pull-out force of the construct was determined using a mechanical testing machine.

The mean pull-out forces of the experiment group and the control group were 1949 [plusmn] 361.55 N and 1338.57 [plusmn] 220.26 N, respectively. The pull-out force of the experiment group was significantly higher than those of the control group with 99.9% confidence (p 0.001).

The pedicle screws rigidly anchor the internal fixation devices to the vertebral colon. In classical construct design, pedicle screws share the load. Adding extra anchoring points decreases screw share and may prevent construct pull-out. This study shows that the trans-spinous crosslink can serve as an anchoring point and increases the construct pull-out strength.

The pedicle screws rigidly anchor the internal fixation devices to the vertebral colon. In classical construct design, pedicle screws share the load. Adding extra anchoring points decreases screw share and may prevent construct pull-out. This study shows that the trans-spinous crosslink can serve as an anchoring point and increases the construct pull-out strength.

The purpose of this study was to see how thyroxine affected the sensory and motor function of a damaged sciatic nerve in male rats.

FA total of forty adult male Wistar rats were separate to four groups with ten individuals. Then, crush injury was done on the right sciatic nerve In all groups using a vessel clamp. In thyroxine treatment groups after crush rats given regular doses of thyroxine (5 and 10 µg/kg) for one week intraperitoneally. Negative control group treated intraperitoneally with distilled water as a vehicle. And in sham operated group only surgical procedures was done without nerve crush. Then, behavioral, histological and morphometric parameters were assessed at the regeneration time.

After one week treatment with thyroxine the motor function improves significantly following a sciatic nerve crush (P ≤ 0.05). Also, morphometric parameters and sensory restoration improved in thyroxine treatment groups.

Findings of this study showed that neuro-protective effects of thyroxine can be due to the stimulatory effects of thyroxine in myelin sheath formation and increasing the expression of SCG10 protein which is required for the development of growth cones.

Findings of this study showed that neuro-protective effects of thyroxine can be due to the stimulatory effects of thyroxine in myelin sheath formation and increasing the expression of SCG10 protein which is required for the development of growth cones.

Intrathecal drug delivery systems (IDDS) are an effective treatment for malignant and non-malignant chronic pain. The aim of this study was to assess interrater and intrarater reliability of postoperative plain radiographs, which are routinely performed to confirm the correct placement of the catheter tip after IDDS implantation.

This was a retrospective analysis of plain radiographs obtained from patients implanted with intrathecal catheters and morphine pumps. Each plain radiograph was assessed independently by three raters with varying expertise, at three different time points, to confirm the position of the intrathecal catheter tip. Krippendorff's alpha coefficient was used to calculate both the interrater and intrarater reliability.

There was a high level of agreement among the three raters and the three reviews of each rater separately when assessing the location of intrathecal catheter tips in plain radiographs from 126 patients. This was evidenced by the Krippendorff's alpha value being 0.99 in The development of diagnostic algorithms or tools, to assist physicians and enable a more uniform approach in radiograph evaluation, should be encouraged.Background Post-stroke epilepsy (PSE) is quite common in clinical setting, it's necessary to systematically evaluate the medication safety and effectiveness of Oxcarbazepine (OXC) and carbamazepine (CBZ) for the treatment of PSE. Methods We searched Medline and other databases to identify the randomized controlled trials (RCTs) comparing the OXC and CBZ for the treatment of PSE. Two authors extracted and analyzed the data independently with Revman 5.3 software. Q-test and I2 was used to test the statistical heterogeneity., Fixed or random effect models were selected according to the heterogeneity. Results Eight RCTs which include 671 patients were involved in this study. The meta-analyses result showed that the overall efficiency of OXC was significantly better than CBZ treatment (OR=4.55, 95%CI (3.04-6.81)), the overall adverse events (OR=0.27, 95%CI (0.18-0.42) and the incidence of vomit (OR=0.28, 95%CI (0.09-0.85)) of OXC was significantly less than CBZ treatment. Significant differences are not detected on the incidence of rash (OR=0.45, 95%CI (0.19-1.07)), lethargy (OR=0.49, 95%CI (0.16-1.45)), dizziness (OR=0.51, 95%CI (0.20-1.35)), between OXC and CBZ treatment. Conclusions OXC seems to be superior to CBZ in the treatment of PSE with being more effective and safer. However, more research on OXC and CBZ in the treatment of PSE is needed in the later stage due to the limitation of sample size and number of patients in this study.

This study aimed to present the quantitative development of the geniculate ganglion (GG) in foetal cadavers.

This study focused on 60 temporal bones of 30 (15 female and 15 male) foetuses aged 18-30 weeks of gestation (mean age, 22.83 ± 3.49 weeks) to measure the length, width and area of the GG.

According to gestational weeks and months, the ganglion length (1.21 ± 0.41 mm), width (1.03 ± 0.28 mm) and area (1.24 ± 0.61 mm2) did not change. In terms of sexes or sides, ganglion dimensions were not significantly different. Positive correlation was found between the length and width (p = 0.033, r = 0.276), between the length and area (p 0.001, r = 0.762) and between the width and area (p 0.001, r = 0.622). Linear functions were calculated for the ganglion area (y = 0.355 + 0.039 × weeks), length (y = 0.636 + 0.025 × weeks) and width (y = 0.634 + 0.017 × weeks).

The ganglion size did not change in foetal cadavers aged 18-30 weeks of gestation. This finding may be important for anatomists and embryologists in performing morphometric studies and understanding the development of the GG and for neuro-otologists and neurosurgeons in achieving greater success in skull base surgeries.

The ganglion size did not change in foetal cadavers aged 18-30 weeks of gestation. This finding may be important for anatomists and embryologists in performing morphometric studies and understanding the development of the GG and for neuro-otologists and neurosurgeons in achieving greater success in skull base surgeries.

Parkinson\'s Disease (PD) has non-motor manifestations such as sleep disturbances in addition to motor symptoms. The aim of this study is to investigate the effects of subthalamic deep brain stimulation (STN DBS) therapy on sleep quality of PD patients and the relationship between sleep, motor symptoms, depression, and adverse effects of dopamine replacement therapies.

A total of 26 PD patients have been included and assessed using various tools both 1 week before and 8 months after the STN DBS therapy. The data collection tools were the Unified Parkinson\'s Disease Rating Scale (UPDRS), Beck Depression Inventory (BDI), Montreal Cognitive Assessment (MoCA), Parkinson's Disease Questionnaire (PDQ-39), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS) and Polysomnography.

PSQI, ISI, and ESS scores were found to have significantly improved after the STN DBS therapy (p=0.002, p=0.006, p 0.001, respectively), as were the scores obtained from several PSQI subhe PD patients\' sleep. This result was attributed to the neuromodulatory effects of the STN DBS independent of the motor symptoms, depression levels, and LED decrease.

Painful atlantoaxial (C1-2) osteoarthritis (AAOA) has been described over 40 years ago. The condition may cause severe pain symptoms and disability related to the unilateral suboccipital pain and, in some cases, occipital neuralgia. One of the greatest challenges with AAOA is making the diagnosis. Diagnosis is commonly missed or delayed when headaches are treated in isolation or when pain is attributed to subaxial spondylosis Case Description Here we present an illustrative case involving a 67-year-old male presenting with classic painful AAOA. After failing conservative treatments, he was evaluated with morphologic, radiological studies and a diagnostic injection. He was successfully treated with bilateral, navigation guided C1 lateral mass and C2 pedicle screw fixation and fusion.

When there is clinical suspicion for painful AAOA, providers have numerous diagnostic modalities, including newer hybrid techniques, that can be used to solidify the diagnosis. When conservative efforts fail, C1-2 fusion is an effective and enduring treatment for most patients.

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