Background: Unintended durotomy is an infrequent but well-recognized Complication during degenerative lumbar spine surgery. The current literatures report a wide variation in incidence of durotomy during degenerative lumbar spine surgery.
Objective: To assess the incidence, treatment, clinical consequence, complications of unintended durotomy during degenerative lumbar spine surgery, and the results of 2-24 months clinical follow-up.
Patients and Methods: A prospective study was conducted on 264 patients who underwent degenerative lumbar spine surgery performed in Al-Sheikh Zayed Hospital and private nursing home hospital- medical city in Baghdad from January 2011 to June 2012. Patients managed by spine fixation were excluded from this study.
Results: The incidence of unintended durotomy during spine surgery was 8.33% (22 of 264 cases). The incidence varies according to the type of surgery being performed (6.66% in primary discectomy, 12.5% in decompressive laminectomy and 21.73% in revision surgery). Unintended durotomy was more common in revision surgery compared with primary surgery (21.73% vs 7.05%; p < .001), and it was significantly more common among elderly patients (17.39% in patients > 60 years old; p = .006). Most of the durotomies were managed by primary repair. A mean follow-up of 6 months showed good long-term clinical results.
Conclusions: All unintended durotomies must be repaired primarily. Durotomies that were immediately recognized and treated did not lead to any significant sequelae at a mean follow-up of 6 months.
Most of the literature on the management and application terkzat waved the last period on large organizations was the negligence of knowledge management in small organizations where research aims to find out knowleddge management, small projects In oxygen Ahli plant in Iraq, and the fact the role of knowledge management in small projects from the standpoint of employees in order to achieve this used production method results. The results showed that knowledge management has a role in the high level of productivity during the years 2010-2013. The results showed that knowledge management has a role in the high level of productivity during the years 2
... Show MoreKp index correlates with the many magnetosphere properties, which are used to measure the level of magnetic activity. In the solar system, the two different planets, Mercury with weak magnetic field and Jupiter with strong magnetic field, are selected for this study to calculate the planet's magnetosphere radius (RMP) which represents the size of magnetosphere compared with solar activity through Kp index, through two types of geomagnetic conditions; quiet and strong for the period (2016-2018). From the results, we found that there are reversible relations between them during strong geomagnetic storms, while there are direct relations during quiet geomagnetic conditions. Also it is found that the
... Show MoreLaryngoscopy and tracheal intubation are considered the most invasive stimuli in anesthesia. They provoked cardiovascular responses that include hypertension, tachycardia and dysrhythmias. Various pharmacological approaches have been used to blunt or attenuate such pressor responses. The present study was designed to evaluate the effect of medazolom, lignocaine and propranolol as a valuable adjuvant to fentanyl in attenuating hemodynamic responses to endotracheal intubation in normotensive patients. Thirty two patient with physical status I or II according to the score of American Society of Anesthesiologist (ASA), scheduled for elective surgery under standard general anesthesia, were randomly allocated into four groups (8 patients in ea
... Show MoreBACKGROUND: The humeral shaft fractures have a good rate of union, despite this fact, still there is a significant rate of nonunion after nonoperative treatment and more often after operative treatment. AIM: The aim of the study is to evaluate the autogenous onlay graft with compression plate for treatment of persistent humeral shaft non-union with failed previous surgery both radiological and functional outcome. MATERIALS AND METHODS: A prospective study on twenty patients having persistent aseptic non-union age between 20 and 60 years old, after failed surgical treatment of fractures humeral shaft in Al-Zahra teaching and Al-Kindy teaching hospitals, while infected nonunion, diabetes mellitus, secondary metastasis, smoking, a
... Show MoreAbstract:
Organizations need today to move towards strategic innovation, which means the analysis of positions, especially the challenges faced by the change in the external environment, which makes it imperative for the organization that you reconsider their strategies and orientations and operations, a so-called re-engineering to meet those challenges and pressures. Now this research dilemma intellectual two-dimensional, yet my account in not Take writings and researchers effect strategic innovation in re-engineering business processes, according to science and to inform the researcher, and after the application represented in the non-application of such resear
... Show MoreThe Na-alginate bead is commonly used in biotechnology fields such as adsorption due to ion exchange between Ca and Na with elements. Scanning electron microscopy (SEM-EDX) has proven to be a comparative method in the detections of these adsorbed elements, but the un-flat forming area of beads that can introduce impossible of the detection of element adsorbed. In contrast, X-ray fluorescence (XRF) documents analysis of elements, direct examination, which may analysis the adsorbents of elements. Here, this Study evaluated the possibility by using XRF for the direct analysis for examples of Cd and Ag in a bench stand. This Study compared this to commonly use
... Show MoreThis paper deals with the modeling of a preventive maintenance strategy applied to a single-unit system subject to random failures.
According to this policy, the system is subjected to imperfect periodic preventive maintenance restoring it to ‘as good as new’ with probability
p and leaving it at state ‘as bad as old’ with probability q. Imperfect repairs are performed following failures occurring between consecutive
preventive maintenance actions, i.e the times between failures follow a decreasing quasi-renewal process with parameter a. Considering the
average durations of the preventive and corrective maintenance actions a
... Show MoreThe Study aims to show the role of Flexible Budget in planning and control The Factory over head.
The study consists four reaserchs the First introduction for the role of Budget in planning and control The second definition Flexible Badget the Third Factory overhed cost variances Analysis The four conclusions and recommendations.
The factory overhead cost represents great ratio from product cost so the management must planning and control on cost Through the year by the Budget of factory over head in the beginning of the year and determind overhead rater.
Praise to Allah, Lord of the Worlds. Thank you very much. Blessed. As his face should be majestic and great. His authority, and may peace and blessings be upon our master Muhammad, a perpetual blessing until the Day of Judgment
And upon the God of purity, His righteous companions, and those who follow them in righteousness until the Day of Judgment. But after:-
Anyone who looks into the history of nations, peoples, and the conditions of human beings will see that naturalization as a person’s affiliation to a particular state is something that happened only in recent centuries. In ancient times, a person’s loyalty was to the tribe to which the person belonged, and he was integrated into it and attributed to it, and in
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The great importance that distinguish these factorial experiments made them subject a desirable for use and application in many fields, particularly in the field of agriculture, which is considered the broad area for experimental designs applications.
And the second case for the factorial experiment, which faces researchers have great difficulty in dealing with the case unbalance we mean that frequencies treatments factorial are not equal meaning (that is allocated a number unequal of blocks or units experimental per tre
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