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Outcome of surgical untethering of tethered cord syndrome in adults due to spina bifida occulta

Background:. Children with spina bifida occulta require early surgery to prevent neurological deficits. The treatment of patients with a congenitally tethered cord who present in adulthood remains controversial.

Objective: The aim of this study is to describe the outcome obtained in 61 adult patients with congenital TCS and no prior surgical treatment who underwent surgical untethering.

Methods: This prospective study was conducted on 61 adult patients who underwent surgical untethering for spina bifida occulta at four neurosurgical centers in Baghdad / Iraq  between March 2000 and January 2018. Patients who had undergone prior myelomeningocele repair or tethered cord release surgery were excluded.

The most common intraoperative findings were lipomyelomeningocele (41%) and a tight terminal filum (36%). The follow-up duration ranged from 10.8 to 149.5 months (mean 20.9 months). Of the 34 patients with back pain, status improved in 65%, worsened in 3%, remained unchanged in 18%, and improved and later recurred in 15%. Lower-extremity pain improved in 16 patients (53%), remained unchanged in 23%, improved and then recurred in 17%, and worsened in 7%. Lower-extremity weakness improved in 47%, remained unchanged in 47%, and improved and then recurred in 5%. Finally, of the 17 patients with lower-extremity sensory changes,

status improved in 35%, remained unchanged in 35%, and the information on five patients was unavailable. Surgical complications included three wound infections, one cerebrospinal fluid leak, and two pseudomeningoceles requiring surgical revision. One patient developed acute respiratory distress syndrome and sepsis postoperatively and died several days later.

Conclusions: Adult-age presentation of a congenital tethered cord is unusual. Despite a slight increase in postoperative neurological injury in adults, surgery has relatively low risk and offers good potential for neurological improvement or stabilization. As in children, we recommend early surgery in adults with this disorder. The decision to undertake surgery, however, should be modulated by other factors such as a patient’s general medical condition and risk posed by anesthesia.

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Publication Date
Thu Sep 30 2021
Journal Name
Journal Of Economics And Administrative Sciences
Human Resource Management and its Impact on the Level of Job Performance: An Analytical Research in the Iraqi Ministry of Interior

        The current research aims to highlight the role of human resource management with its practices (human resource planning, selection and placement, training and development, performance evaluation, compensation, and incentives) in raising the level of individuals' performance and its dimensions (task performance, contextual performance, unproductive work behavior, and adaptive performance) by explaining the research problem, which can be limited to the low level of performance of individuals, where the researchers use the descriptive analytical approach and the SPSS program in the practical aspect of the research community represented by the general manager and his assistant

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Publication Date
Mon Oct 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Comparison of Beran estimator using Nadaraya-Waston and Prestley-chao weights in estimating the conditional survival function of breast cancer patients

This study includes the application of non-parametric methods in estimating the conditional survival function of the Beran method using both the Nadaraya-Waston and the Priestley-chao weights and using data for Interval censored and Right censored of breast cancer and two types of treatment, Chemotherapy and radiation therapy Considering age is continuous variable, through using (MATLAB)  use of the (MSE) To compare weights The results showed a superior weight (Nadaraya-Waston) in estimating the survival function and condition of Both for chemotherapy and radiation therapy.

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Publication Date
Thu Mar 13 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The Influence of Different Fabrication Techniques and Preparation Designs on the Marginal Adaptation of Ceramic Veneers (An In vitro Comparative Study)

Background: Ceramic veneers represent the treatment of choice in minimally invasive esthetic dentistry; one of the critical factors in their long term success is marginal adaptation. The aim of the present study is to evaluate the marginal gap of ceramic veneers by using two different fabrication techniques and two different designs of preparation. Material and methods: A typodont maxillary central incisor used in the preparation from which metal dies were fabricated, which were in turn used to make forty stone dies. The dies divided into four experimental groups, each group had ten samples: A1: prepared with butt-joint incisal reduction and restored with IPS e.max CAD, A2: prepared with overlapped incisal reduction and restored with IPS e.

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Publication Date
Fri Mar 15 2019
Journal Name
Journal Of The College Of Education For Women
The Impact of Anticyclones Merge on the Temperature in the stations of Mosul, Baghdad and Basra for the Period (2005-2015)

           The Anticyclone Merge affects Iraq’s climate clearly through its impact on the different climatic elements. where it appears while they pass through special and distinctive weather . and most of this affection appears in temperatures, Therefore, this research study the relationship between the repetition and the survival period of the Anticyclone Merge and temperature average by using coefficient correlation (Pearson) that shows there’s strong inverse relationship between the integration of Anticyclones and temperatures average.                        &nbs

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Publication Date
Tue Aug 24 2021
Journal Name
Agronomy
Impact of Nitrogen Rate in Conventional and Organic Production Systems on Yield and Bread Baking Quality of Soft Red Winter Wheat

Soft red winter wheat (SRW) is characterized by high yield and relatively low protein content. In Kentucky, there is growing demand from local artisan bread bakers for regionally produced flour, requiring production of grain with increased protein content and/or strength. The objective of this two-year field experiment was to evaluate the effect of nitrogen (N) management on five cultivars of winter wheat on yield and bread baking quality traits of modern and landrace SRW cultivars (Triticum aestivum L.). All five cultivars were evaluated using two N application rates in conventional and organic production systems. All traits measured were significantly affected by the agricultural production system and N rate, although plant height

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Publication Date
Thu Mar 13 2025
Journal Name
Journal Of Baghdad College Of Dentistry
Dissolution of inorganic phosphorous ion from human enamel treated with different concentration of Siwak aqueous extract in comparison with sodium fluoride

Background: The use of Miswak, chewing sticks (salvadorapersica) can be traced back to Babylonians some 7000 years ago. It is commonly used throughout the world especially for the purpose of oral hygiene. Muslims are using as the religious view. Current study aimed to test the ability of aqueous siwak extract to increase the resistance of enamel surface against acid dissolution compared to sodium fluoride. Materials and Method: Twenty maxillary first premolars were treated with the selected solutions included two aqueous siwak extract concentration(5%,10%) and sodium fluoride(0.05%)as control positive for 2 minutes once daily for 20days interval, de ionized water was used as control negative. The concentration of the dissolved phosphorus i

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Publication Date
Sun Jan 05 2020
Journal Name
International Journal Of Psychosocial Rehabilitation
The Effect of Motor Sense Exercises for Developing Motor and Physiological Abilities of Backstroke and Forward Stroke Service Skill in Badminton

The aim of the research is to prepare motor sense exercises for developing motor and physiological abilities of backstroke and forward stroke service skill in badminton and investigated their effect. The research is adopted the experimental method with two groups design. The sample of the research is 8 players (13-15 years). The sample is divided into two groups of 4 players for each group. Both groups are exposed to pre and post tests, after the experimented were finished, the results are statically analyzed. The results have showed that there are positive developing abilities of motor and physiological of service skill in badminton. Finally, these prepared exercises are recommended for developing players’ abilities in badminton.

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Publication Date
Sun Mar 19 2023
Journal Name
Nasaq Journal
The impact of the Roundhouse strategy on the achievement of the fifth grade secondary school in physics and their pivotal thinking

The aim of the research is to study the effect of the roundhouse strategy on the achievement of fifth grade secondary school in physics and their pivotal thinking. The experiment has been applied for obtaining the data, which were processed statistically using the Statistical Package for Social Sciences, the results revealed that the students of the experimental group who studied using the roundhouse strategy was superior to the students of the control group who studied in the traditional method in the achievement exam. The results also show that there are statistically significant differences between the mean scores of the students of the experimental group and the control group in the pivotal thinking exam, in favor of the experimental gr

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Publication Date
Thu Mar 13 2025
Journal Name
Journal Of Baghdad College Of Dentistry
The study of tempromandibular joint disorders and anti-cyclic citrullinated peptide antibodies in serum and saliva of patients with rheumatoid arthritis

Background: Rheumatoid arthritis is an autoimmune disease that affects mainly the synovial membranes and articular structures and is characterized by chronic, systemic inflammation involving multiple joints.Being a synovial joint, the Temporomandibular Joint is subject to the same disorders affecting other synovial joints, including RA.Beside it was considered as a specific serological marker for diagnosing RA disease ,antibodies to cyclic citrullinated peptide have proven to be associated with joints destruction, though; it may play a potential role in the prediction of the disease severity. Materials and Methods: Sixty nine individuals (69) were enrolled in this study, forty nine (49) were patients diagnosed with Rheumatoid Arthritis, a

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Publication Date
Tue Dec 11 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of the Impact of Electronic Health Information Systems upon Medical, Medical Backing and Administrative Decisions in Al-Kindy Teaching Hospital

Objective(s): To determine the impact of the electronic Health Information Systems upon medical, medical Backing and administrativedecisions in Al-Kindy Teaching Hospital. Methodology: A descriptive analytical design is employed through the period of June 14th 2015 to August 15th 2015. A purposive "non- probability" sample of (50) subject is selected. The sample is comprised of (25) medical and medical backing staff and (25) administrative staff who are all involved in the process of decision making in Al-Kindy Teaching Hospital. A self-report questionnaire, of (68) item, is adopted and developed for the purpo

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