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Outcome of surgical untethering of tethered cord syndrome in adults due to spina bifida occulta
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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
Sun Jan 01 2023
Journal Name
Journal Of Clinical And Experimental Dentistry
Preventive effect of combined Er, Cr: YSGG and fluoride gel on acid resistance of the permanent tooth enamel: An in vitro study
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Publication Date
Wed Feb 22 2017
Journal Name
Geological Society, London, Special Publications
Role of facies diversity and cyclicity on the reservoir quality of the mid-Cretaceous Mishrif Formation in the southern Mesopotamian Basin, Iraq
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Publication Date
Wed Nov 20 2024
Journal Name
Naunyn-schmiedeberg's Archives Of Pharmacology
The potential role of targeting the leptin receptor as a treatment for breast cancer in the context of hyperleptinemia: a literature review
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Since cancer is becoming a leading cause of death worldwide, efforts should be concentrated on understanding its underlying biological alterations that would be utilized in disease management, especially prevention strategies. Within this context, multiple bodies of evidence have highlighted leptin’s practical and promising role, a peptide hormone extracted from adipose and fatty tissues with other adipokines, in promoting the proliferation, migration, and metastatic invasion of breast carcinoma cells. Excessive blood leptin levels and hyperleptinemia increase body fat content and stimulate appetite. Also, high leptin level is believed to be associated with several conditions, including overeating, emotional stress, inflammation, obesity,

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Publication Date
Wed Dec 12 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Determination of the Impact of Electronic Health Information Systems upon Medical, Medical Backing and Administrative Business Fields in Al-Kindy Teaching Hospital
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Objective(s): To determine the impact of the Electronic Health Information Systems upon medical, medical backing and administrative business fields in Al-Kindy Teaching Hospital and to identify the relationship between such impact and their demographic characteristics of years of employment, place of work, and education. Methodology: A descriptive analytical design is employed through the period of April 25th 2016 to May 28th 2016. 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

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Publication Date
Mon Feb 01 2016
Journal Name
Journal Of Economics And Administrative Sciences
Evaluation of real estate investment projects with framework theory of real options: A case study in the shopping center project (Baghdad Mall)
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Focused research aims to provide a framework cognitive analytical nature of real estate investments and how they evaluated in the light of the assessment tools of modern theory of real options, and the possibility to rely on that theory in the detection of the true value of projects, real estate investments that would maximize the value of the investment decision taken, and the analysis of those projects that arise in the real estate markets and environments is the organization, which she was to make sure cases and high-risk, compared with entrances techniques, discounted cash flow (net present value). Based on the assumption lies in the possibility of the application of the implic

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Publication Date
Sat Dec 01 2018
Journal Name
Journal Of Economics And Administrative Sciences
Research Title: The Relationship Between Strategic Orientation and Organizational Performance (Applied research in the Ministry of Defense / Office of the Inspector-General)
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Abstract
The aim of the study is to study the relationship between strategic orientation and organizational performance. The strategic direction is the main purpose for which the organization is found. Therefore, it is the main engine for all the activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. ,. The research problem was formed by several questions to determine the level of the strategic direction and the nature of its relationship with organizational performance in the Iraqi Ministry of Defense / Inspector General's Office as the field of application to answer. The sample was selected by a sample of 60 individuals, department managers, And the que

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Publication Date
Thu Dec 01 2022
Journal Name
Inorganic Chemistry Communications
Entrapment of polyethylene terephthalate derived carbon in Ca-alginate beads for solid phase extraction of polycyclic aromatic hydrocarbons from environmental water samples
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Publication Date
Mon Jan 01 2018
Journal Name
Matec Web Of Conferences
Investigation of surface area of lakes and marshes from satellite images by using remote sensing and geographic information system integration in Iraq
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Water level and distribution is very essential in almost all life aspects. Natural and artificial lakes represent a large percentage of these water bodies in Iraq. In this research the changes in water levels are observed by calculating the areas of five different lakes in five different regions and two different marshes in two different regions of the country, in a period of 12 years (2001 - 2012), archived remotely sensed images were used to determine surface areas around lakes and marshes in Iraq for the chosen years . Level of the lakes corresponding to satellite determined surface areas were retrieved from remotely sensed data .These data were collected to give explanations on lake level and surface area fluctuations. It is imp

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Publication Date
Mon Jan 01 2024
Journal Name
Baghdad Science Journal
Using Wild Plant Species Grown in Wadi Al – Tib Region North East of Al – Ammara, Iraq, as Indicators of Heavy Metals Accumulation
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The current study included, studying the ability of eight genera of plants belong to Brassicaceae family, Brassica tournifortii, Cakile Arabica, Capsella bursa – pastoris,Carrichtera annua, Diplotaxis acris, Diplotaxis haru , Eruca sativa and Erucaria hispanica to accumulate ten heavy metals Cadmium, Chromium , Copper, Mercury, Manganese ,Nickel ,Lead ,and Zinc . Plant leaves samples were collected from Al-Tib area during spring of 2021.The data demonstrated that, the highest conc. of Cd was 2.7 mg/kg in Diplotaxis acris leaves and lower value was 0.3 mg/kg in Cakile Arabica leaves. For Co, the highest conc.was 1.3 mg/kg in Capsella bursa – pastoris leaves, whereas the lower value was 0.5 mg/kg in Cakile arabica leaves. As for Cr ele

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Publication Date
Tue Jun 11 2002
Journal Name
Iraqi Journal Of Laser
The Use of a Pulsed Nd: YAG Laser Radiation for the Removal of Intracanal Debris and Smear Layer in Extracted Human Teeth
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The efficiency of Nd:YAG laser radiation in removing debris and smear layer from prepared root
canal walls was studied. Fifty-seven human extracted single rooted anterior teeth were divided into three
groups. A group that was not lased is considered as a control group. The remaining teeth were exposed to
different laser parameters regarding laser energy, repetition rate and exposure time. For the case of the set of
parameters of 7 mJ laser energy, the cleaning was maximum at 3 p.p.s. repetition rate for 3 seconds exposure
time for, the coronal, middle and apical thirds. Above and below this energy level, there was an overdose
(melting) or under dose (no effect). Nevertheless for 10mJ laser energy case, the cleaning effi

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