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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
Sat Jun 01 2024
Journal Name
Results In Engineering
Electrochemical preparation and characterization of a new configuration SnO2 anode and its application for treating petroleum refinery wastewater
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Publication Date
Fri Feb 25 2022
Journal Name
Open Access Macedonian Journal Of Medical Sciences
Prospective Comparative Study of Fixing Displaced Transverse Patellar Fracture by Tension Band Wiring Versus Cannulated Screws with Wiring
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BACKGROUND: Transverse fractures of the patella are important fractures with a wide variety of subtypes, the common incidence in the age group of 20–50 years. Surgical interference aims to achieve a perfect alignment of the joint surface, in addition to rigid fixation of the fracture for early re-habitation and early movement to retain the extensor mechanism of the knee joint. AIM: The aim of this study was to compare the radiological and functional outcomes of the displaced transverse patella fracture in adult patients treated by ORIF using tension band wiring versus cannulated screws with wiring. METHODS: A prospective analytic comparative study was conducted in Al-Kindy Teaching Hospital/Baghdad/Iraq for 18 months from Apr

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Publication Date
Wed Mar 29 2017
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Comparative Effects of Fentanyl, Medazolam, Lignocaine and Propranolol on Controlling the Hemodynamic Pressor Response during Laryngoscopy and Intubation
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Laryngoscopy 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

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Publication Date
Sun Feb 03 2019
Journal Name
Iraqi Journal Of Physics
Microscopic effective charges and quadrupole moments of sd-shell and sd-pf cross-shell nuclei with Z≥13
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Publication Date
Thu Aug 30 2018
Journal Name
Journal Of Engineering
Monitoring Land Cover Change Using Remote Sensing and GIS Techniques: a Case Study of Al-Dalmaj Marsh, Iraq
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Al-Dalmaj marsh and the near surrounding area is a very promising area for energy resources, tourism, agricultural and industrial activities. Over the past century, the Al-Dalmaje marsh and near surroundings area endrous from a number of changes. The current study highlights the spatial and temporal changes detection in land cover for Al-Dalmaj marsh and near surroundings area using different analyses methods the supervised maximum likelihood classification method, the Normalized  Difference Vegetation Index (NDVI), Geographic Information Systems(GIS),  and Remote Sensing (RS). Techniques spectral indices were used in this study to determine the change of wetlands and drylands area and of other land classes, th

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Publication Date
Sun Jul 25 2021
Journal Name
Natural Resources Research
Effect of Water Flooding on Oil Reservoir Permeability: Saturation Index Prediction Model for Giant Oil Reservoirs, Southern Iraq
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Publication Date
Sat Mar 30 2019
Journal Name
Studia Universitatis Babeș-bolyai Chemia
"Excess and deviations properties for the binary solvent mixtures of tetrahydrofurfuryl alcohol with some aromatic hydrocarbons at 298.15K "
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Publication Date
Tue Aug 01 2023
Journal Name
Journal Of Photochemistry And Photobiology A: Chemistry
Silver oxide-zeolite for removal of an emerging contaminant by simultaneous adsorption-photocatalytic degradation under simulated sunlight irradiation
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Publication Date
Tue Sep 18 2018
Journal Name
Water
A Systematic Operation Program of a Hydropower Plant Based on Minimizing the Principal Stress: Haditha Dam Case Study
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Dam operation and management have become more complex recently because of the need for considering hydraulic structure sustainability and environmental protect on. An Earthfill dam that includes a powerhouse system is considered as a significant multipurpose hydraulic structure. Understanding the effects of running hydropower plant turbines on the dam body is one of the major safety concerns for earthfill dams. In this research, dynamic analysis of earthfill dam, integrated with a hydropower plant system containing six vertical Kaplan turbines (i.e., Haditha dam), is investigated. In the first stage of the study, ANSYS-CFX was used to represent one vertical Kaplan turbine unit by designing a three-dimensional (3-D) finite element (F

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Publication Date
Tue Feb 01 2022
Journal Name
Baghdad Science Journal
An Epidemiological and Multidrug Resistance Study for E. coli Isolated from Urinary Tract Infection (Three Years of Study)
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Uropathogenic E. coli (UPEC) is problematic and still the leading cause of urinary tract infections worldwide. It is developed resistance against most antibiotics. The investigation, surveillance system, and efficient strategy will facilitate selecting an appropriate treatment that could control the bacterial distribution. The present study aims to investigate the epidemiology and associated risk factors of uropathogenic E. coli and to study their antibiotic resistance patterns. 1585 midstream urine specimens were collected from symptomatic urinary tract infections (UTI) patients (225 males and 1360 females) admitted to Zakho emergency hospital, Zakho, Kurdistan Region, Iraq from January 2016 until the end of December 2

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