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We report a case of a neonate with complex spinal dysraphism and associated anomalies of the axial skeleton. Based on the clinical presentation and radiographic findings, and recent advances in the understanding of human embryogenesis, we formulate a hypothesis that such a presentation is the result of failure of normal gastrulation. A 1-day-old male neonate presented with multiple right-sided anomalies, including hypoplastic right face and decreased movement of the right upper extremity. Radiographic studies demonstrated absent right cervical hemivertebrae, right cervical lipomyelomeningocele, and cervical diplomyelia with right hemicord terminating in a blind pouch. Anterior and posterior cervical and thoracic fusion with instrumentation was performed at the age of 3 years, and on follow-up the patient had improvement in right upper extremity strength. Complex spinal dysraphism is a pathological process that occurs during different stages in human development. We describe a case involving a rare lateral lipomyelomeningocele in the cervical-thoracic area.

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One glaucoma challenge is the treatment of leaking trabeculectomy blebs. Simple methods such as patching, autologous blood injection, compression sutures or cyanoacrylate glue application often fail. Because the conjunctiva is thin and ischemic, it often can't be sutured together so major surgery is required to excise the thin tissue and advance healthy conjunctiva. We report the preliminary results of Tisseel and Tisseel treated with two wavelengths from Vanderbilt's free electron laser placed on leaking trabeculectomy bleb holes in Dutch belted rabbits. The holes were healed at one week in the sutured group and in the 7.7 tm FEL-treated Tisseel group. One hole was healed in the cyanoacrylate gluetreated group. Holes remained in the other treatment groups. Tisseel irradiated with 7.7 tm energy from the free electron laser may promote healing oftrabeculectomy bleb holes.

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