Background: Lumbar burst fractures are common spinal injuries that cause severe instability with kyphotic deformities and neurological complications requiring surgical decompression and reconstruction with spinal instrumentation for unstable burst fracture, but there is controversy about the optimal surgical approach anterior, posterior or combined approach. Objectives: To assess the efficacy & safety of anterolateral approach in decompression and reconstruction with spinal instrumentation for lumbar burst fractures. Subjects & Methods: A retrospective study including 16 patients, 10 males and 6 females with lumbar burst fractures and anterior compression treated operatively by anterolateral approach for corpectomy and single level fusion by using expandable cage or mesh cage loaded with bone graft and plat with screws. The clinical and radiological follow up after discharge from the hospital ranged from 12 to 24 months. Results: All patients improved regarding the Frankel score more than one grade after surgery, except 2 cases of grade A didn't improve. Mean preoperative visual analogue scale was 7.4 improving to 0.9 postoperatively. The mean Local kyphosis improved from 8.8˚ before surgery to −1˚ after surgery. Conclusions: Anterolateral approach is feasible, effective, and safe approach for unstable lumbar burst fractures. Angular deformity is successfully corrected when the anterior approach is used.

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Background: Chronic low back pain is a serious health problem. Chronic pain affects negatively quality of life and should be treated as interest as personal handicapping issues.Objective: To discuss etiologies and risk factors of failed back surgery syndrome (FBSS) with evaluation of different management modalities to help lowering its incidence and upgrading patient's outcome.Patients and methods: This was a cross sectional retrospective study on randomized group of patients (50 patients) performed between May 2014 and May 2018 at El Sheikh Zayed specialized hospital. They complained from lower back pain with or without legs pain and had done one or more lumbar surgeries. All patients were subjected to history taking and neurological examination (motor power, stretch signs -strait leg raising, femoral stretch-and bladder control). Radiographic documentation was for all patients including magnetic resonance imaging (MRI) lumbar spinal stenosis (LSS).Results: Forty-four patients (88%) were managed by surgical re-intervention after clinical evaluation including complain analysis and neurological assessment and correlating it with pre-operative radiological findings. Six patients (12%) were found to have no radiological findings correlated to their complaints. Conclusion:Failed back surgery syndrome acts like a malignant disease that we are unable to completely treat it, but we can control it. In our study, we can catch many factors which will help. Patient selection to be fit candidate for lumbar surgery is a main matter.

Background Various complications of endoscopic third ventriculostomy (ETV) have been described. One has to recognize these complications and learn how to avoid them. Methods We performed a literature review regarding the reported complications of ETV procedures discussed in a correlated manner with the surgical steps. Furthermore, we reviewed the technical notes described by experienced neuroendoscopists, including surgical indications, choice of the endoscopic entry point and trajectory, anatomic orientation, proper bleeding control and tight closure, to prevent and deal with such complications. Results and conclusion A lesson learned that comprehensive knowledge of ventricular anatomy with proper orientation by studying the preoperative images is mandatory and one should be aware of all complication types and rates.