Background Data: Improving the knowledge about the epidemiology of the traumatic brachial plexus injuries (BPI) helps in providing an appropriate assessment and management of these cases. This issue is important especially in those injuries that have much burden on the individual and national income. Purpose: To evaluate the epidemiological, clinical, and outcome of traumatic brachial plexus injuries in Suez Canal University and Damanhur Medical National Institute Hospitals over 2 years. Study Design: A retrospective descriptive clinical case study. Patients and Methods: Eighteen patients had traumatic brachial plexus injury were operated by our team from January 2014 to December 2015. Data regarding the age, sex, causes of BPI, patterns of injury, surgical approaches, surgical procedures and recovery outcome were collected. Results: All the patients were males with mean age 31 years, 72% encountered road traffic accidents (RTA), and 90% were because of motorbike accidents. 60% showed upper BPI. Neurolysis, nerve grafting and nerve transfer were the surgical procedures that were followed. Functional recovery had been achieved in about 61% of the study population. Conclusion: Our study gives insight into epidemiological aspects of the BPI in Egypt and the role of our new center in the management of those injuries. Taking into consideration the small number of the study population, our results were more or less similar published literatures. (2016ESJ112)

Background Data: Epidermoid cysts grow slowly so the symptoms would present with slowly progressive course and delay in the diagnosis that may extend up to years. 4 Presence of neurological symptoms and signs is usually detected that might be associated with local mild but persistent back pain. Purpose: To describe a case presentation of spinal epidermoid cyst. Study design: A case report of intradural thoracic an epidermoid cyst. Patients and Methods: Our case was a forty years old male patient presenting with left lower limb motor weakness. He had a 5 month history of slowly progressive left lower limb weakness and not associated with sphincter disturbance. Magnetic resonance imaging of the spine demonstrated an intradural lesion of the thoracic part of the spinal cord. Results: The lesion was excised totally and 14 days after the surgical removal, the motor power of the left lower limb showed marked improvement up to grade 4 on MRC scale. Conclusion: The diagnosis of intradural epidermoid cyst could be considered in patients with slowly progressive lower limbs weakness and mild persistent back pain. (2016ESJ121)

Background Data: Spinal column trauma is relatively uncommon in pediatric patient and not frequently encountered among the 1 st two years especially in the thoracic region. Purpose: To describe a rare presentation of thoracic spine fracture within the first 2 years of age. Study Design: A case report. Patients and Methods: We report case of 18 month old male patient with significant both lower limbs weakness after history of falling from height. Examination revealed paraplegia while full motor power of both upper limbs. Computed Tomography (CT) thoracic spine showed compression fracture of the sixth thoracic vertebrae. This has been confirmed by magnetic resonance imaging (MRI) that showed significant central cord contusion opposed this fracture. Conservative treatment was selected with custom made spine brace associated with physiotherapy sessions. Results: Spontaneous volitional lower limb movements have been reported within 8 months after the insult. Conclusion: The neurologic deficit is still the key for the examiner to suspect the presence of spinal cord insult that can be associated spine fracture especially in this young age. (2016ESJ120)

The article does not contain information about medical device(s)/drug(s). No funds were received in support of this work. The authors report no conflict of interest.

Background Data: Failure of closure of the caudal end of the neural tube is believed to be the embryological cause of spina bifida. Surgical repair is the ultimate solution and consists of multiple steps. Skin closure is the final and main step and is essential for a successful repair. We focused on different types of skin closure in the current study. Purpose: To set predictive factors for selecting different types of skin closure in the closure of spina bifida aperta. Study Design: A retrospective case study. Patients and Methods: Between April 2016 and April 2017, 30 patients (16 males and 14 females) who underwent surgical intervention for spina bifida aperta were reported. Twenty-four patients (80%) had myelomeningocele, 3 patients (10%) meningocele, and 3 patients (10%) myeloschisis. The types of skin closure designs were recorded and evaluated. Moreover, the factors that can affect designing the skin closure presented in this study were reported and evaluated retrospectively. Results: In this series, 60% (N = 18) of the patients underwent primary closure, 13.3% (N = 4) closure by using double transpositional skin flaps, and 26.6% (N = 8) skin closure using double rotational skin flaps. Conclusion: The data of this study may suggest that, in patients with spina bifida aperta, selection of the primary direct skin closure and skin flap closure is a significant predictor of the final outcome. The presence of a pedicle and the size of the mass in relation to the back were significant outcome factors, while the shape of the defect was not a significant outcome factor. (2020ESJ207)