Background: There are wide treatment modalities for degenerative disc diseases of cervical spines. However, surgery is indicated when conservative treatment fails, and each procedure had its limitation. Aim of the work: To compare the outcome between cervical peek cage and dynamic cervical implant for anterior cervical discectomy fusion (ACDF) for patients with degenerated cervical disc disease. Patients and methods: Fifty patients with degenerative disk disease (DDD) were treated by cervical polyetheretherketone (PEEK) cage (25 patients) and another 25 with dynamic cervical implant (DCI). All patients assessed pre-and post-operatively by clinical and radiological examinations, with pain assessment by visual analogue scale and calculation of the range of motion. Any neurological deficits were documented in both pre-and post-operative periods. Results: Both groups were comparable regarding patient characteristics, preoperative pain and preoperative range of motion. The mean percentage of pain reduction was significantly higher among PEEK when compared to DCI group (81.93±7.07 vs 66.23±11.48 respectively). In DCI group, preoperative mean range of motion at the operated level was 7.56, changed to 6.64 postoperatively, which is statistically significant. Similarly, in PEEK cage group, preoperative mean range of motion at operated level was 7.60 Changed to 7.52 which is statistically non-significant. Complications were mild and treated conservatively. Conclusion: PEEK cage is associated with better alleviation of pain either at the neck or arm pain. On the other side, DCI is associated with slightly better range of motion. However, global range of motion is comparable between both groups.

Background: Shunt migration after Lumboperitoneal [LP] shunt procedures can occur upward into the spinal subarachnoid space and downward into the abdominal cavity. Cranial migrations are less common than downward migration into the abdominal cavity. Defects of the fixation devices in the shunt system are considered the main cause. Aim of the work: To evaluate fixed node maneuver, a new technique to avoid shunt migration. Patients and methods: Among many cases of shunt installations, we selected 30 patients who received a first-time shunt installation for different causes [pseudotumor cerebri [24 cases], primary cerebrospinal fluid [CSF] rhinorrhea [5 cases] and one case for persistent postoperative lumbar CSF leak]. All cases underwent LP shunt with fixed node in group [A; 15 patients] and the traditional mode of fixation in group [B; 15 patients], with evaluation of postoperative clinical improvement and shunt migration. Results: Clinical improvement occurred in 27 [90%] patients. However, shunt migration was recorded in 2 [13.3%] patients of the second group [B], while in group [A], no recorded shunt migration. Conclusion: We advocated clinical efficacy of fixed node maneuver of lumboperitoneal shunt to avoid shunt migration.