Background: Stereotactic surgery is recommended over dramatic excision for the management of thalamic malignancies because the thalamus is a vital structure surrounded by essential white matter pathways. Aim of the work: Assessment of the benefits and safety of the framebased stereotactic surgery in thalamic lesions. Patients and Methods: Retrospective study conducted on 15 patients suffering from different thalamic lesions, recruited from Neurosurgery Department, Al-Azhar University and Ministry of Health Hospitals over the period from 2016 to 2021.Result: Patients mean age were 39.53 ± 15.58 years old. 40% of them were males and 60% were females. Majority (81.8%) of patients presenting with headache preoperatively had improved postoperatively, no statistically significant difference. patients with Dysphasia, 44.4% improved as a result of the operation. Regarding patients presenting with symptoms of increased intracranial pressure; the 3 patients who presented with repeated vomiting had improved. For consciousness level, 50% of patients presenting with DCL had improved. Patients presenting with bilateral hyperreflexia, showing clinical improvement in 100% of patients. Pneumocephalus was the most common complications met, which was prevalent in 66.7% of patients followed by intralesional hematoma which performed 20% of the population. Obstructive hydrocephalus came into the least order. Conclusion: Thalamic lesions treated by frame-based stereotactic surgery showed postoperative improvement of headache, symptoms of increased intracranial pressure, and bilateral hyper-reflexia with no statistically significant difference between pre. and post-operative symptoms, on the other side no improvement were documented regarding unilateral hyperreflexia, Right and left hemiparesis, ataxia and vision.

Background: Lumbar spondylolisthesis frequently causes a sagittal imbalance of the spine because it frequently co-occurs with other abnormalities, including forward slip and kyphosis. Spinopelvic sagittal balance is critical in spondylolisthesis assessment and treatment. The traditional fixation placement method, referred to as "short segment fixation," involves placing pedicle screws into the lower and slipping vertebral bodies. The upper vertebrae received additional pedicle screws, resulting in a long segment fixation.. Aim of the work:To to assess the results of long-segment with posterolateral fusion fixation (Long-segment PLF) versus short-segment fixation with interbody fusion (Short-segment PLIF) for the treatment of high-grade lumbar spondylolisthesis. Patients and methods: Study design: It was designed as a prospective, randomized comparison study. Setting: Al Azhar university hospitals. Subjects: According to the used surgical technique, we recruited 60 high-grade lumbar spondylolisthesis patients into 2 independent groups: the long-segment PLF group, including 30 patients, and the short-segment PLIF group, including 30 patients. Methods: Each patient underwent thorough history-taking, neurological testing, and a VAS for back and leg pain. Pre-operative radiological assessment included (X-rays and MRI) and assessment of the Japanese Orthopedic Association score (JOA score). Posterior decompression with insitu posterior transpedicular screw fixation and posterolateral fusion by long segment [long-segment] fixation; and posterior decompression, reduction, and transpedicular screw fixation [short segment] with interbody fusion were the surgical techniques used. Post-operative outcome measures include VAS scale back and leg pain, post-operative JOA score, complications rate, along with patient satisfaction outcome.. Results:The study population's average age was (47.1 ± 11.2) years, with 63.3 % of females and 36.7 % of males. We found a highly significant decline in VAS ratings (back and leg pain) and a highly significant increase in JOA score in the short and long-segment PLF groups (p < 0.01 respectively). A study comparing the two groups discovered that the long-segment PLF group experienced a significantly lower rate of complications compared to the short-segment PLIF group (p < 0.05), but there have been no significant differences in postsurgical outcome (patient satisfaction) (p > 0.05). Conclusion:To conclude, both short and long-segment PLF operation techniques were proven to be equally effective regarding improvement of primary clinical outcomes (e.g., success and good satisfaction rates and VAS values for back and leg pain and JOA scores), but the complications rate was greater in the shortsegment PLIF patient group.

Background: Chiari malformation type I (CM-I) is treated surgically by suboccipital craniectomy with or without duraplasty. Duraplasty may be performed using a variety of dural grafts, including autologous pericranium, allografts, xenografts, and synthetic substitutes. Aim of the work:To assess outcome and CSF leakage incidence according to type of dural graft in CM-I patients. Patients and methods: This study included twenty-eight patients with Chiari malformation type I who underwent posterior fossa decompression with duroplasty were randomly assigned into two equal groups: Group A (N=14): patients were treated with a dural substitute Engineered collagen matrix grafts (DuraGen). Group-B (N=14): patients were treated with free tissue fascia lata graft. All patients had neurological assessment and basal laboratory investigations. Magnetic resonance imaging (MRI) of the brain and craniocervical junction as well as computed tomography (CT) of the brain were done preoperatively.. Results: Regarding clinical outcome, fascia lata group showed higher significant excellent rate (92.9%) than DuraGen group (57.1%) (p=0.032). Also, one patient showed good outcome and none showed poor outcome in patients with fascia lata graft while there were four patients with good outcome, two with poor outcome in DuraGen graft patients without significance. Considering postoperative complications, only one patient (7.1%) in fascia lata group showed tight bandage while DuraGen group showed eight patients (57.1%) with CSF leakage (p=0.001), four patients (28.6%) needed reoperations (p=0.033), two cases (14.3%) with Aseptic meningitis and ten cases (71.4%) with tight bandage (p < 0.001). Conclusion: CM-I decompression surgery with duraplasty by fascia lata graft has a better outcome and lower significant rate of CSF leakage and other postoperative complications than engineered collagen graft (DuraGen).

Cervical vertebroplasty is a successful operation for decompression of the spinal cord and optimum restoration of cervical lordosis in individuals with severe canal stenosis. In this research, we demonstrate our method of reconstruction and replacement to the cervical vertebral body disorders with an expandable titanium cage or polyetheretherketone (PEEK). Neurologic status, morbidity, and mortality were evaluated before and after the surgery. We conducted a single-center, prospective study for all patients with cervical vertebral body lesions, who underwent single-stage vertebrectomy with an expandable titanium cage or PEEK, plate and screws reconstruction of the vertebral body. The study period between January 2014 and June 2020 in Al- Azhar university hospitals. The study included 25 patients who underwent single-stage, anterior-approach surgery. We used an expandable titanium mesh cage in five of them, and the other 20 were reconstructed using PEEK, plate, and screws. All patients had neurological symptoms before surgery, including brachialgia, motor deficit, or sphincter problems. The mean follow-up was 45.7 months (1-65 months). Neurological improvement was recorded in 20 patients at the last follow-up time, and five patients were not improved.