Schistosomiasis of the central nervous system is uncommon. Schistosoma mansoni is the most common cause of a spinal cord lesion, although Schistosoma haematobium is sometimes responsible. The conus medullaris is the primary site for spinal lesion. The spinal lesion of schistosomiasis may be in the form of a mass lesion or acute necrotizing myelitis, or it may be silent and symptomless. Diagnosis of spinal cord schistosomiasis is commonly retrospective but may be suggested by laboratory and radiological studies. We were confronted with a case of bilharzial granuloma of the conus in a 7-year-old boy. This patient sought treatment for sphincteric disturbance. Myelography showed an intradural lesion in the area of the conus (opposite L1-L2). The mass proved pathologically to be S. haematobium granuloma. There was no previous history of bilharzial infestation. The neurological deficits improved markedly after surgery and antibilharzial treatment.

Background Data: Penetrating spinal cord injuries caused by missile or stab wound injuries are uncommon. The harm may be due to the direct injurious effect or may be due to the resulting vascular insult either in the form of an intra-or extradural hemorrhage or spinal infarction or a late infection at the site of injury. Penetrating injuries may cause a neurological motor, sensory or an autonomic deficits or a combination of them. Both the conservative and the surgical treatments are widely practiced among the neurosurgeons. Such injuries not only affect the patient's lifestyle but also influence the whole patient's family. Purpose: To Evaluate the penetrating spinal injuries and describe the multiteam management and report both clinical and radiological characteristics of the patients. Also, we would assess the course and the prognosis in both complete and incomplete spinal cord injuries. Study Design: A cohort study conducted to patients with penetrating injuries Patients and Methods: A case series retrospective study of 28 patients presented to the emergency department at Sohag university hospital between March 2012 and March 2015 with penetrating spinal injuries caused by knives, dagger, and missile and nail gun injuries. A full history was taken. Complete general and neurological examination including motor power, sensory examination using Frankel grading classification. Results: The average age was 28.36±5.96 (range 19-37) years. Twelve injuries were in lumbar spine, 12 in the dorsal spine, and 4 in the cervical spine. None of the cases shows an infection or a cerebrospinal fluid leak. Spinal cord injuries were as follow; 16 cases (57.1%) showed no spinal cord injuries, 8 patients (28.6%) showed incomplete spinal cord injuries and 4

Background and aims: Low back pain is mostly due to disc herniation and has a burden upon economy and social aspects of life. Failure to improve after open lumbar discectomy is frustrating. Therefore, identifying predictors of improvement is of great clinical benefit. Aims: This research was conducted to evaluate whether an early exercises rehabilitation program using educational booklet would provide benefit to patients following open lumbar discectomy and determine potential factors of improvement.Patients and methods: Design: Single blind randomized controlled trial. Eighty-eight patients scheduled for open lumbar discectomy from January 2017 to January 2019 at Assiut and Ain Shams Universities hospitals in Egypt were randomly assigned to two groups. Control group (n = 44) received routine postoperative instructions while intervention group (n = 44) received routine instructions in addition to early exercises rehabilitation program and were also provided with a specifically designed educational booklet. Patients were followed up after six months using Oswestry disability index.Results: There was significant improvement among intervention group as compared to control group in several domains of Oswestry disability index (walking, sitting, standing, sleeping, travelling and sexual and social life). Better pre-operative Oswestry disability index score and early application of exercises rehabilitation program using an educational booklet predicted better postoperative Oswestry disability index score after six months.Conclusion: Application of an early exercise rehabilitation program and providing patients with a specifically designed educational booklet would be helpful for patients following open lumbar discectomy. Clinical Relevance: Early exercises rehabilitation program can be used by nursing staff as a reference in management of patients following open lumbar discectomy.

Posterior mediastinal dumb-bell tumours are neurogenic tumours that extend from the mediastinum to the intraspinal canal. They represent a surgical challenge because they may be resected using a staged or a single-stage approach. Until recently, a classic posterolateral thoracotomy was the gold standard for surgical resection for the intrathoracic segment. In the meantime, video-assisted thoracoscopic surgery has gained great acceptance among most thoracic surgeons because of the decreased surgical trauma, less operative blood loss and fewer postoperative complications and the shorter hospital stays. Proper selection of cases for thoracoscopic excision is crucial for ensuring good surgical outcomes. Factors such as tumour size, location and presence or absence of features suggesting malignancy should be considered. This procedure can offer great help in different case scenarios involving posterior mediastinal dumb-bell tumours. For giant tumours that will eventually need a thoracotomy, video-assisted thoracoscopic surgery helps the surgical team to choose an optimal site for a tailored thoracotomy incision and rule out any metastatic pleura seedings. In cases of small intrathoracic segments of dumb-bell tumours (≤ 6–8 cm) that require combined spinal and thoracic procedures in a single-stage approach, a combined posterior and video-assisted thoracoscopic surgical approach can be implemented for total resection of the tumour.

Background Data: Neural tube defects (NTDs) include a wide variety of pathologies due to the intrauterine failure of neural tube closure. It includes anencephaly which is incompatible with life, encephalocele and myelomeningocele and meningocele. Myelomeningocele (MMC) the commonest and worst form in which the spinal cord and the meninges protrude from a defect in the spine. Meningocele is a less severe form in which only the meninges protrude into a sac. MMC represents a major health problem with a higher incidence in developing countries. It is one of the death associated diseases in infants and early childhood. It compromises the patient's life quality and causes lifelong disabilities. Other congenital anomalies might be associated with the SB like congenital hydrocephalus, congenital talipus, and congenital heart diseases. Purpose: To study patients' epidemiological data and possible risk factors in our locality. Study Design: A cohort descriptive retrospective clinical case study. Patients and Method: We reported 122 babies with spina bifida cystica came to neurosurgery clinic in Sohag university hospital between January 2009 and January 2015. We collect their epidemiological data and ask their parents about the possible factors. Results: In 122 patients with spina bifida cystica, the age range varies from 1 day to 8 months (the mean age was 2 months). The study involved 66 males (54%) and 56 females (46%). 71 cases had associated hydrocephalus (58%), 33 had congenital talipus deformity (27%) and 26 cases had associated cardiovascular disease (21%). Seventy three percent of cases (N=89) came from rural area. Conclusion: spina bifida cystica is a common disease in Sohag government. Both sexes affected equally. Incidence was higher in rural areas, mothers who took medication in the first trimester, those who were not on regular folate intake and in families who had a previous baby with spina bifida cystica. (2015ESJ107)