Sixty three patients who had a lumbar subarachnoid catheter placed for closed continuous cerebrospinal fluid drainage and the complications are presented. The drain was successful in achieving the desired goal in 59 patients (93,6%). The complications are mainly divided into 3 groups; A - complications related to alterations in CSF drainage rate, B - complications due to mechanical failure of the catheter, C - infection. The overall complication rate is found to be 44,4%. Overdrainage, pneumocephalus and meningitis are found to be the most severe complications, but most of these complications are reversible with early recognition. Unfortunately one patient died following meningitis and hepatic failure. Lumbar subarachnoid drainage is a safe method unless the development of any neurological findings should prompt rapid discontinuation of lumbar drainage and immediate radiographic evaluation.

The authors conclude that the screw misplacement decreased the original spinal stability provided by the instrumentation. Therefore, correct placement of pedicle screws is required to maintain long-term spinal stability.

No abstract

The dorsolateral, suboccipital, transcondylar technique was used in this cadaveric study. The angle and distance measurements in the corridors were taken intradurally both superior and inferior of the foramen magnum level. In the first stage of this study, the findings which were gained from the standard lateral suboccipital approach were compared with the findings after condyle and lateral atlantal mass removal. After condylectomy, the approach to anterior foramen magnum via both corridors was found to be shorter and the lateral angle of the exposure of the anterior foramen magnum was found to be wider. The considerable shortening of the distances to the anterior foramen magnum, especially in the superior corridor, emphasises the necessity of combining standard approaches with condylectomy. In addition, it was found that after condylectomy, considerable widening of both transverse and longitudinal planes in the inferior corridor allows the surgeon greater access to work on lesions. Furthermore, the freed space between the superior corridor and the interior corridor, which was gained by condylectomy, shows that condylectomy provides a combined approach to the inferior and superior parts of the foramen magnum anteriorly.

AIM:The authors compared the incidence of radiologically documented and/or symptomatic adjacent segment degeneration in and between patients who underwent anterior or posterior single-level, simple discectomy. MATERIAL and METHODS: 79 patients were clinically and radiologically examined for adjacent segment degeneration (ASD). The results were compared to evaluate which approach was predominant for adjacent segment disc degeneration. RESULTS: ASD was found in 57 of a total of 79 patients. 24% of the patients demonstrated clinical and radiographic evidence and 48% of the patients demonstrated only radiographic evidence of ASD. Both anterior and posterior single level simple discectomy had similar rates for adjacent segment disease (p>0,05) . ASD was found to appear earlier in patients who had anterior cervical discectomy (4.78 vs 9.85 years, p :0,005). Symptomatic evidence of ASD was found to start earlier than radiological evidence of ASD (4.67 vs 7.63 years, p:0,003). Radiographic evidence of adjacent segment degeneration was observed more commonly compared to symptomatic evidence of ASD (38 vs 19 patients, p:0.002). CONCLUSION: Although, radiographic and clinical evidence of ASD is inevitable for both simple cervical discectomy procedures, neither anterior nor posterior simple cervical discectomy is the predominant approach for causing ASD.