Khaldoun El-Abed

University Hospitals Bristol and Weston NHS Foundation Trust

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Sefa W. Canbilen

University Hospitals Bristol and Weston NHS Foundation Trust

M. J. Hutchinson

Southmead Hospital

I. W. Nelson

Southmead Hospital

Sharon Dixon

University of Exeter

Mohamed Barakat

Zagazig University

Sedighi Ali

Tabriz University of Medical Sciences

Talal Ibrahim

Qatar University

Mo Barakat

Alzahra Medical and Education Center

Ali Mofidi

Morriston Hospital

Denise O’Connor

Monash University

Cooperative Institutions

University Hospitals Bristol and Weston NHS Foundation Trust

University Hospitals Bristol NHS Foundation Trust

Weston General Hospital

Alzahra Medical and Education Center

Frenchay Hospital

University of Bristol

Aligarh Muslim University

Quaid-i-Azam University

North Bristol NHS Trust

Cheltenham General Hospital

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The value of radiographs obtained during forced traction under general anaesthesia in predicting flexibility in idiopathic scoliosis with Cobb angles exceeding 60°

Journal of Bone and Joint Surgery - British Volume (2008)

Talal Ibrahim O. Gabbar Khaldoun El-Abed M. J. Hutchinson I. W. Nelson

Our aim in this prospective radiological study was to determine whether the flexibility rate calculated from radiographs obtained during forced traction under general anaesthesia, was better than that of fulcrum-bending radiographs before corrective surgery in predicting the extent of the available correction in patients with idiopathic scoliosis. We evaluated 33 patients with a Cobb angle > 60 degrees on a standing posteroanterior radiograph, who had been treated by posterior correction. Pre-operative standing fulcrum-bending radiographs and those with forced-traction under general anaesthesia were obtained. Post-operative standing radiographs were taken after surgical correction. The mean forced-traction flexibility rate was 55% (SD 11.3) which was significantly higher than the mean fulcrum-bending flexibility rate of 32% (SD 16.1) (p < 0.001). We found no correlation between either the forced-traction or fulcrum-bending flexibility rates and the correction rate post-operatively (p = 0.24 and p = 0.44, respectively). Radiographs obtained during forced traction under general anaesthesia were better at predicting the flexibility of the curve than fulcrum-bending radiographs in curves with a Cobb angle > 60 degrees in the standing position and may identify those patients for whom supplementary anterior surgery can be avoided.

Cobb angle

10.1302/0301-620x.90b11.20690

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Functional Outcome Study of Patients After Surgical Decompression for Lumbar Spinal Stenosis: Effects of Concomitant Pathology

Journal of Spinal Disorders & Techniques (2002)

Ali Mofidi Denise O’Connor Khaldoun El-Abed John P. McCabe

The aim of this study is to identify factors associated with poor outcome in the medium (2-5 years) postoperative period following lumbar stenosis surgery. Fifty-six consecutive patients who underwent decompression for lumbar spinal stenosis were retrospectively analyzed using chart and radiologic review, questionnaire using American Association of Orthopaedic Surgeon's MODEM questionnaire containing disability, symptoms, and illness rating, as well as Short Form-36 questionnaires. Postoperatively, there was 98% partial or total relief in leg pain, 85% had partial or total relief in back pain, and 69% had partial or total recovery of neurologic deficit. Functional outcome according to the Short Form-36 was comparable with the age-adjusted population when other comorbidities were taken into account. We found a direct relationship between poor outcome and coexisting medical conditions (p <0.001). Accompanying comorbid conditions have a significant impact on outcome after surgical decompression for lumbar spinal stenosis.

Concomitant

Back Pain

10.1097/00024720-200210000-00006

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Stand-Alone Cages in Anterior Cervical Discectomy & Fusion: Mid-term Outcomes

Global Spine Journal (2016)

Khaldoun El-Abed

Introduction To review and analyze the clinical outcome and radiological changes of one-level and two-level anterior cervical discectomy and fusion (ACDF) with stand-alone Trabecular Metal™ cages. ACDF using a stand-alone cage is a popular procedure with little published long-term follow-up, we reviewed our cases performed between 2001–2011. Material and Methods Patients between 36 and 64 years of age, diagnosed with cervical radiculopathy, who underwent ACDF were available for at least 3 years follow-up and included in this study. All levels were low-cervical (below C4). Clinical outcomes were assessed using Odom's Criteria, VAS, and by assessing axial neck pain, radicular arm pain, upper extremity weakness, and upper extremity numbness. Fusion was assessed by lateral radiographs looking for bone breaching and radiolucent lines around the device, in addition to dynamic radiographs, postoperative cervical lordosis was measured by the Drexler Method Results Ninety patients were included in the study, 51 patients underwent two-level ACDF modified Robinson approach, and 39 patients underwent one-level ACDF. Mean age was 44 ± 10.4 years and mean follow-up time was 4.5 ± 2.6 years. Patients reported excellent or good outcomes (90%), VAS improved in 90% of patients from a mean of 3 preoperatively, to a mean of 9 at 1 year, and a mean of 8 at 3 years follow up. Improvement in axial neck pain (80%), radicular arm pain (95%), upper extremity weakness (85%), and upper extremity numbness (90%). No cage extrusion or migration occurred. Subsidence occurred in 8% of levels fused. Clinical improvements were not related to the occurrence of subsidence. Radiographs confirmed restoration of cervical lordosis above 45 degrees, with maintenance over the follow up period. There was symptomatic anterior osteophytes formation or calcifications of anterior longitudinal ligament in 25% of patients at the final follow-up; the reoperation rate was 3.6%. There was no persistent dysphagia, or voice complaints, no dural tear, tracheal or oesophageal perforation. One patient developed deep MRSA infectious infarction of spinal cord, treated with antibiotics, and recovered totally upon one-year follow up. Based on the 3 criteria for fusion, 90% of patients confirmed fusion at 1 year follow up. Conclusion Mid- to long-term results show that ACDF with Trabecular Metal™ cages is safe and effective treatment of single and two-level cervical disc radiculopathy and neck pain.

Neck pain

Radiodensity

Cervical radiculopathy

Radicular pain

10.1055/s-0036-1582838

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