To evaluate the surgical treatment of tethered cord syndrome (TCS), a prospective analysis of 43 patients operated at Neurosurgery Department Zagazig University hospitals from May 2013 to January 2017 with 1 year follow-up had been done. Adult and children patients with tethered cord syndrome subjected to microscopic surgeries for release of cord and nerves tethering with exclusion of primary repair of meningiomyelocele, paraplegic patients, hydrocephalic patients, and ages below 2 years old. Magnetic resonance imaging (MRI) of the spine was done for all patients and urodynamic studies for patients more than 6 years old preoperative and postoperative after 1 year of surgery. Ten patients were adults > 18 years old and male to female ratio was about 2:1. All patients presented with multiple clinical manifestations which either improved or stable during follow-up after surgery. Controllable complications occurred: cerebrospinal fluid (CSF) leak in 18.6% and wound infection in 4.7%. Urodynamic studies improved in 73% of patients after surgery and children showed significant improvement in all symptoms except back pain than adult patients. Microscopic surgery is of value for patients suffering tethered cord syndrome with low risk of complications.

Tumor stem cells have been found in a variety of neoplasms and stated to have a role in tumor progression. This study aimed to evaluate the prognostic significance of biomarkers which are said to be related to these cells, i.e., EZH2, ALDH1 and Ki-67, and their correlation with each other in astrocytic gliomas.

Background: Surgical resection of brain mass lesion mandates safety and the best outcome for the patient. Objectives: The aim of this study was the evaluation of intraoperative ultrasound (IOUS) in gross total resection of brain mass lesions and patients’ safety in comparison to conventional surgery. Materials and methods: In total, 632 patients were operated for brain mass lesion resection at Neurosurgery Department, Zagazig University Hospitals, during the period from January 2011 to October 2018 and divided randomly into two groups, IOUS group and conventional group, for the detection value of IOUS in resection, safety, and outcome after 3 months follow-up. Results: The IOUS group showed statistically significant gross total resection regardless to pathology, location, size, age, and sex in favor of IOUS use, and also, there were significantly less complications and better outcome after 3 months follow-up with the IOUS group. Significantly better outcome was found with gross total resection in total surgeries. Conclusions: The use of IOUS during brain mass lesion surgery is safe and can assist the surgeon in gross total resection with better outcome.

BACKGROUND: The treatment strategies of astrocytoma have not changed considerably due to the restricted appreciation of its biology. OBJECTIVES: This study aimed to evaluate the expression of the stem cell-related proteins (CD133 and Sox2) and their

Background and Aims: Intraoperative regional analgesia and enhanced recovery are standard care models aimed at reducing perioperative opioid use following spine surgeries. This study aimed to examine the analgesic effect of retrolaminar block in promoting recovery and pain relief after posterior lumbar discectomy. Methods: The patients undergoing elective posterior lumbar discectomy were randomised into the retrolaminar group (n = 36) (received an intra-operative bilateral retrolaminar block with 15 mL of bupivacaine 0.25%, 2 mL (8 mg) of dexamethasone, and 2 mL of magnesium sulphate 10% (200 mg) on each side) and control group (n = 36) (received standard general anaesthesia). Primary outcomes were recovery time (time from isoflurane discontinuation to the first response to verbal command) and time to discharge (time from admission to the post-anaesthesia care unit (PACU) to discharge from the PACU, when Aldrete score was ≥9). P values < 0.05 were considered statistically significant. Results: The extubation, recovery, and discharge times were significantly shorter in the retrolaminar group compared to the control group ( P < 0.001). Postoperative pain scores were significantly lower in the retrolaminar group for up to 8 h compared to only 2 h in the control group ( P < 0.001). The time to first administration of ketorolac post-operatively was significantly longer in the retrolaminar group compared to the control group ( P < 0.001). The total consumption of ketorolac post-operatively was significantly reduced in the retrolaminar group compared to the control group ( P < 0.001). Conclusion: Intra-operative retrolaminar block is an easy and effective opioid-free regional anaesthesia technique that improves recovery after posterior lumbar discectomy.