Multidisciplinary approach to L3/L4 lumbar disc prolapse masquerading as focal limb myositis-a radiological challenge.

Prolapsed intervertebral discs are commonly associated with back ache and sciatica. Management is often conservative with analgesia and physiotherapy. Nerve root injections and discectomy procedures are used where conservative measures fail.

Does rectal examination have any value in the clinical diagnosis of cauda equina syndrome?

Purpose: This study aims to quantify the value of digital rectal examination (DRE) in the clinical diagnosis of cauda equina syndrome.

Methods: A retrospective case note review was performed on all patients referred to a University Teaching Hospital over a one-year period with documented suspicion of cauda equina syndrome. All Patients underwent MRI scanning to either confirm or rule out the diagnosis.

A study investigating the validity of modified Tokuhashi score to decide surgical intervention in patients with metastatic spinal cancer.

Purpose: Predicted survival of a patient is the most important parameter that helps to guide the treatment of a patient with metastatic spinal cancer. We aimed to investigate the reliability of modified Tokuhashi score in the decision-making process in patients with metastatic spinal cancer.

Methods: We performed a review of our prospectively collected Metastatic Cancer Database over a period of 4 years (2007-2010).

Spinal subdural hematoma as a complication of spinal surgery: can it happen without dural tear?

Post spinal surgery subdural hematoma is a rare entity. This is a report of a case of acute post-operative spinal subdural hematoma, without any dural injury. The case was managed expectantly and went on to complete resolution of the hematoma and full clinical recovery.

Social implications of balloon kyphoplasty: prospective study from a single UK centre.

Purpose: The incidence of osteoporotic fractures is increasing with an ageing population. This has potential consequences for health services, patients and their families. Treatment of osteoporotic vertebral compression fractures (OVCFs) has been limited to non-surgical measures so far.

Orthopaedic trauma care: a two-tier system?

Orthopaedic trauma requiring surgical admission presents to our hospitals right throughout the week. However, the level of service provided to trauma patients appears to fluctuate with more surgery facilities available during weekday "office-hours" with reduced facilities at the weekend. The National Confidential Enquiry into Peri-operative Deaths (NCEPOD) in 1999 laid down guidelines for orthopaedic trauma surgery in elderly patients clearly stating that no elderly patient requiring an urgent operation should have to wait for more than 24 h once fit for surgery.

The mannequin sign.

Study Design: Prospective observational study.

Objectives: The critical appraisal of the mannequin sign in the validation of patients with symptoms of sciatica.

Summary Of Background Data: Sixty-five consecutive patients with magnetic resonance imaging-proven lumbar disc herniation and symptoms of sciatica.

Cervical cord compression in an elderly patient with Hurler's syndrome: a case report.

Study Design: A case of cervical cord compression in an elderly lady with Hurler's syndrome is reported.

Objective: To report the occurrence of cervical cord compression in a 56-year-old patient of Hurler's syndrome, making her the oldest patient with Hurler's. The case report also highlights the appropriate management that could be given to this group of difficult patients.