Cervical Meningocele about 2 Operated Cases

Cervical meningoceles are the least common forms of spina bifida, representing between 4% to 8% of all spinal dysraphisms. They are not accompanied by neurological deficit in childhood but attached cord syndrome can occur with growth. Surgical treatment, in addition to avoiding rupture and correcting the aesthetic damage, will preserve neurological functions. We report 2 cases that we took care of. They are a 5-month-old infant and a 3-year-old girl. The first presented a 7 cm rounded meningocele pedunculated through the C1 lamina defect. The second presented an 8.6 cm polylobed meningocele pedunculated through the C2 lamina defect. They both underwent surgery with good progress.

Thoracic and Lumbar Spine Fracture, Type C of Magerl: About Two Cases and Review of Literature

Introduction: Thoracic and lumbar spine fracture, type C of MAGERL is one of the most biomechanically and neurologically unstable lesions, induced by significant damage to the bone, disk and ligament complex. Materials and Methods: We report two cases of Thoracic and lumbar fracture, type C of MAGERL hospitalized in the Neurosurgery department of the Grand Yoff General Hospital in Dakar during a period from June 2014 to June 2017. Observations: 1st case: 44-year-old patient, referred from abroad because of multi systemic trauma related on road traffic accident. On physical examination sustained a thoracic spine trauma classified ASIA D. Body CT scan showed T4 - T5 fracture-dislocation Type C of MAGERL, multiple ribs fracture with a right slight haemothorax, a sternal, a left humerus and scapulas fracture. Thoracic Posterior approach was done using laminar hooks. Clinical and anatomical results are good. 2nd case: 20-year-old patient, referred for thoraco-lumbar trauma because of occupational accident. The initial clinical examination classified it ASIA B. CT scan investigation, demonstrated a L1-L2 fracture type C of MARGEL. Thoraco lumbar spine posterior approach was done using pedicular screw fixation. Two years after trauma the patient recovered completely from his paraplegia. Conclusion: Thoracic and lumbar spine fractures, type C of MAGERL are compelling and instable fracture. Performing posterior instrumentation can achieve a good stabilization and reduction of the lesion.

Spinal Cord Injuries without Visible Bone Lesions: Analysis of Four Consecutive Cases

Objectives: Interest of this study is to report four cases of spinal cord injuries without bone lesion. Evolution of the injured patients according to the initial clinic assessment at admission and the treatment performed are discussed. Materials and Methods: From January to December 2016, we performed a retrospective study at the Neurosurgery Department of Hospital General Grand Yoff of Dakar. Four patients were followed for spinal cord injury without visible bone lesions. We analyzed the clinical, radiological, therapeutic and evolutionary data. Trauma caused by stabbing was excluded. Results: In a year, 83 cases of spinal trauma with neurological deficit were hospitalized in the department. Among them, 4 had spinal cord injuries without visible bone lesions. The average age was 31.7 years with extremes ranging from 14 to 47 years. The sex ratio of male/female was 3. We have recorded 2 cases of road traffic accidents, 1 case of fall from height and 1 case of sports accident. On the neurological level, we found 3 cases of tetraplegia, and 1 brachial monoplegia. Computed tomography in all patients was normal. All of them benefited from magnetic resonance imaging that showed spinal cord injury. All patients were under conservative treatment. One patient fully recovered, two partially and one passed away. Conclusion: In presence of any post traumatic myelopathy case, the absence of disco-vertebral lesions should bring to mind the SCIWORA as well as indicate the realization of magnetic resonance imaging.