Biomedical subjects
Publications and source records attributed to S Govender.
Vertebral haemangiomas are benign lesions but can be responsible for a variety of symptoms varying from localised pain to myelopathy and paralysis. Two successfully treated cases of spinal cord compression caused by vertebral haemangiomas are reported.
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Osseous infection due to Cryptococcus neoformans is rare. A case of paraplegia due to vertebral cryptococcal infection in a child is reported.
A prospective study of 39 patients with traumatic spondylolisthesis of the axis is reported. Classification of the fracture was based on the criteria of White and Punjabi (1978). In previous studies (Effendi et al., 1981; Levine and Edwards, 1985) stability of the undisplaced and slightly displaced fracture was based on flexion/extension radiographs. Union was obtained in all fractures without using a rigid cervical orthosis. We feel that assessing stability dynamically soon after injury when there is marked muscle spasm does not provide an accurate assessment, nor does it not alter the management of these injuries, as shown in this study.
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We report on five patients with Salmonella typhi spondylitis who were immunologically normal and had no prodromal gastrointestinal illness. The diagnosis was confirmed on blood cultures, Widal test, and needle biopsy of the spine. Appropriate antibiotic treatment resulted in a favorable outcome.
This article reports a long-term follow-up assessment (10-15 years) of eight children treated with a vascularized rib pedicle graft after an anterior spinal decompression for paralysis resulting from tuberculosis. Neurologic recovery, fusion, and hypertrophy of the rib grafts were noted in all patients. The vascularized rib pedicle grafts were superior to autologous rib grafts in supporting and promoting early fusion of the anterior column in children with kyphosis resulting from tuberculosis.
Sixteen patients had paraplegia due to tuberculosis of the cervicodorsal junction. Spinal decompression was performed through an extended lower cervical approach, and a humeral allograft was used to reconstruct the anterior column. All patients improved neurologically with satisfactory correction of the deformity and successful incorporation of the allograft.
In a retrospective study, 24 patients treated at King Edward VIII Hospital from 1985 to 1988 for acute pyogenic psoas abscess were reviewed. The main initial complaints were a painful hip and difficulty in walking. Twenty-two patients had a fixed flexion deformity of the ipsilateral hip. Ultrasonography used as a screening method elucidated the clinical diagnosis in 19 patients. Twenty-two children required incision and drainage, and Staphylococcus aureus was isolated in 20 patients either on blood culture or pus swab. Although the condition is common in the tropics, an acute pyogenic psoas abscess should always be considered in the differential diagnosis of pain in the hip region.
Spinal tuberculosis characteristically involves two contiguous vertebral bodies with narrowing of the disk space. We report on 11 children with atypical spinal tuberculosis. Three had disease confined to a single body, four had extradural extraosseous involvement presenting as an abscess, and isolated infection of the neural arch was seen in four children. Seven children had neurological involvement. Treatment included posterior decompression for the extradural extraosseous involvement, biopsy and drainage for the neural arch infection, and anterior decompression and fusion for the single-body disease. The patients had antituberculosis treatment for 18 months, and all seven children with neurological involvement recovered.