A Survey on Cortical Bone Trajectory for Spinal Fusions

There have been a number of developments in screw design and implantation techniques over recent years, including proposal of an alternative trajectory entitled as cortical bone trajectory (CBT). Cortical bone trajectory has been investigated in recent medical treatments as an alternative for screw fixation aimed at increasing purchase of pedicle screws in higher density bone. CBT screw insertion follows a lateral path in the transverse plane and caudocephalad path in the sagittal plane. This technique has been advocated because it is reportedly less invasive, improves screw−bone purchase and reduces neurovascular injury. Furthermore CBT pedicle screw fixation provides stabilization to multilevel lumbar segment with low-grade spondylolisthesis comparable to the standard trajectory pedicle screw construct. However, these claims have not been supported by robust clinical evidence. Recent investigations focus on evaluations of CBT as a pioneer method.

The Role of Steroid in Post Myelography Headache

Myelography is a diagnostic procedure to indicate spinal defects. After the inception of new means of spinal cord imaging, use of myelography has been limited. Since there are contraindications for other modalities in some patients, we have to use myelography. The most common complication of myelography is post myelography headache (PMH). Many methods have been proposed to alleviate the pain. In this clinical trial study we assess the role of steroid in PMH

Brain Tumors in Elderly

Brain tumors in elderly are increasing as the number of people, who comprise the older population, does.About half of the patients with brain tumors appear to be over 60 years of age.In this review article, Glioblastoma multiform, as the most common malignant tumor of the central nervous system in elderly is discussed in details of definition, prognosis, diagnosis, treatment and differential diagnosis. Other tumors such as meningioma, pituitary adenoma, CNS lymphoma and metastasis are also included to be reviewed.  Treatment plans, either conservative or aggressive, classic or novel, approved or under investigation, are presented. Furthermore different attitudes of treatment in the past and recently are also argued. Conventional therapy, Surgery, Radiotherapy, chemotherapy radioimmunotherapy, hormonal therapy and some other novel methods of treatments are discussed in details for the glioma.Determining factors which may be associated to the patient's response to each treatment planare also discussed. Finally, some age related issues are provided to be paid attention to consider an old patient with brain tumor, and planning an optimal treatment in order to make the best management decisions.Until recently,  peoplewith brain tumors in elderly, were used to be treated in conservative plans and often were excluded of the clinical trials but now the number of patients who desire and receive more aggressive therapy for brain tumors is increasing