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A 54-year-old Caucasian woman presented with a 6 week history of periscapular pain and a T1 radiculopathy associated with Horner's syndrome. MRI of her cervicothoracic spine revealed an intervertebral disc herniation at the level of T1-2. During investigation she experienced some improvement in her symptoms and a conservative approach was pursued. At 6 months her pain and radiculopathy had resolved, and there was mild residual ptosis., (2014 BMJ Publishing Group Ltd.)

A 17-year-old patient was aggressively attacked and stabbed in the dorsal region of his back by a knife. He was admitted to the emergency room of the Hammoud Hospital University Medical Center, Saida, Lebanon lying in the prone position. The neurological examination revealed that the stabbing object was fixed at the dorsal spine level at the T-7 level, where it was inserted inside the vertebral body. Luckily, the blade of the knife was parallel to the nervous tracts of the spinal cord; thus, he showed no neurological deficits. This case provides an overview of how neurosurgical principles can be applied to trauma patients with spine injuries due to close combat weapons.

A 39-year-old male patient known to have neurofibromatosis-1, presented with sciatica and low back pain. At the age of 27, an MRI of the spine revealed widening of the lumbar canal due to posterior scalloping of the last 4 lumbar vertebrae. Repeat MRI and simple lateral lumbosacral plain film at the age of 39, revealed significant progression of the lumbosacral lesion. In view of the progression of the disease during the last 15 years, we opted for insertion of a lumbo-peritoneal (LP) shunt to decrease the CSF pressure, which is the most probable cause of scalloping. We shied away from lumbar fixation as we thought that this would not stop the vertebral erosion. The LP shunt affected good symptomatic and radiologic outcome over a 2-year follow up.

Twenty-three patients affected with severe spasticity as a result of several clinical pathologies were treated with intrathecal Baclofen and administered at a lumbar level by means of an implantable infusion system. The system allows programming of any drug dosage in a continuous infusion fashion in the subarachnoid space. The appropriate patients were selected using specific criteria and the patients were regularly reviewed regarding the level of the spasticity and functional capacity. The required daily doses were determined using a specific detailed system. The doses needed varied according to the pathologic or clinical diagnosis. The doses administered by the global method at the beginning of the treatment were 91.96 microg/day and 137.81 microg/day in the final phase. These doses were higher in patients with medullary traumatic lesion, diffuse cerebral lesion and spastic idiopathic paraparesis. Relatively mild side effects were produced by the therapeutic doses used.