Spinal epidural abscess: diagnosis and management

Three cases of spinal epidural abscess managed at the University Hospital of the West Indies are presented. This disorder, a neurosugical emergency, runs a variable course, and, if improperly managed, may lead to paraplegia and death. The aetiology, diagnosis and management of this disease are discussed (AU)

A neurosurgical profile - abstract

Neurosurgical disease patterns, trends and workload in a hospital with 30 years' neurosurgical experience, serving a population of 1/3 milion were studied to assess, provide guidelines for more cost-effective patient care and to provide data for the development of neurosurgical facilities in developing areas. At the San Fernando General hospital, Trinidad, 1979-1988, there was a general increase in total hospital admissions (approximately 48,000/yr), neurosurgical admissions (73 to 161/yr), transfers to the neurosurgical unit (39 to 76/yr), new clinic patients (170 to 269/yr), consultations (181 to 351/yr), neuro-radiological procedures (44 to 105/yr), and surgical procedures (32 to 140 yr). There was an increase in bed occupancy rate (68 percent to 87 percent) and a reduction in the length of stay per patient (16 to 11 days), and in deaths (from a peak of 20 to 13/yr). There was a decrease in invasive studies with the advent of computerized axial tomographic scanning and magnetic resonance imaging, and myelograms showed a sharp rise due in part to newer water soluble contrast media. Surgical procedures showed a trend to more definite cranial surgery with a sharp rise in spinal surgery - laminectomy. There was and increase in the relative value score and factor which take case complesity into consideration. The commonest condition was head trauma followed by cervical spondylosis, brain tumours, seizures, spinal fractures, herniated lumbar disc, hydrocephalus and congenital anomalies and spinal tumours (AU)

Some lesions of the spine in immigrants

This paper is based on some radiographic appearances in the spine seen in immigrants to Britain. Most patients were Asian or West Indian. In this account Britain's 'white' population will be referred to as 'Caucasian' (AU)

Degenerative joint disease in a Jamaican rural population

The prevalence of degenerative joint disease has been measured in a random sample of adults aged 35-64 years living in a rural area in Jamaica and compared with that found in similar surveys in the United Kingdom. Radiological evidence of osteo-arthrosis in general showed the same prevalence in the two races, with the exception of certain joints which showed significant differences. Lumbar disk degeneration was also found to have a similar prevalence, though the involvement of multiple disks was significantly more common in Jamaica. Cervical disk degeneration was both more common and more severe in Jamaica. Symptoms in Jamaica were less frequent in relation to all sites of osteo-arthrosis except the cervical spine, and Jamaicans seemed to have fewer symptoms and less incapacity than Englishmen with the same degree of disk degeneration.(Summary)