khaled saoud - Academia.edu (original) (raw)
Papers by khaled saoud
Background: The goal of stereotactic radiosurgery for cerebral arteriovenous malformations (AVMs)... more Background: The goal of stereotactic radiosurgery for cerebral arteriovenous malformations (AVMs) is to obliterate the AVM nidus, decrease the risk of future hemorrhage, and improve seizure severity, headache, or other neurological deficits. Objectives: evaluation of gamma knife radiosurgery as a modality of treatment of intracranial arteriovenous malformation. Patients and Methods: this study was conducted on 108 patients of intracranial AVMs between 2002 and 2010. All cases of AVMs were included in the study with exception of those had previous conventional radiotherapy for their intracranial AVMs or those with AVMs requiring staged volume treatment. Results: Complete obliteration of AVMs was documented by MR imaging and cerebral angiography in 94 patients (87%). Only 5 patients (4.6%) showed bleeding from their treated AVMs. Permanent residual deficit was observed in 4 of the 5 patients with hemorrhage. In 23 patients (21.3%), symptomatic adverse radiation effects (AREs) (edema) ...
QJM: An International Journal of Medicine, 2021
Background Degenerative lumbar disorders are relatively common condition that typically affects p... more Background Degenerative lumbar disorders are relatively common condition that typically affects persons over the age of 50 and are more common in females. Patients typically present with a constellation of symptoms that include back pain, radiculopathy, and/or neurogenic claudication. Aim of the Work to assess the clinical and radiological outcome of Transforaminal Lumbar Interbody Fusion (TLIF) and posterolateral fusion (PLF) in the treatment of degenerative lumbar disorders. Patients and Methods a prospective study was conducted on patients with degenerative lumbar spondylolisthesis and degenerative lumbar spine stenosis who were admitted to Neurosurgical department at Ain Shams University hospital and Arab contractors medical center and underwent lumbar spine fixation with either transforaminal interbody fusion or posterolateral fusion from February 2017 to February 2019. The patients were divided into two groups according to the operative procedure done for each group. Group A (...
Asian Journal of Neurosurgery, 2020
Background: The classic laminectomy for spinal decompression was the treatment of choice of the d... more Background: The classic laminectomy for spinal decompression was the treatment of choice of the degenerative lumbar canal stenosis (LCS). Many surgeons prefer to add instrumented lumbar fusion to avoid future instability after the removal of posterior elements. Adding fusion is associated with more bleeding and longer periods of hospitalization. Minimally invasive lumbar decompression (MILD) has been advocated for successful decompression with less bleeding loss and shorter hospitalization. Aim of the Work: To evaluate and compare the clinical outcomes of two different treatment modalities for degenerative LCS: the classic laminectomy with posterolateral transpedicular screw fixation and the MILD. Patients and Methods: Fifty patients with degenerative LCS were randomized from two institutions: Ain Shams University Hospital and Arab Contractors Medical Center, who underwent surgeries for degenerative LCS between 2016 and 2018 with 1-year follow-up. The study compared two cohorts: Gro...
Journal of Orthopaedics, 2018
Introduction: Lumbar spondylolisthesis is a common cause of morbidity in middle aged individuals.... more Introduction: Lumbar spondylolisthesis is a common cause of morbidity in middle aged individuals. Spinal fusion with instrumentation has become the gold standard for lumbar segmental instability. Studies which correlate the improvement in radiology postoperatively with functional outcome show contrasting reports. This study is aimed at finding the correlation between clinical and radiological outcomes after surgery with transforaminal lumbar interbody fusion. Methods: A retrospective study in 35 patients who underwent transforaminal lumbar interbody fusion in a period of 1 year was done. Preoperative pain (VAS Score), functional ability (ODI), radiological parameters (slip angle, slip grade, disc height, foraminal height, lumbar lordosis) were compared with postoperative recordings at the last followup. Functional improvement (Macnab's criteria) and fusion (Lee's fusion criteria) were assessed. Statistical analysis was done with student's paired t-test and Pearson's correlation coefficient. Results: VAS score, ODI improved from 8 to 2 and 70 to 15 respectively. Slip angle improved from 23°to 5°on an average. 80% patients showed fusion and 85% showed good clinical outcome at 1 year followup. Analyzing with Pearson correlation coefficient showed no significant relation between pain scores and radiological parameters. But there was statistically significant relation between radiological fusion and the final clinical outcome. Conclusion: TLIF produces spinal fusion in most individuals. Strong spinal fusion is essential for good clinical outcome in spondylolisthesis patients who undergo TLIF. Reduction in slip is not necessary for all patients with listhesis.
Cureus, 2016
Background: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option fo... more Background: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three-and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three-and four-level ACDF. Methods: Two cohorts of patients who underwent ACDF for the treatment of three-and fourlevel disease were compared. Thirty-three patients underwent implantation of zero-profile devices that included titanium screw fixation (Group A). Thirty-five patients underwent implantation of stand-alone PEEK cages without any form of screw fixation (Group B). Results: In Group A, twenty-seven patients underwent a three-level and six patients a four-level ACDF, with a total of 105 levels. In Group B, thirty patients underwent a three-level and five patients underwent a four-level ACDF, with a total number of 110 levels. In Group A, the mean preoperative visual analog scale score (VAS) for arm pain was 6.4 (range 3-8), and the mean postoperative VAS for arm pain decreased to 2.5 (range 1-7). In group B, the mean preoperative VAS of arm pain was 7.1 (range 3-10), and the mean postoperative VAS of arm pain decreased to 2 (range 0-4). In Group A, four patients (12%) developed dysphagia, and in Group B, three patients (9%) developed dysphagia. Conclusions: This study found zero-profile instrumentation and PEEK cages to be both safe and effective for patients who underwent three-and four-level ACDF, comparable to reported series using plate devices. Rates of dysphagia for the cohort were much lower than reports using plate devices. Zero-profile segmental fixation devices and PEEK cages may be considered as viable alternatives over plate fixation for patients requiring multi-level anterior cervical fusion surgery.
Asian journal of neurosurgery, 2012
Cirsoid aneurysms of scalp are rare lesions which are mainly treated by surgical excision. Endova... more Cirsoid aneurysms of scalp are rare lesions which are mainly treated by surgical excision. Endovascular embolization was described either alone or prior to surgery in order to minimize the risk of bleeding. However, the endovascular therapy also carries the risk of scalp necrosis, escape of embolization material to circulation, and recurrence of the lesion. To evaluate the results of well-planned classic surgical excision of cirsoid aneurysm. This is a retrospective case series study. This is a retrospective case series study on nine patients with cirsoid aneurysms who were treated with surgical excision. Preoperative Planning for location, size, feeding arteries, and venous drainage of the lesions were done by plain and contrast enhanced CT, MRI, MR angiogram, and selective internal and external carotid angiograms. Complete surgical excision for the lesions was done. Postoperative evaluation of excision was done by cranial magnetic resonance angiography in all the patients. The mea...
Journal of Spine, 2013
Objective: To assess the feasibility of anterior cervical procedures in the treatment of C5 palsy... more Objective: To assess the feasibility of anterior cervical procedures in the treatment of C5 palsy occurring after posterior cervical decompression procedures done for the treatment of cervical spondylotic myelopathy. Introduction: In this study we hypothesized that anterior cervical decompression would benefit these patients through widening the cervical foramen, directly by rongeurs and drills and indirectly by placing an intervertebral spacer (cervical cage). The aim of the study is to assess whether a more proactive approach would benefit these patients. Materials and methods: Between January 2005 and September 2011, 200 posterior cervical procedures have been done by the authors, for the treatment of cervical spondylotic myelopathy (CSM). The procedures done were laminectomy with or without instrumentation. Forty cases developed C5 palsy postoperatively (20%). 20 cases (50%) presented immediate postoperatively and the rest presented during the first week postoperatively. All the cases started a course of conservative treatment of steroids, analgesics and physiotherapy. Thirty patients (75%) improved on conservative treatment. Ten patients did not improve after more than one year of conservative management. Two cases had a single level anterior cervical discectomy and cage fusion (ACDF), 3 cases had single level ACDF with plate fixation and 3 cases had 2 levels ACDF with plate fixation. Two cases had 3 levels ACDF with interbody fusion and plate fixation. The operative choice was made in order to increase the lordotic curve and the foraminal diameter. Results: Immediately postoperatively all patients had improved radicular pain. Assessment of the motor power was made immediately postoperative and 3 months afterwards with continuous physiotherapy. There was no change in the C5 palsy in all cases on the immediate postoperative examination, whereas all cases showed improvement of at least 2 grades in the 3 months postoperative visits. All patients at the final follow up had an MMT (Manual Muscle Test) grade of at least 3. Six patients reached an MMT grade of 4 or more. One case had recurrent myelopathy 9 months after 3 levels ACDF and fixation. His MRI showed adjacent segment degeneration at a higher level and had led to myelopathy. He improved on conservative treatment. Two cases died during follow up period: one at 10 months postoperatively from complications of massive myocardial infarction and the other one 15 months postoperatively from bronchogenic carcinoma diagnosed 7 months after surgery. Conclusion: Postoperative C5 palsy following posterior decompression for cervical spondylotic myelopathy is not an uncommon occurrence and the majority of cases will respond to conservative treatment. Anterior decompression procedures may offer a safe and effective solution for those few patients who do not respond to a prolonged period of conservative management.
Purpose: Treating patients with malignant gliomas has always been a difficult task. We are invest... more Purpose: Treating patients with malignant gliomas has always been a difficult task. We are investigating the efficacy of using cisplatin as radiosensitizer during standard course of radiotherapy followed by Lomustine (CCNU), and Vincristine (Oncovine) chemotherapy and the possible improve survival. The primary end of this study was time to progression, the secondary end points were response, toxicity, and the overall survival. Patients and Methods: After surgery (open debulking surgery, stereotactic craniotomy, or stereotactic biopsy), the adult chemo-naïve patients who were pathologically proven to have high-grade glioma i.e. anaplastic astrocytoma (AA), and Glioblastoma multiforme (GBM) were eligible. They received cisplatin 35mg/m 2 weekly during radiotherapy, which was given conventionally 5 days a week, 200 cGY per treatment to a maximum dose of 6400 cGY. This was followed by 6 cycles of chemotherapy that consisted of CCNU 100 mg/m 2 D1 every 6 weeks and vincristine 1.4 mg/m 2 ...
esns.org.eg
Introduction: Glomus Jugulare tumors represent a great therapeutic challenge. Previous papers hav... more Introduction: Glomus Jugulare tumors represent a great therapeutic challenge. Previous papers have documented good results with these tumors. However, the relationship between clinical improvement and tumor shrinkage has never been assessed ...
esns.org.eg
Stereotacic Biopsy of Brain Stem Lesions, A Report of 65 Cases ... Khaled MF Saoud, Wael A. Reda,... more Stereotacic Biopsy of Brain Stem Lesions, A Report of 65 Cases ... Khaled MF Saoud, Wael A. Reda, Wael A. Ezat, Ayman A. El-Shazly and Mamdouh Salama Department of Neurosurgery, Ain Shams University ... Introduction: In adults, brain stem lesions are ...
Background: The goal of stereotactic radiosurgery for cerebral arteriovenous malformations (AVMs)... more Background: The goal of stereotactic radiosurgery for cerebral arteriovenous malformations (AVMs) is to obliterate the AVM nidus, decrease the risk of future hemorrhage, and improve seizure severity, headache, or other neurological deficits. Objectives: evaluation of gamma knife radiosurgery as a modality of treatment of intracranial arteriovenous malformation. Patients and Methods: this study was conducted on 108 patients of intracranial AVMs between 2002 and 2010. All cases of AVMs were included in the study with exception of those had previous conventional radiotherapy for their intracranial AVMs or those with AVMs requiring staged volume treatment. Results: Complete obliteration of AVMs was documented by MR imaging and cerebral angiography in 94 patients (87%). Only 5 patients (4.6%) showed bleeding from their treated AVMs. Permanent residual deficit was observed in 4 of the 5 patients with hemorrhage. In 23 patients (21.3%), symptomatic adverse radiation effects (AREs) (edema) ...
QJM: An International Journal of Medicine, 2021
Background Degenerative lumbar disorders are relatively common condition that typically affects p... more Background Degenerative lumbar disorders are relatively common condition that typically affects persons over the age of 50 and are more common in females. Patients typically present with a constellation of symptoms that include back pain, radiculopathy, and/or neurogenic claudication. Aim of the Work to assess the clinical and radiological outcome of Transforaminal Lumbar Interbody Fusion (TLIF) and posterolateral fusion (PLF) in the treatment of degenerative lumbar disorders. Patients and Methods a prospective study was conducted on patients with degenerative lumbar spondylolisthesis and degenerative lumbar spine stenosis who were admitted to Neurosurgical department at Ain Shams University hospital and Arab contractors medical center and underwent lumbar spine fixation with either transforaminal interbody fusion or posterolateral fusion from February 2017 to February 2019. The patients were divided into two groups according to the operative procedure done for each group. Group A (...
Asian Journal of Neurosurgery, 2020
Background: The classic laminectomy for spinal decompression was the treatment of choice of the d... more Background: The classic laminectomy for spinal decompression was the treatment of choice of the degenerative lumbar canal stenosis (LCS). Many surgeons prefer to add instrumented lumbar fusion to avoid future instability after the removal of posterior elements. Adding fusion is associated with more bleeding and longer periods of hospitalization. Minimally invasive lumbar decompression (MILD) has been advocated for successful decompression with less bleeding loss and shorter hospitalization. Aim of the Work: To evaluate and compare the clinical outcomes of two different treatment modalities for degenerative LCS: the classic laminectomy with posterolateral transpedicular screw fixation and the MILD. Patients and Methods: Fifty patients with degenerative LCS were randomized from two institutions: Ain Shams University Hospital and Arab Contractors Medical Center, who underwent surgeries for degenerative LCS between 2016 and 2018 with 1-year follow-up. The study compared two cohorts: Gro...
Journal of Orthopaedics, 2018
Introduction: Lumbar spondylolisthesis is a common cause of morbidity in middle aged individuals.... more Introduction: Lumbar spondylolisthesis is a common cause of morbidity in middle aged individuals. Spinal fusion with instrumentation has become the gold standard for lumbar segmental instability. Studies which correlate the improvement in radiology postoperatively with functional outcome show contrasting reports. This study is aimed at finding the correlation between clinical and radiological outcomes after surgery with transforaminal lumbar interbody fusion. Methods: A retrospective study in 35 patients who underwent transforaminal lumbar interbody fusion in a period of 1 year was done. Preoperative pain (VAS Score), functional ability (ODI), radiological parameters (slip angle, slip grade, disc height, foraminal height, lumbar lordosis) were compared with postoperative recordings at the last followup. Functional improvement (Macnab's criteria) and fusion (Lee's fusion criteria) were assessed. Statistical analysis was done with student's paired t-test and Pearson's correlation coefficient. Results: VAS score, ODI improved from 8 to 2 and 70 to 15 respectively. Slip angle improved from 23°to 5°on an average. 80% patients showed fusion and 85% showed good clinical outcome at 1 year followup. Analyzing with Pearson correlation coefficient showed no significant relation between pain scores and radiological parameters. But there was statistically significant relation between radiological fusion and the final clinical outcome. Conclusion: TLIF produces spinal fusion in most individuals. Strong spinal fusion is essential for good clinical outcome in spondylolisthesis patients who undergo TLIF. Reduction in slip is not necessary for all patients with listhesis.
Cureus, 2016
Background: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option fo... more Background: Anterior cervical discectomy and fusion (ACDF) is a well-accepted treatment option for patients with cervical spine disease. Three-and four-level discectomies are known to be associated with a higher complication rate and lower fusion rate than single-level surgery. This study was performed to evaluate and compare zero-profile fixation and stand-alone PEEK cages for three-and four-level ACDF. Methods: Two cohorts of patients who underwent ACDF for the treatment of three-and fourlevel disease were compared. Thirty-three patients underwent implantation of zero-profile devices that included titanium screw fixation (Group A). Thirty-five patients underwent implantation of stand-alone PEEK cages without any form of screw fixation (Group B). Results: In Group A, twenty-seven patients underwent a three-level and six patients a four-level ACDF, with a total of 105 levels. In Group B, thirty patients underwent a three-level and five patients underwent a four-level ACDF, with a total number of 110 levels. In Group A, the mean preoperative visual analog scale score (VAS) for arm pain was 6.4 (range 3-8), and the mean postoperative VAS for arm pain decreased to 2.5 (range 1-7). In group B, the mean preoperative VAS of arm pain was 7.1 (range 3-10), and the mean postoperative VAS of arm pain decreased to 2 (range 0-4). In Group A, four patients (12%) developed dysphagia, and in Group B, three patients (9%) developed dysphagia. Conclusions: This study found zero-profile instrumentation and PEEK cages to be both safe and effective for patients who underwent three-and four-level ACDF, comparable to reported series using plate devices. Rates of dysphagia for the cohort were much lower than reports using plate devices. Zero-profile segmental fixation devices and PEEK cages may be considered as viable alternatives over plate fixation for patients requiring multi-level anterior cervical fusion surgery.
Asian journal of neurosurgery, 2012
Cirsoid aneurysms of scalp are rare lesions which are mainly treated by surgical excision. Endova... more Cirsoid aneurysms of scalp are rare lesions which are mainly treated by surgical excision. Endovascular embolization was described either alone or prior to surgery in order to minimize the risk of bleeding. However, the endovascular therapy also carries the risk of scalp necrosis, escape of embolization material to circulation, and recurrence of the lesion. To evaluate the results of well-planned classic surgical excision of cirsoid aneurysm. This is a retrospective case series study. This is a retrospective case series study on nine patients with cirsoid aneurysms who were treated with surgical excision. Preoperative Planning for location, size, feeding arteries, and venous drainage of the lesions were done by plain and contrast enhanced CT, MRI, MR angiogram, and selective internal and external carotid angiograms. Complete surgical excision for the lesions was done. Postoperative evaluation of excision was done by cranial magnetic resonance angiography in all the patients. The mea...
Journal of Spine, 2013
Objective: To assess the feasibility of anterior cervical procedures in the treatment of C5 palsy... more Objective: To assess the feasibility of anterior cervical procedures in the treatment of C5 palsy occurring after posterior cervical decompression procedures done for the treatment of cervical spondylotic myelopathy. Introduction: In this study we hypothesized that anterior cervical decompression would benefit these patients through widening the cervical foramen, directly by rongeurs and drills and indirectly by placing an intervertebral spacer (cervical cage). The aim of the study is to assess whether a more proactive approach would benefit these patients. Materials and methods: Between January 2005 and September 2011, 200 posterior cervical procedures have been done by the authors, for the treatment of cervical spondylotic myelopathy (CSM). The procedures done were laminectomy with or without instrumentation. Forty cases developed C5 palsy postoperatively (20%). 20 cases (50%) presented immediate postoperatively and the rest presented during the first week postoperatively. All the cases started a course of conservative treatment of steroids, analgesics and physiotherapy. Thirty patients (75%) improved on conservative treatment. Ten patients did not improve after more than one year of conservative management. Two cases had a single level anterior cervical discectomy and cage fusion (ACDF), 3 cases had single level ACDF with plate fixation and 3 cases had 2 levels ACDF with plate fixation. Two cases had 3 levels ACDF with interbody fusion and plate fixation. The operative choice was made in order to increase the lordotic curve and the foraminal diameter. Results: Immediately postoperatively all patients had improved radicular pain. Assessment of the motor power was made immediately postoperative and 3 months afterwards with continuous physiotherapy. There was no change in the C5 palsy in all cases on the immediate postoperative examination, whereas all cases showed improvement of at least 2 grades in the 3 months postoperative visits. All patients at the final follow up had an MMT (Manual Muscle Test) grade of at least 3. Six patients reached an MMT grade of 4 or more. One case had recurrent myelopathy 9 months after 3 levels ACDF and fixation. His MRI showed adjacent segment degeneration at a higher level and had led to myelopathy. He improved on conservative treatment. Two cases died during follow up period: one at 10 months postoperatively from complications of massive myocardial infarction and the other one 15 months postoperatively from bronchogenic carcinoma diagnosed 7 months after surgery. Conclusion: Postoperative C5 palsy following posterior decompression for cervical spondylotic myelopathy is not an uncommon occurrence and the majority of cases will respond to conservative treatment. Anterior decompression procedures may offer a safe and effective solution for those few patients who do not respond to a prolonged period of conservative management.
Purpose: Treating patients with malignant gliomas has always been a difficult task. We are invest... more Purpose: Treating patients with malignant gliomas has always been a difficult task. We are investigating the efficacy of using cisplatin as radiosensitizer during standard course of radiotherapy followed by Lomustine (CCNU), and Vincristine (Oncovine) chemotherapy and the possible improve survival. The primary end of this study was time to progression, the secondary end points were response, toxicity, and the overall survival. Patients and Methods: After surgery (open debulking surgery, stereotactic craniotomy, or stereotactic biopsy), the adult chemo-naïve patients who were pathologically proven to have high-grade glioma i.e. anaplastic astrocytoma (AA), and Glioblastoma multiforme (GBM) were eligible. They received cisplatin 35mg/m 2 weekly during radiotherapy, which was given conventionally 5 days a week, 200 cGY per treatment to a maximum dose of 6400 cGY. This was followed by 6 cycles of chemotherapy that consisted of CCNU 100 mg/m 2 D1 every 6 weeks and vincristine 1.4 mg/m 2 ...
esns.org.eg
Introduction: Glomus Jugulare tumors represent a great therapeutic challenge. Previous papers hav... more Introduction: Glomus Jugulare tumors represent a great therapeutic challenge. Previous papers have documented good results with these tumors. However, the relationship between clinical improvement and tumor shrinkage has never been assessed ...
esns.org.eg
Stereotacic Biopsy of Brain Stem Lesions, A Report of 65 Cases ... Khaled MF Saoud, Wael A. Reda,... more Stereotacic Biopsy of Brain Stem Lesions, A Report of 65 Cases ... Khaled MF Saoud, Wael A. Reda, Wael A. Ezat, Ayman A. El-Shazly and Mamdouh Salama Department of Neurosurgery, Ain Shams University ... Introduction: In adults, brain stem lesions are ...