This study was to evaluate the morphological features of degenerative spinal stenosis and adequacy of lateral canal stenosis decompression via unilateral and bilateral laminectomy. Measurements of facet joint angulation (FJA), mid facet point (MFP), mid facet point distance (MFPD), the narrowest point of the lateral spinal canal (NPLC) and the narrowest point of the lateral spinal canal distance (NPLCD) were performed. At L4L5 of the right and left side, the mean distance between the lateral border of the dura and MFP was 1.0 ± 0.2 cm and 1.0 ± 0.3cm respectively. The mean NPLC was seen at 0.7 ± 0.3 and 0.7 ± 0.3 cm cm from the dura. At L5S1 of the right and left side, the mean distance between the lateral border of the dura and MFP was 1.2± 0.2 and 1.3 ± 0.2 cm respectively. The mean NPLC was seen at 0.8 ± 0.4 and 0.9 ± 0.5 cm from the dura. Unilateral laminectomy may result in incomplete decompression.
Spinal Stenosis

Introduction: The vertical diameter of the foramen isdependent upon the vertical diameter of the correspondingintervertebral disc. A decrease in disc vertical diameter hasdirect anatomic consequences to the foraminal diameter andarea available for the nerve root passing through it. Thisstudy is to establish the relationship amongst theintervertebral disc vertical diameter, lateral foramendiameters and nerve root compression in the lumbarvertebra.Materials and Methods: Measurements of the studyparameters were performed using sagittal MRI images. Theparameters studied were: intervertebral disc verticaldiameter (DVD), foraminal vertical diameter (FVD),foraminal transverse diameter (FTD) and nerve root diameter(NRD) of both sides. The relationship between the measuredparameters were then analyzed.Results: A total of 62 MRI images were available for thisstudy. Statistical analysis showed moderate to strongcorrelation between DVD and FVD at all the lumbar levelsexcept at left L23 and L5S1 and right L3L4 and L4L5.Correlation between DVD and FTD were not significant atall lumbar levels. Regression analysis showed that a decreaseof 1mm of DVD was associated with 1.3, 1.7, 3.3, 3.3 and1.3mm reduction of FVD at L1L2, L2L3, L3L4, L4L5 andL5S1 respectively.Conclusion: Reduction of DVD was associated withreduction of FVD. However, FVD was relatively wide forthe nerve root even with complete loss of DVD. FTD wasmuch narrower than the FVD making it more likely to causenerve root compression at the exit foramina. Theseanatomical details should be given consideration in treatingpatients with lateral canal stenosis.

sensitivity and specificity of nerve root sedimentation sign(NRS) in our populations. The NRS is a radiological sign todiagnose lumbar spinal stenosis (LSS). It is claimed to bereliable with high sensitivity and specificity. MaterialsandMethods:A total of 82 MRI images from 43patients in Group A (LSS) and 39 patients in Group B (nonLSS) were analysed and compared for the presence of theNRS sign. Two assessors were used to evaluate intra andinter-assessor reliability of this sign based on 56 (33 patients,Group A and 23 patients, Group B). The findings werestatistically analysed using SPSS software. Results:There was a significant association between spinalclaudication and leg numbness with LSS (p<0.001 andKappa=0.857, p<0.001). The inter-assessor reliability wasalso good (Kappa of 0.786, p<0.001).Conclusion:The NRS sign has high sensitivity andspecificity for diagnosing LSS. The sign also has good intraand inter-assessor reliability.

Foreign body aspiration is commonly described in infants and children. However, recently, a newhigh-risk group was identified among young women, especially those from the Muslim populationwho wear the traditional hair scarf. This is due to the habit of holding the scarf pin in between thelips to free hands to adjust the scarf more easily. Talking, laughing, or coughing while fixing thescarf may result in inadvertent inhalation of the pin into the tracheobronchial tree. We present acase of scarf pin inhalation and the challenges encountered in managing this patient during thesuccessful removal of the pin via flexible bronchoscopy under fluoroscopy guidance. This particularcase was technically challenging for us as the sharp tip of the needle was pointing upward andpiercing the bronchial mucosa.