Electrophysiological Evaluation of the Incidence of Martin-Gruber Anastomosis in Healthy Bosnian Population Background: Martin-Gruber anastomosis (MGA) is the well known anostomosis that occur at the various levels between the median and ulnar nerves. This anastomosis involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve. Knowledge of the incidence of this anastomosis is necessary because MGA can cause confusion in the assesment of nerve injuries and compressive neuropathies. Aim: We aimed to assess the occurance and motor velocities of median to ulnar nerve communication (MGA) in the forearm of Bosnian population by electrophysiological examinations. Material and Methods: One hundred and twenty forearms from a series of 60 volunteers (25 females, 35 males, 23-78 years of age) were studied electrophysiologically using needle recording electrodes. Volunteers with peripheral neuropathies were excluded from the study. Needle recording electrodes were places on the thenar and hypothenar muscles. The median and ulnar nerves were stimulated supramaximally at the wrist and the elbow and compound muscle action potentials (CMAPs) were recorded as well as motor conduction velocities of median and ulnar nerves. Results: Martin-Gruber anastomosis was found in 27 of 120 forearms; it was bilateral in 7 and unilateral in 13, on the right side in nine and on the left side in four forearms. There were no significant sexual differences in the incidence. In MGA, when stimulating median nerve the respond of abductor digiti minimi was registered in 11, whereas the respond of opponens pollicis when stimulating ulnar nerve was registered in 18 subjects. This finding was statistically significant. Conclusion: With high incidence of MGA in Bosnian population, it is necessary to be aware of the existance of this anomaly, location and its possible presentation.

Background: Many apparent advantages of the magnetic resonance imaging (MRI) in establishing diagnosis of lumbar disc herniation are counter parted by its relatively high cost and sparse availability in developing countries. Thus, a significant portion of patients are still subjected to lumbar disc surgery based solely on computed tomography (CT) findings. Aim: The aim of this study was to compare diagnostic characteristics of afore mentioned radiological tests (CT and MRI) and to investigate if the choice of diagnostic test influences outcome of discectomy. Methods: Basic demographic, clinical and radiological variables were evaluated in a group of 70 patients operated on for disc herniation of whom 30 were operated based on MRI findings and the remainder were operated based on CT scan alone. Outcome was assessed using Visual Analogue Scale (VAS) and Roland-Morris (RM) scale 6 months postoperatively and correlated to the type of neuroradiological examination. Basic diagnostic characteristic of the two diagnostic modalities (MR and CT) were compared. Results: The type of radiological investigation was shown to be statistically poor predictor of outcome after microdiscectomy. Even though MR scan was more sensitive in detecting disc extrusion than CT (sensitivity of 100% versus 65%, respectively), the presence of preoperative MR scan did not influence the outcome. Conclusion: We conclude that although the presence of preoperative MR scan does not influence outcome, higher sensitivity and specificity in detecting disc extrusions and superior ability to detect nerve root compression warrant an introduction of MR scan prior to any disc surgery.

Trigonocephaly denotes the calvarial deformity caused by premature closure of the metopic suture (metopic synostosis). The frequency of craniosynostosis in general is estimated to be 0.4 per 1000 live births, and trigonocephaly accounts for 5% of all craniostenoses, meaning that this condition is fairly rare. Several studies disclosed that craniosynostosis in twins is a very rare occurrence among craniofacial anomalies. We present a rare case of trigonocephaly in twins where surgery yielded cosmetically satisfactory results.

Introduction: It is a well recognized fact that a significant proportion of patients operated on for lumbar disc herniation exhibit a poor outcome, regardless of the apparent technical success of the operative procedure itself. Aim: to identify a set of widely available variables that accurately predict short-term outcome after discectomy and to develop a predictive model based upon those variables. Patients and methods: Basic demographic, clinical and radiological variables were evaluated in a group of 70 patient operated on for disc herniation. Outcome was assessed using VAS and RM scales 6 months postoperatively and correlated to aforementioned variables. Results: Preoperative pain intensity and duration, age and type of disc herniation were all shown to be statistically significant predictors of short-term outcome, unlike sex, type of radiological investigation and preoperative tension sign testing results. Multivariate regression analysis including only variables previously identified as good outcome predictors revealed that the pain intensity exhibited the strongest correlation with outcome, followed by pain duration, type of disc herniation and age. Even though MR scan was more sensitive in detecting disc extrusion than CT (sensitivity of 100% versus 65%, respectively), the presence of preoperative MR scan did not influence the outcome. Conclusion: The study identified a set of widely available and easily attainable variables as fair predictors of short-term outcome after lumbar discectomy. Subsequent logistic regression resulted in a predictive model whose accuracy is to be determined in another prospective study.