Indian Spine Journal最新文献_第10页

In-vivo clinical validation of perpendicular to superior articular process as thoracic pedicle trajectory: A retrospective case series of 60 pediatric scoliosis 垂直于上关节突作为胸椎椎弓根轨迹的体内临床验证：60例儿童脊柱侧弯的回顾性病例系列

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/ISJ.ISJ_57_20

Aziz Ahmad, C. Ali, O. Stokes

{"title":"In-vivo clinical validation of perpendicular to superior articular process as thoracic pedicle trajectory: A retrospective case series of 60 pediatric scoliosis","authors":"Aziz Ahmad, C. Ali, O. Stokes","doi":"10.4103/ISJ.ISJ_57_20","DOIUrl":"https://doi.org/10.4103/ISJ.ISJ_57_20","url":null,"abstract":"Study Design: This is a retrospective case series study. Objective: Thoracic pedicle screw insertion can be technically challenging because of narrow pedicles. Placement of thoracic pedicle screws in pediatric scoliosis and adult deformity surgeries, due to three-dimensional rotation of vertebrae, is even more challenging because the usual landmarks are less evident, and the sagittal trajectory is more difficult to correctly orientate due to the vertebral rotation. We describe a variation of freehand technique to guide sagittal trajectory of thoracic pedicle screw. Materials and Methods: The inferior articular process of cranially adjacent vertebrae is osteotomized using a Capener Gouge to expose the superior articular process (SAP) of the thoracic vertebrae to be instrumented. An O’Connell dissector is then placed flush on the SAP. The main shaft of the dissector is at right angle to the base plate; pedicle finder is placed parallel to the shaft and follows the same sagittal trajectory as the shaft. Results: A total of 390 pedicle screws were identified in a consecutive series of 60 scoliosis patients inserted using this technique. Only one screw was revised for lateral breach. There was no intra-operative complication or neurological sequelae in any of our patients. Conclusion: Freehand pedicle screw placement remains a very common technique, used particularly by pediatric scoliosis surgeons. One of the drawbacks of previous reports of the freehand technique is that the sagittal trajectory is not clearly defined. Our technique fills this gap, and this series demonstrates that the technique produces a reliable and consistent result.","PeriodicalId":34652,"journal":{"name":"Indian Spine Journal","volume":"4 1","pages":"163 - 169"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43088414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indexing of journal: Impact or relevance 期刊索引:影响或相关性

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/ISJ.ISJ_62_21

M. Chadha, Anil Jain

引用次数: 0

Return to work after surgical treatment for cervical spondylotic myelopathy 脊髓型颈椎病手术治疗后重返工作岗位

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/ISJ.ISJ_18_21

A. Paul, R. Amritanand, K. David, Venkatesh Krishnan

{"title":"Return to work after surgical treatment for cervical spondylotic myelopathy","authors":"A. Paul, R. Amritanand, K. David, Venkatesh Krishnan","doi":"10.4103/ISJ.ISJ_18_21","DOIUrl":"https://doi.org/10.4103/ISJ.ISJ_18_21","url":null,"abstract":"Purpose: The purpose of the study was to determine the rate and predictors of return to work (RTW) after surgery for cervical spondylotic myelopathy (CSM). Overview of Literature: RTW is arguably the most important outcome following spine surgery from a patient’s perspective. But, to the best of our knowledge, there have been no reports in the English literature describing RTW among patients undergoing surgery for moderate-to-severe CSM. Materials and Methods: We included adult patients with CSM with Nurick grade ≥ 3 who underwent surgery. They were divided into two groups: those who returned to work within 6 months (group 1) and those who did not (group 2) and their outcomes were analyzed. Results: A total of 34 patients were included in the study. Baseline characteristics were comparable between the groups. Only 18 (52.9%) patients returned to work by 6 months. The nature of work had a statistically significant association with RTW by 6 months (P = 0.005) with failure to RTW specifically seen in manual laborers. Age, body mass index, symptom duration, pre-operative absenteeism, smoking, diabetes mellitus, number of levels operated, surgical approach, and post-operative complications did not have significant association with RTW. Better functional outcomes were seen in patients who returned to work as calculated using Nurick grade (P = 0.000) and modified Japanese Orthopedic Association score (P = 0.001). All the patients who returned to work and 75% of the patients who did not RTW were satisfied with the outcome of surgery (P = 0.039). Conclusion: In spite of functional improvement, CSM was associated with poor RTW with manual laborers being the most vulnerable group. This study will help surgeons modulate patient expectations as well as provide a platform for counseling them.","PeriodicalId":34652,"journal":{"name":"Indian Spine Journal","volume":"4 1","pages":"170 - 175"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46521383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Midline solitary osteochondroma of C2 vertebra with myelopathy in a child: A case report with review of literature 儿童C2椎体中线孤立性骨软骨瘤伴脊髓病1例报告并文献复习

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/isj.isj_53_20

Saumyajit Basu, N. Agarwal, S. Gowda, Aditya Bhanta

{"title":"Midline solitary osteochondroma of C2 vertebra with myelopathy in a child: A case report with review of literature","authors":"Saumyajit Basu, N. Agarwal, S. Gowda, Aditya Bhanta","doi":"10.4103/isj.isj_53_20","DOIUrl":"https://doi.org/10.4103/isj.isj_53_20","url":null,"abstract":"Spinal osteochondromas with neurological deficits are rare. Only 0.5% to 1% of spinal osteochondromas present with neurological dysfunction. We hereby present a case of osteochondroma of the C2 lamina with neurological deficit and unique presentation.A 10-year-old female presented with a history of severe weakness of all four limbs after a fall. Weakness had spontaneously improved over initial three days and she presented to us with mild weakness of the right upper limb about two weeks after the fall. On examination, neck movements were full and painless with spastic quadriparesis and a motor power of grade 4/5 in all four limbs with extensor plantars.On radiology, CT scan of the cervical spine showed an osseous outgrowth from the C2 lamina in the midline projecting into the spinal canal, directed superiorly toward the dens. An MRI showed spinal-cord compression with cord deformation and signal changes.She underwent en bloc excision of the tumor mass, which was severely impinging on the spinal cord. Histopathology confirmed a diagnosis of osteochondroma. At four-year follow-up, there was complete recovery with no signs of recurrence.Spinal osteochondroma is a rare but potential cause of spinal-cord compression in a child with varied presentation.","PeriodicalId":34652,"journal":{"name":"Indian Spine Journal","volume":"4 1","pages":"229 - 233"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43460784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Single-stage decompression of C1–D9 anterior epidural abscess by a gas-producing enteric pathogen 产气肠道病原体单期减压治疗C1–D9硬膜外前脓肿

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/ISJ.ISJ_85_20

Vetri Nallathambi, M. Chander

引用次数: 0

Association of developmental lumbar spinal canal stenosis and stunting 发展性腰椎管狭窄与发育迟缓的关系

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/isj.isj_20_20

Jamlick Muthuuri

{"title":"Association of developmental lumbar spinal canal stenosis and stunting","authors":"Jamlick Muthuuri","doi":"10.4103/isj.isj_20_20","DOIUrl":"https://doi.org/10.4103/isj.isj_20_20","url":null,"abstract":"Objective: To determine a possible relationship between developmental lumbar spinal canal stenosis (DLSS) and stunting. Background: Stunting is due to failure of longitudinal length with shortened long bones. Stunted individuals have failure of growth of long bones implying a possibility of involvement of short and flat bones. The hypothesis in this study is that DLSS is part of a generalized skeletal dysplasia. Materials and Methods: This is a cross-sectional study (CSA) of 400 patients looking at the association of DLSS with stunting. The study compares the size of the spinal canal in individuals with stunting and those without stunting. Stunting was defined according to the WHO/UNICEF criteria of −2SD of the median height of the same population. The participants were divided into two types: those who were deemed stunted and those who were not. DLSS was similarly defined as −2SD of the relevant measured parameter. The study included skeletally mature patients between 18 and 60 years. All syndromic individuals, those with spine tumors and previous spine surgery, were excluded. Results: Four hundred individuals were sampled from a pool of 597 participants. One hundred and eight or 27% were stunted. The stunted individuals had statistically significantly shallow canal depths or anteroposterior diameters (11.2 ± 2.0 mm vs. 14.6 ± 2.6 mm, t(398) = −11.1, P < 0.001), and narrower canal widths (transverse diameters) (14.6 ± 3.3 mm vs. 18.8 ± 4.5 mm, t(398) = −8.1, P < 0.001) and smaller CSAs (134.0 ± 49.4 mm vs. 220.2 ± 82.0, t(398) = −9.4, P < 0.001) when compared to individuals with normal heights. Odds ratio was 10. Conclusions: Stunted individuals have smaller lumbar spinal canals when compared to nonstunted individuals. It can be concluded that developmental lumbar spinal canal stenosis is part of a generalized skeletal dysplasia.","PeriodicalId":34652,"journal":{"name":"Indian Spine Journal","volume":"4 1","pages":"149 - 154"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43797769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Early experiences in the management of traumatic spinal injuries at a level 1 trauma center in India during the COVID-19 pandemic 2019冠状病毒病大流行期间印度一级创伤中心创伤性脊髓损伤管理的早期经验

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/ISJ.ISJ_9_21

K. Farooque, Tushar Nayak, B. Siamwala, Aayush Aryal

{"title":"Early experiences in the management of traumatic spinal injuries at a level 1 trauma center in India during the COVID-19 pandemic","authors":"K. Farooque, Tushar Nayak, B. Siamwala, Aayush Aryal","doi":"10.4103/ISJ.ISJ_9_21","DOIUrl":"https://doi.org/10.4103/ISJ.ISJ_9_21","url":null,"abstract":"Context: Overwhelmed by COVID-19 patients requiring urgent medical attention and intensive care beds, majority of our medical resources are allocated for the management of the current pandemic. Other urgent cases requiring surgical attention also need to be optimally addressed. Aims: The aim of this article is to report the early results and organizational protocol in the management of traumatic spinal fractures at a level-1 trauma center during the current pandemic. Settings and Design: This is a retrospective study of patients with vertebral fractures operated by a single surgeon between April and October 2020. All patients were tested for the SARS-CoV-2 virus, and the tests were repeated every 72 h. We modified our institutional protocol to aid the early management of emergency traumatic spine cases during this pandemic. Descriptive analysis of data collected from hospital records was carried out using Statistical Package for Social Sciences, Virginia, USA, Version 20. Results: A total of 44 patients were operated. Burst fracture was the most common fracture with a fall from height being the most common mechanism of injury. Two patients tested positive for the novel corona virus. There were no complications and none of the healthcare staff involved in the patient care or patients reported symptoms of COVID-19 during a 30-day follow‐up period. Conclusion: Surgical treatment of patients with vertebral fractures, with strict adherence to personal protective measures and local guidelines, did not increase the risk of contracting SARS‐CoV2 to either healthcare workers or patients during the lockdown period.","PeriodicalId":34652,"journal":{"name":"Indian Spine Journal","volume":"4 1","pages":"198 - 202"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42909483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brown tumor causing thoracic compressive myelopathy: A case report and review of literature 胸部压迫性脊髓病的褐色肿瘤1例报告及文献复习

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/isj.isj_48_20

M. Ramachandraiah, T. Kishen

{"title":"Brown tumor causing thoracic compressive myelopathy: A case report and review of literature","authors":"M. Ramachandraiah, T. Kishen","doi":"10.4103/isj.isj_48_20","DOIUrl":"https://doi.org/10.4103/isj.isj_48_20","url":null,"abstract":"Brown tumors are nonneoplastic bony lesions resulting from primary, secondary or tertiary hyperparathyroidism. Primary hyperparathyroidism is caused by parathyroid adenomas or parathyroid hyperplasia while chronic renal failure is a common cause of secondary hyperparathyroidism. Elevated parathyroid hormone levels cause increased osteoclastic activity, bone resorption and reactive fibroblastic proliferation leading to the formation of Brown tumor. Although Brown tumors are more commonly seen in the maxilla and mandible, it can occur in the long, flat bones or any bone. It is less commonly seen in the spine. In this report, we discuss the presentation, management, difficulties with histopathological diagnosis, and follow-up of a Brown tumor in a 55-year-old gentleman undergoing renal dialysis who presented with thoracic compressive myelopathy. Our patient underwent a T4 laminectomy, tumor debulking, and T2–T6 instrumented posterior fusion. Based on histopathological examination of the tissue specimen and raised serum parathyroid hormone levels, we arrived at a diagnosis of Brown tumor. Our review of the literature revealed 62 cases of vertebral Brown tumor resulting in neurologic symptoms. The lesion was more common in females (58%), those aged between 40 and 49 years (26%), and in the thoracic spine (51.6%). Early surgical intervention and management of the underlying cause of hyperparathyroidism lead to sustained symptomatic improvement. Brown tumor should be considered in the differential diagnosis of expansile vertebral lesions in the presence of hyperparathyroidism or chronic kidney disease. Treatment of the underlying hyperparathyroidism and decompression of the neural structures with or without stabilization is recommended.","PeriodicalId":34652,"journal":{"name":"Indian Spine Journal","volume":"4 1","pages":"203 - 213"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47769412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Paradoxical reactions in spinal tuberculosis: A case series 脊柱结核的矛盾反应：一系列病例

Indian Spine Journal Pub Date : 2021-07-01 DOI: 10.4103/ISJ.ISJ_77_20

G. Zaveri, Nitin Jaiswal

{"title":"Paradoxical reactions in spinal tuberculosis: A case series","authors":"G. Zaveri, Nitin Jaiswal","doi":"10.4103/ISJ.ISJ_77_20","DOIUrl":"https://doi.org/10.4103/ISJ.ISJ_77_20","url":null,"abstract":"Introduction: Clinical or radiological worsening of pre-existing tubercular lesions or appearance of new lesions in patients who have shown initial improvement following antitubercular chemotherapy (ATT) is termed as a paradoxical reaction (PR). The appearance of these lesions after spine surgery raises the possibilities of drug resistance, treatment failure, and surgical site infection. This retrospective case series aims to describe the presentation of PRs in spinal tuberculosis (TB), identify risk factors, and propose a treatment plan for PRs within the spine. Materials and Methods: Nine patients (2 males and 7 females; mean age 31.2 years), who underwent posterior transpedicular decompression and instrumented fusion for spinal TB, presented 4–7 weeks later with a soft, large swelling at the surgical site. In one patient, the swelling had burst through the skin resulting in a discharging wound. Two patients had screw pullout with local kyphosis. All patients had been started on ATT only after index surgery and had experienced improvement in constitutional symptoms, pain, and neurology. Magnetic resonance imaging showed large fluid collection at the surgical site without any new bony lesions. Results: All patients underwent surgical debridement with two patients requiring revision instrumentation. Examination of tissue and fluid revealed caseating granulomas and mycobacteria. Continuation of the same ATT led to uneventful healing. Conclusion: PRs in patients with spinal TB presented with a cold abscess at the surgical site between 4 and 7 weeks after starting ATT. Surgical drainage with debridement and continuation of ATT without changes to the regimen led to uneventful healing in all patients. Young age, female sex, thoracic lesions, and patients virgin to ATT prior to surgery were risk factors.","PeriodicalId":34652,"journal":{"name":"Indian Spine Journal","volume":"4 1","pages":"176 - 180"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46775810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lateral and oblique interbody fusions in degenerative and isthmic spondylolisthesis 退行性和峡部滑脱的侧斜椎间融合

Indian Spine Journal Pub Date : 2021-01-01 DOI: 10.4103/ISJ.ISJ_66_20

G. Swamy, Vishwajeet Singh, N. Evaniew, K. Thomas

引用次数: 0