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He is a very passionate speaker that loves helping people achieve their goals and to get more fulfillment out of their lives. The term ‘motivation’ has been derived from the word ‘motive’. The motive may be defined as an inner state of our mind that moves or activates or energizes and directs our behavior towards our goals. In simple terms, motives or needs are ways of behavior.

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His life at home when he was young was described by him as abusive and chaotic because he left home at the age of 17. Robbins began promoting seminars for motivational speaker and author Jim Rohn when he was 17 years old. Later he decided to begin his own journey by hosting his own seminars organized through Robbins Research International. Tony Robbins has affected and changed so many people’s lives positively through his seminars, motivational speeches, inspirational quotes, and best-selling books.

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Motivation may be defined as the process that motivates a person into action and induces him to continue the course of action for the achievement of goals. Motivation refers to the way in which urges, drives, desires, striving, aspirations, or needs direct, control, or explain the behavior of human beings. Motivational speakers are those persons who give direction to human behavior to achieve goals or fulfill needs glory casino.

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The school started functioning as a second grade college with the introduction of F A classes in 1889. In 1898, it was upgraded to a first grade degree college.

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He was born November 6, 1926, in Coffee County, Alabama, and passed away on November 28, 2012. Zig Ziglar actually served in the army from 1935 to 1946 during World War II. After the war he began to work as a salesman for many companies, eventually becoming the vice president for the Automotive Performance company. Then he started taking part in motivational seminars and also wrote many motivational books. Zig Ziglar is one of the best motivational speakers in the world. A lot of wisdom has come from Zig Ziglar over the years.

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The tourney successful France gets underway this play and the Red Rose are among the teams gunning for glory this autumn. After five years with the club, Mizan, a founding member of Muktijoddha Sangsad Krira Chakra, left in 1982 when politicians started using political clout during HM Ershad’s regime. Match fixing started with political influence, Mubasshar said. Back then, some local politicians sold their wives’ ornaments, homes,and cars to finance these clubs since they were so invested and passionate about football or cricket.

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“Notoriety and muscle power got hold of clubs [such as Victoria], which is why the sports sector is in a vulnerable condition,” he said. We would secure fifth or sixth place in the Premier League [the top tier of the country’s football leagues], and we even defeated Abahani and Mohameddan,” he recalled. ST Aslam, a well-known former national football player, and member of Bangladesh Football Federation [BFF], played for Victoria Sporting Club from 1977 to 1979. B M College is one of the renowned Historical college of Beautiful Bangladesh.

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She has written several books on the topic of personal finance and won two Emmy Awards and eight Gracie Awards. Oprah Winfrey, full name Oprah Gail Winfrey is an American talk show host, television producer, actress, author, and philanthropist. She was born on January 29, 1954, in Kosciusko, Mississippi. Oprah Winfrey has been ranked among the world’s most influential women. Oprah Winfrey isn’t a professional motivational speaker, but she has delivered hundreds of thought-provoking keynote speeches and authored numerous inspirational books. Most inspirational quotes by Oprah Winfrey were said during her famous talk show The Oprah Winfrey Show that was aired for more than two decades.

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Another ‘casino’ club, Kalabagan Krira Chakra, was one of the country’s oldest cricket academies. The club’s status as a football club began to go down once influential politicians took over Victoria. Police raided Victoria Sporting Club and found casino and other gambling equipments on Sunday. The club, allegedly the pioneer of casinos in Bangladesh, was a turning point for Aslam.

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Sacral Fracture with Neurodeficit – Is Laid-Back Approach a Passe?

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Volume 7 | Issue 1 | January-June 2022 | Page: 24-28 | Shreevijay A Phadke, Himanshu G Kulkarni, Sidheshwar S Thosar, Rajendra Sakhrekar

DOI: 10.13107/ijs.2020.v07i01.035

Authors: Shreevijay A Phadke [1], Himanshu G Kulkarni [2], Sidheshwar S Thosar [2], Rajendra Sakhrekar [3]

[1] Department of Spine Surgery, Chirayu Hospital, Ratnagiri, Maharashtra, India.
[2] Department of Spine Surgery, Shraddha Surgical and Accident Hospital, Sangli, Maharashtra, India.
[3] Department of Spine Surgery, Schoen Klinik Neustadt Holestine, Germany.

Address of Correspondence
Dr.Sidheshwar S Thosar,
Fellow Spine Surgery, Shraddha Surgical and accident Hospital, Sangli, Maharashtra, India.
E-mail: dr.sidheshwarthosar@gmail.com

Abstract

Management of sacral fractures with neurological deficits has been a topic of debate. Literature is divided between conservative and operative management. We report a case of a 32-year-old male with post-traumatic unstable complex transverse sacrum fracture and associated stable pelvic ring fractures with loss of bowel and bladder control. He had a fall from the second floor over the buttocks. Plain lateral radiography showed a transverse sacral fracture located between S2 and S3 with kyphosis at the fracture site. MRI showed a compromised canal due to a large retro pulsed fragment pressing over the anterior aspect of sacral roots. Thorough decompression of cauda equina and sacral roots was performed, and sacral ala fracture was fixed with two percutaneous 6.5 mm cannulated cancellous Ilio-sacral screws and two 3.5 mm recon locking plates were applied for the sacrum. The patient regained his bladder control 3 months after the surgery and bowel control 4 months after the surgery. At the end of 1 year, the patient has persistent saddle anaesthesia but good bowel and bladder control. Early decompression and stabilization of unstable complex sacrum fractures with neurological compromise can facilitate optimum neurological improvement and favourable clinical outcomes in terms of early mobilization and pain relief.

Keywords: Fracture, Sacrum, Decompression surgery

References

  1. Mehta S, Auerbach JD, Born CT, Chin KR. Sacral fractures. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2006 Nov 1;14(12):656-65.
  2. Vaccaro AR, Kim DH, Brodke DS, Harris M, Chapman J, Schildhauer T, Routt MC, Sasso RC. Diagnosis and management of sacral spine fractures. JBJS. 2004 Jan 1;86(1):166-75.
  3. Dussa CU, Soni BM. A hidden injury. Emergency medicine journal. 2004 May 1;21(3):390-1.
  4. Denis F, Davis S, Comfort T. Sacral fractures: an important problem. Retrospective analysis of 236 cases. Clinical orthopaedics and related research. 1988 Feb 1;227:67-81.
  5. Bellabarba C, Schroeder GD, Kepler CK, Kurd MF, Kleweno CP, Firoozabadi R, Chapman JR, Kandziora F, Schnake KJ, Rajasekaran S, Holstein JH. The AOSpine sacral fracture classification. Global Spine Journal. 2016 Apr;6(1_suppl):s-0036.
  6. Roy-Camille RA, Saillant GE, Gagna GI, Mazel CH. Transverse fracture of the upper sacrum. Suicidal jumper’s fracture. Spine. 1985 Nov 1;10(9):838-45.
  7. Strange-Vognsen HH, Lebech A. An unusual type of fracture in the upper sacrum. Journal of orthopaedic trauma. 1991 Jan 1;5(2):200-3.
  8. Robles LA, Plantillas E. An unusual transverse sacral fracture treated with early decompression: case report. Journal of Neurosurgery: Spine. 2006 Dec 1;5(6):546-9.
  9. Fountain SS, Hamilton RD, Jameson RM. Transverse fractures of the sacrum. A report of six cases. The Journal of bone and joint surgery. American volume. 1977 Jun 1;59(4):486-9.
  10. Levine AM (2003) Fractures of the Sacrum. In: Browner BD, Jupiter JB, Levine AM,TraftonPG (eds) Skeletal trauma, 3rd edn. W.B. Saunders Company, Philadelphia, pp. 1031–1051.
  11. Mahajan R, Tandon V, Das K, Nanda A, Venkatesh R, Chhabra HS. Management of neglected sacral fracture with cauda equina syndrome: report of two cases with review of literature. Spinal cord series and cases. 2016;2:15028.
  12. Kim MY, Reidy DP, Nolan PC, Finkelstein JA. Transverse sacral fractures: case series and literature review. Canadian Journal of Surgery. 2001 Oct;44(5):359.
  13. Gibbons KJ, Soloniuk DS, Razack N. Neurological injury and patterns of sacral fractures. Journal of neurosurgery. 1990 Jun 1;72(6):889-93.
  14. Dussa CU, Soni BM. Influence of type of management of transverse sacral fractures on neurological outcome. A case series and review of literature. Spinal Cord. 2008 Sep;46(9):590-4.
  15. König MA, Jehan S, Boszczyk AA, Boszczyk BM. Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies. European Spine Journal. 2012 May;21(5):829-36
  16. Bellabarba C, Schildhauer TA, Vaccaro AR, Chapman JR. Complications associated with surgical stabilization of high-grade sacral fracture dislocations with spino-pelvic instability. Spine. 2006 May 15;31(11S):S80-8.
  17. Kulkarni AG, Tapashetti S, Tambwekar VS. Outcomes of coccygectomy using the “Z” plasty technique of wound closure. Global spine journal. 2019 Dec;9(8):802-6.
How to Cite this Article: Phadke SA, Kulkarni HG, Thosar SS, Sakhrekar R | Sacral Fracture with Neurodeficit – Is Laid-Back Approach a Passe? | International Journal of Spine | January-June 2020; 7(1): 24-28.

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Langerhans Cell Histiocytosis of Dorsal Spine in a Child Presenting with Deformity of the Back: A Rare Case Report and Review of Literature

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Volume 7 | Issue 1 | January-June 2022 | Page: 19-23 | Bharath HD, Krishnakumar R, Jeffy John

DOI: 10.13107/ijs.2020.v07i01.034

Authors: Bharath HD [1], Krishnakumar R [1], Jeffy John [2]

[1] Department of Spine Surgery, Medical Trust Hospital, Cochin, Kerala, India.
[2] Department of Pathology, Medical Trust Hospital, Cochin, Kerala, India.

Address of Correspondence
Dr. Krishnakumar R,
Department of Spine Surgery, Medical Trust Hospital, Cochin, Kerala, India.
E-mail: krishnakumar.ram@gmaiall.com

Abstract

Background: Back pain in the pediatric population is a common complaint with wide differentials including mechanical cause, musculoskeletal involvement, infectious or inflammatory pathologies, and tumors. Transient back pain is common among children, and in majority of cases resolves without any treatment or with rest and mere hot/cold fomentations. However, pain disproportionate to physical findings and not reduced by pain medications, strongly suggest the presence of a serious underlying pathology. Case presentation: A 13 year old boy presented with a history of mild mid back pain lasting for a week associated with gradually developing deformity of the back, noticed by his parents. There is no history of any injury or fall prior to presentation. He had no history of any other constitutional symptoms. Upon radiological investigations he was found to have an isolated lytic lesion in D9 vertebra with differentials of tubercular/neoplastic/metastatic etiologies. Histopathological examination after biopsy was suggestive of Langerhans cell histiocytosis and was proven by immunohistochemistry. He was managed with conservative line of treatment with analgesics and other supportive care. Discussion: LCH is considered a pediatric disease, and involvement of the pediatric spine in not uncommon. A child presenting with persistent and progressive back pain should be evaluated in detail even if the child is not presenting with any other constitutional symptoms to rule out rare causes of vertebral lytic lesions. There are no cases reported in the literature suggesting LCH of the spine in pediatric population presenting as the deformity of the back. Conservative treatment is a good choice for a patient with LCH without neurological deficits or spinal instability.
Keywords: Spine deformity, Children, LCH, Back pain

References

1. Bernstein RM, Cozen H. Evaluation of back pain in children and adolescents. Am Fam Physician 2007;76:1669 76.
2. Feldman DS, StraightJJ, Badra MI, MohaideenA, Madan SS. Evaluation of an algorithmic approach to pediatric back pain. J Pediatr Orthop 2006;26:353 7.
3. Brown CW, Jarvis JG, Letts M, Carpenter B. Treatment and outcome of vertebral Langerhans cell histiocytosis at the Children’s Hospital of Eastern Ontario. Can J Surg 2005;48:230 6.
4. Khung S, Budzik JF, Amzallag Bellenger E, LambillioteA, Soto Ares G, Cotten A, et al. Skeletal involvement in Langerhans cell histiocytosis. Insights Imaging 2013;4:569 79.
5. Beltran J, Aparisi F, Bonmati LM, Rosenberg ZS, Present D, Steiner GC (1993) Eosinophilic granuloma: MRI manifestations. Skelet Radiol 22(3):157–161
6. Kilborn TN, Teh J, Goodman TR (2003) Paediatric manifestations of Langerhans cell histiocytosis: a review of the clinical and radiological findings. Clin Radiol 58(4):269–278
7. Peng XS, Pan T, Chen LY, Huang G, Wang J. Langerhans’ cell histiocytosis of the spine in children with soft tissue extension and chemotherapy. Int Orthop 2009;33:731 6.
8. Garg S, Mehta S, DormansJP. Langerhans cell histiocytosis of the spine in children. Long term follow up. J Bone Joint Surg Am 2004;86 A: 1740 50.
9. Ghanem I, Tolo VT, D’Ambra P, Malogalowkin MH. Langerhans cell histiocytosis of bone in children and adolescents. J Pediatr Orthop 2003;23:124 30.
10. Azouz EM, Saigal G, Rodriguez MM, Podda A (2005) Langerhans’ cell histiocy tosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol 35(2):103–115. doi:10.1007/s00247-004-1262-0
11. Puigdevall M, Bosio S, Hokama J, Maenza R (2008) Langerhans cell histiocytosis of the atlas in the pediatric spine: total reconstitution of the bone lesion after nonoperative treatment. A report of two cases. J Bone Joint Surg 90(9):1994–1997. doi:10.2106/jbjs.g.01352
12. Bertram C, Madert J, Eggers C (2002) Eosinophilic granuloma of the cervical spine. Spine 27(13):1408–1413

How to Cite this Article: HD Bharath, R Krishnakumar, John J Langerhans | Cell Histiocytosis of
Dorsal Spine in a Child Presenting with Deformity of the Back: A Rare Case Report and Review of Literature| International Journal of Spine | January-June 2020; 7(1): 19-23.

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Fat is Bad? Lumbar Discectomy in Patients with High Body Mass Index

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Volume 7 | Issue 1 | January-June 2022 | Page: 12-18 | Akshay B Phuse, Sumit Sinha, Nishant Yagnik, Ankush Gupta

DOI: 10.13107/ijs.2020.v07i01.033

Authors: Akshay B Phuse [1], Sumit Sinha [2], Nishant Yagnik [2], Ankush Gupta [2]

[1] Department of Spine Surgery, Atlas Spine and Orthopaedic Hospital, Nagpur, Maharashtra, India.
[2] Department of Spine Surgery, Paras Hospitals, Gurgaon, Haryana, India.

Address of Correspondence
Dr. Akshay B Phuse,
Spine Surgeon, Department of Spine Surgery, Atlas Spine and Orthopaedic
Hospital, Nagpur, Maharashtra, India.
E-mail: phuse.akshay@gmail.com

Abstract

Objective: Spine surgeons are experiencing increased morbidly obese patients with lumbar spine pathology in regular practice. There is a close association between back pain and morbid obesity, particularly due to chronic stresses on the spine. Our objective of this review of literature is to identify the difficulties encountered by the spine surgeons in lumbar spine microdiscectomy and to provide possible solutions for the same. All pre-operative, intra-operative including surgical techniques and post-operative complications with clinical outcomes are taken into consideration.

Methods: obesity was defined as body mass index (BMI) more than 30kg/m2 whereas  Morbidly obese are the people who have BMI more than 40kg/m2 or BMI 35kg/m2 associated with at least 2 co morbid conditions. Keywords were taken as Micro discectomy, lumbar spine disease, morbidly obese, obese, obesity related spine pathology, spinal surgery in obese, Body mass index. This review article examined articles published concerning “lumbar microdiscectomy in obese patients” on Pub Med and Google scholar. We also included some articles related to lumbar fusion surgery in obese patient. Articles in which lumbar spine surgeries operated on non-obese patients and surgeries performed at cervical and dorsal level were excluded. We included 71 articles published on the related topic

Results:  Review illustrated that obese patients were at higher risk of complications at all stages of management. Pre-operatively obese patients showed inferior outcome to conservative management. Health care professionals  are challenged in transportation, imaging, and resuscitation procedures of obese patients  because of large body fat. Intra operatively obese patients have showed increased blood loss, operative time and infection rates. Even surgeries in obese patients were technically demanding. Obese patients demonstrated inferior clinical outcomes, increased complications rates compared to non-obese patients. Minimally invasive spine surgery has shown better and promising results in lumbar discectomy.

Conclusion: lumbar surgeries on obese patients is fraught with multiple challenges starting from preoperative period might through the surgical procedure and rehabilitation With the increasing availability of technology and surgical expertise, MIS has proven to be equally effective, if not better, than traditional lumbar surgeries in this group of patients. Smaller surgical incisions, early mobilization and shorter duration of hospital stay are some of the advantages of this technique

Keywords: Micro discectomy, Lumbar spine disease, Morbidly obese, Obese, Obesity related spine pathology, Spinal surgery in obese, Body mass index.

References

1. Leboeuf–Yde C, Kyvik KO, Bruun NH. Low back pain and lifestyle. Part II—obesity: information from a population-based sample of 29,424 twin subjects. Spine. 1999 Apr 15;24(8):779-84.
2. Hellsing AL, Bryngelsson L. Predictors of musculoskeletal pain in men: a twenty-year follow-up from examination at enlistment. Spine. 2000 Dec 1;25(23):3080-6.
3. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011-2014.
4. Gasibat Q, Simbak NB, Barasi SE, Almangoush A. Measuring the Relationship between Obesity and Low Back Pain: A Review Article. American Journal of Medical Sciences. 2017;5(2):35-9.
5. Theodora Lappa RD, Ioannis Kyriazis MD. Obesity Epidemiology and Management-Up to Date Short Review. International Journal of Caring Sciences. 2018;11(1):599-606.
6. Banjare J, Bhalerao S. Obesity associated noncommunicable disease burden. International Journal of Health & Allied Sciences. 2016 Apr 1;5(2):81-.
7. Jakoi AM, Pannu G, D’oro A, Buser Z, Pham MH, Patel NN, Hsieh PC, Liu JC, Acosta FL, Hah R, Wang JC. The clinical correlations between diabetes, cigarette smoking and obesity on intervertebral degenerative disc disease of the lumbar spine. Asian spine journal. 2017 Jun;11(3):337.
8. Epstein NE. More risks and complications for elective spine surgery in morbidly obese patients. Surgical neurology international. 2017;8.
9. Marquez-Lara A, Nandyala SV, Sankaranarayanan S, Noureldin M, Singh K. Body mass index as a predictor of complications and mortality after lumbar spine surgery. Spine. 2014 May 1;39(10):798-804.
10. Patel N, Bagan B, Vadera S, Maltenfort MG, Deutsch H, Vaccaro AR, Harrop J, Sharan A, Ratliff JK. Obesity and spine surgery: relation to perioperative complications. Journal of Neurosurgery: Spine. 2007 Apr 1;6(4):291-7.
11. Lingutla KK, Pollock R, Benomran E, Purushothaman B, Kasis A, Bhatia CK, Krishna M, Friesem T. Outcome of lumbar spinal fusion surgery in obese patients: a systematic review and meta-analysis. The bone & joint journal. 2015 Oct;97(10):1395-404.
12. Bono OJ, Poorman GW, Foster N, Jalai CM, Horn SR, Oren J, Soroceanu A, Ramachandran S, Purvis TE, Jain D, Vira S. Body mass index predicts risk of complications in lumbar spine surgery based on surgical invasiveness. The Spine Journal. 2018 Jul 1;18(7):1204-10.
13. Castle-Kirszbaum MD, Tee JW, Chan P, Hunn MK. Obesity in neurosurgery: a narrative review of the literature. World neurosurgery. 2017 Oct 1;106:790-805.
14. Flippin M, Harris J, Paxton EW, Prentice HA, Fithian DC, Ward SR, Gombatto SP. Effect of body mass index on patient outcomes of surgical intervention for the lumbar spine. Journal of Spine Surgery. 2017 Sep;3(3):349.
15. Puvanesarajah V, Werner BC, Cancienne JM, Jain A, Pehlivan H, Shimer AL, Singla A, Shen F, Hassanzadeh H. Morbid obesity and lumbar fusion in patients older than 65 years: complications, readmissions, costs, and length of stay. Spine. 2017 Jan 15;42(2):122-7.
16. Buerba RA, Fu MC, Gruskay JA, Long III WD, Grauer JN. Obese Class III patients at significantly greater risk of multiple complications after lumbar surgery: an analysis of 10,387 patients in the ACS NSQIP database. The Spine Journal. 2014 Sep 1;14(9):2008-18.
17. Burks CA, Werner BC, Yang S, Shimer AL. Obesity is associated with an increased rate of incidental durotomy in lumbar spine surgery. Spine. 2015 Apr 1;40(7):500-4.
18. Phan K, Lee NJ, Kothari P, Kim JS, Cho SK. Risk factors for readmissions following anterior lumbar interbody fusion. Spine. 2018 Mar 1;43(5):364-9.
19. Akinnusi ME, Pineda LA, El Solh AA. Effect of obesity on intensive care morbidity and mortality: a meta-analysis. Critical care medicine. 2008 Jan 1;36(1):151-8.
20. Burks CA, Werner BC, Yang S, Shimer AL. Obesity is associated with an increased rate of incidental durotomy in lumbar spine surgery. Spine. 2015 Apr 1;40(7):500-4.
21. Green BN, Johnson CD, Haldeman S, Griffith E, Clay MB, Kane EJ, Castellote JM, Rajasekaran S, Smuck M, Hurwitz EL, Randhawa K. A scoping review of biopsychosocial risk factors and co-morbidities for common spinal disorders. PloS one. 2018 Jun 1;13(6):e0197987.
22. Shahbandar L, Press J. Diagnosis and nonoperative management of lumbar disk herniation. Operative Techniques in Sports Medicine. 2005 Apr 1;13(2):114-21.
23. Eleswarapu AS, Divi SN, Dirschl DR, Mok JM, Stout C, Lee MJ. How Effective is Physical Therapy for Common Low Back Pain Diagnoses?: A Multivariate Analysis of 4597 Patients. Spine. 2016 Aug 15;41(16):1325-9.
24. Bhatia A, Flamer D, Shah PS, Cohen SP. Transforaminal epidural steroid injections for treating lumbosacral radicular pain from herniated intervertebral discs: a systematic review and meta-analysis. Anesthesia & Analgesia. 2016 Mar 1;122(3):857-70.
25. Cushman D, Mattie R, Curtis B, Flis A, McCormick ZL. The effect of body mass index on fluoroscopic time and radiation dose during lumbar transforaminal epidural steroid injections. The Spine Journal. 2016 Jul 1;16(7):876-83.
26. Khoueir P, Black MH, Crookes PF, Kaufman HS, Katkhouda N, Wang MY. Prospective assessment of axial back pain symptoms before and after bariatric weight reduction surgery. The Spine Journal. 2009 Jun 1;9(6):454-63.
27. Lidar Z, Behrbalk E, Regev GJ, Salame K, Keynan O, Schweiger C, Appelbaum L, Levy Y, Keidar A. Intervertebral disc height changes after weight reduction in morbidly obese patients and its effect on quality of life and radicular and low back pain. Spine. 2012 Nov 1;37(23):1947-52.
28. Takenaka S, Mukai Y, Hosono N, Kaito T. Improvement of thoracic myelopathy following bariatric surgery in an obese patient. Case Reports. 2018 Apr 11;2018:bcr-2017.
29. Jain D, Berven SH, Carter J, Zhang AL, Deviren V. Bariatric surgery before elective posterior lumbar fusion is associated with reduced medical complications and infection. The Spine Journal. 2018 Sep 1;18(9):1526-32.
30. Shanbhogue VV, Støving RK, Frederiksen KH, Hanson S, Brixen K, Gram J, Jørgensen NR, Hansen S. Bone structural changes after gastric bypass surgery evaluated by HR-pQCT: a two-year longitudinal study. European journal of endocrinology. 2017 Jun 1;176(6):685-93.
31. Epstein NE. Bariatric bypasses contribute to loss of bone mineral density but reduce axial back pain in morbidly obese patients considering spine surgery. Surgical neurology international. 2017;8.
32. Shaw K, Chen J, Sheppard W, Alazzeh M, Park H, Park DY, Shamie AN. Use of the subcutaneous lumbar spine (SLS) index as a predictor for surgical complications in lumbar spine surgery. The Spine Journal. 2018 Dec 1;18(12):2181-6.
33. Rosenfeld HE, Limb R, Chan P, Fitzgerald M, Bradley WP, Rosenfeld JV. Challenges in the surgical management of spine trauma in the morbidly obese patient: a case series. Journal of Neurosurgery: Spine. 2013 Jul 1;19(1):101-9.
34. Winkelman C, Maloney B, Kloos J. The impact of obesity on critical care resource use and outcomes. Critical Care Nursing Clinics. 2009 Sep 1;21(3):403-22.
35. Le NT, Robinson J, Lewis SJ. Obese patients and radiography literature: what do we know about a big issue?. Journal of medical radiation sciences. 2015 Jun;62(2):132-41.
36. Spitler CA, Hulick RM, Graves ML, Russell GV, Bergin PF. Obesity in the polytrauma patient. Orthopedic Clinics. 2018 Jul 1;49(3):307-15.
37. Kalichman L, Guermazi A, Li L, Hunter DJ. Association between age, sex, BMI and CT-evaluated spinal degeneration features. Journal of back and musculoskeletal rehabilitation. 2009 Jan 1;22(4):189-95.
38. Maruyama T, Grivas TB, Kaspiris A. Effectiveness and outcomes of brace treatment: a systematic review. Physiotherapy theory and practice. 2011 Jan 1;27(1):26-42.
39. Baxi V, Budhakar S. Anesthesia management of a morbidly obese patient in prone position for lumbar spine surgery. Journal of Craniovertebral Junction and Spine. 2010 Jan;1(1):55.
40. Douglass J, Fraser J, Andrzejowski J. Awake intubation and awake prone positioning of a morbidly obese patient for lumbar spine surgery. Anaesthesia. 2014 Feb;69(2):166-9.
41. Neligan PJ. Metabolic syndrome: anesthesia for morbid obesity. Current Opinion in Anesthesiology. 2010 Jun 1;23(3):375-83.
42. Cao J, Kong L, Meng F, Zhang Y, Shen Y. Impact of obesity on lumbar spinal surgery outcomes. Journal of Clinical neuroscience. 2016 Jun 1;28:1-6.
43. Onyekwelu I, Glassman SD, Asher AL, Shaffrey CI, Mummaneni PV, Carreon LY. Impact of obesity on complications and outcomes: a comparison of fusion and nonfusion lumbar spine surgery. Journal of Neurosurgery: Spine. 2017 Feb 1;26(2):158-62.
44. Zhang Y, Liu H, He F, Chen A, Yang H, Pi B. Does tranexamic acid improve bleeding, transfusion, and hemoglobin level in patients undergoing multilevel spine surgery? A systematic review and meta-analysis. World neurosurgery. 2019 Jul 1;127:289-301.
45. Cheriyan T, Maier II SP, Bianco K, Slobodyanyuk K, Rattenni RN, Lafage V, Schwab FJ, Lonner BS, Errico TJ. Efficacy of tranexamic acid on surgical bleeding in spine surgery: a meta-analysis. The Spine Journal. 2015 Apr 1;15(4):752-61.
46. Kim DH, Zaremski J, Kwon B, Jenis L, Woodard E, Bode R, Banco RJ. Risk factors for false positive transcranial motor evoked potential monitoring alerts during surgical treatment of cervical myelopathy. Spine. 2007 Dec 15;32(26):3041-6.
47. Olsen MA, Mayfield J, Lauryssen C, Polish LB, Jones M, Vest J, Fraser VJ. Risk factors for surgical site infection in spinal surgery. Journal of Neurosurgery: Spine. 2003 Mar 1;98(2):149-55.
48. Khan NR, Thompson CJ, DeCuypere M, Angotti JM, Kalobwe E, Muhlbauer MS, Camillo FX, Klimo P. A meta-analysis of spinal surgical site infection and vancomycin powder: a review. Journal of Neurosurgery: Spine. 2014 Dec 1;21(6):974-83.
49. Kang DG, Holekamp TF, Wagner SC, Lehman Jr RA. Intrasite vancomycin powder for the prevention of surgical site infection in spine surgery: a systematic literature review. The Spine Journal. 2015 Apr 1;15(4):762-70.
50. Bakhsheshian J, Dahdaleh NS, Lam SK, Savage JW, Smith ZA. The use of vancomycin powder in modern spine surgery: systematic review and meta-analysis of the clinical evidence. World neurosurgery. 2015 May 1;83(5):816-23.
51. Yamada K, Abe H, Higashikawa A, Tonosu J, Kuniya T, Nakajima K, Fujii H, Niwa K, Shinozaki T, Watanabe K, Sakae T. Evidence-based care bundles for preventing surgical site infections in spinal instrumentation surgery. Spine. 2018 Dec 15;43(24):1765-73.
52. Yao R, Tan T, Tee JW, Street J. Prophylaxis of surgical site infection in adult spine surgery: a systematic review. Journal of Clinical Neuroscience. 2018 Jun 1;52:5-25.
53. Goyal A, Elminawy M, Kerezoudis P, Lu VM, Yolcu Y, Alvi MA, Bydon M. Impact of obesity on outcomes following lumbar spine surgery: a systematic review and meta-analysis. Clinical neurology and neurosurgery. 2019 Feb 1;177:27-36.
54. Emery SE, Daffner SD, France JC, Ellison M, Grose BW, Hobbs GR, Clovis NB. Effect of head position on intraocular pressure during lumbar spine fusion: a randomized, prospective study. JBJS. 2015 Nov 18;97(22):1817-23.

How to Cite this Article: Phuse AB, Sinha S, Yagnik N, Gupta A | Fat is Bad? Lumbar Discectomy in
Patients with High Body Mass Index | International Journal of Spine | January-June 2020; 7(1): 12-18.

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Recent Review Article on Os Odontoideum

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Volume 7 | Issue 1 | January-June 2022 | Page: 07-11 | Rajendra Sakhrekar, Mohan Gavande, Sriram Srinivasan

DOI: 10.13107/ijs.2020.v07i01.032

Authors: Rajendra Sakhrekar [1], Mohan Gawande [2], Sriram Srinivasan [3], Himanshu G Kulkarni [4]

[1]  Department of Spine Surgery, Hospital for Sick Children, Toronto, Canada.
[2]  Department of Spine Surgery, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India.
[3] Department of Spine Surgery, Royal Stoke University Hospital, UK.
[4] Department of Spine Surgery, Shraddha Surgical and Accident Hospital, Sangli, Maharashtra, India.

Address of Correspondence
Dr Rajendra Sakhrekar,
Paediatric Spine Fellow, Department of Spine Surgery, Hospital for Sick Children,
Toronto, Canada.
E-mail: raj.sakhrekar1@gmail.com

Abstract

Introduction

Os-odontoideum is a rare condition, described radiographically and clinically as a congenital anomaly of the second cervical vertebra (axis), it a smooth, independent ossicle of variable size and shape separated from the base of a shortened odontoid process by an obvious gap, with no osseous connection to the body of C2.

Material and methods

This study reviewed the literature on OO to evaluate its etiology, the clinical presentations, differential diagnosis, imaging modalities and outcomes in the management of asymptomatic and symptomatic cases of os odontoideum. PubMed, EMBASE, Google Scholar and Cochrane key articles were searched.

Discussion

Considering etiology traumatic hypothesis is favoured over congenital hypothesis as per recent literature on OO. Clinical presentation varies from asymptomatic to mild neck pain to severe myelopathy and neurodeficit. Various C1-C2 instrumentation and fusion techniques like wiring, trans articular screw and laminar screws have been described with good success rates.

Conclusion

Os odontoideum is a rare condition with limited existing literature. Considering significant risks involved if conservative management is opted like severe neurodeficit to sudden death on trivial trauma and the recent improvement of imaging tools helping to understand the pathology of the disease, surgery can be indicated even in an incidentally detected os odontoideum. Although for asymptomatic stable patients’ individual case-by-case approach can be considered depending on factors such as age, activity level, comorbidities, syndromic association and radiographic findings.

Keywords: ‘Os-odontoideum’, ‘surgical management’, ‘etiology’, ‘Atlanto-axial instability’ ‘complications’

References

1) Giacomini C. Sull’esistenza dell’ “os odontoideum” nell’uomo. Gior Accad Med Torino. 1886; 49: 24-28.

2) Bevan WL, Shepherd SW. A Dictionary of the Bible: Comprising its Antiquities, Biography, Geography, and Natural History. Boston, MA, USA: Houghton Mifflin and Company; 1863:1268-1270.

3) Fielding JW, Griffin PP: Os odontoideum: an acquired lesion. J Bone Joint Surg. 1974, 56:187–190

4) Fielding JW, Hensinger R, Hawkins R. Os odontoideum. J Bone Joint Surg Am. 1980; 62(3): 376-383.

5) Ricciardi JE, Kaufer H, Louis DS: Acquired os odontoideum following acute ligament injury. Report of a case. J Bone Joint Surg. 1976, 58:410–412.

6) Dai L, Yuan W, Ni B, Jia L. Os odontoideum: Etiology, diagnosis, and management. Surg Neurol. 2000; 53(2): 106-109. doi:10.1016/S0090-3019(99)00184-6

7) Jumah F, Alkhdour S, Mansour S, He P, Hroub A, Adeeb N, Hanif R, Mortazavi MM, Tubbs RS, Nanda A. Os Odontoideum: A Comprehensive Clinical and Surgical Review. Cureus. 2017 Aug 8;9(8):e1551. doi: 10.7759/cureus.1551. PMID: 29018648; PMCID: PMC5630463.

8) Klimo Jr P, Kan P, Rao G, Apfelbaum R, Brockmeyer D. Os odontoideum: Presentation, diagnosis, and treatment in a series of 78 patients. J Neurosurg Spine. 2008; 9(4): 332342.Website.http://thejns.org/doi/abs/10.3171/SPI.2008.9.10.332.

9) Klimo P, Jr., Coon V, Brockmeyer D: Incidental os odontoideum: current management strategies. Neurosurg Focus. 2011, 31:10. 10.3171/2011.9.focus11227

10) Goel A, Patil A, Shah A, Dandpat S, Rai S, Ranjan S. Os Odontoideum: Analysis of 190 Surgically Treated Cases. World Neurosurg. 2020 Feb;134:e512-e523. doi: 10.1016/j.wneu.2019.10.107. Epub 2019 Oct 26. PMID: 31669688.

11) Hughes TB Jr, Richman JD, Rothfus WE: Diagnosis of Os odontoideum using kinematic magnetic resonance imaging. A case report. Spine. 1999, 24:715–718.

12) Goel A. Indicators of atlantoaxial instability. J Craniovertebr Junction Spine. 2021 Apr-Jun;12(2):103-106.

13) Jordan Lacy, Jitin Bajaj, Atlantoaxial Instability. StatPearls publishing,NCBI bookshelf Jan2021

14) The Section on Disorders of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons Os Odontoideum SpineUniverse Web site. 2001 http://www.spineuniverse.com/pdf/traumaguide/19.pdf

15) Wilson JR, Dettori JR, Vanalstyne EM, Fehlings MG. Addressing the challenges and controversies of managing os odontoideum: results of a systematic review. Evid Based Spine Care J. 2010 May;1(1):67-74. doi: 10.1055/s-0028-1100896. PMID: 23544027; PMCID: PMC3608999.

16) Spierings E, Braakman R. The management of os odontoideum: Analysis of 37 cases. Bone Joint J. 1982; 64(4): 422-428. Website.http://www.bjj.boneandjoint.org.uk/content/64-B/4/422.

17) McGoldrick JM, Marx JA. Traumatic central cord syndrome in a patient with os odontoideum. Ann Emerg Med. 1989; 18(12):1358-1361. doi: 10.1016/S0196-0644(89)80276-892.

18) Dempster AG, Heap SW. Fatal high cervical spinal cord injury in an automobile accident complicating os odontoideum.Am J Foren Med Pathol. 1990; 11(3): 252-256.

19) Zhang Z, Zhou Y, Wang J, et al. Acute traumatic cervical cord injury in patients with os odontoideum. J Clin Neurosci. 2010; 17(10): 1289-1293. doi: 10.1016/j.jocn.2010.01.051

20) Rahimizadeh A, Rahimizadeh A. Os Odontoideum: Review article. Orthop Res Traumatol Open J. 2016; 1(2): 33-55. doi: 10.17140/ORTOJ-1-107

21) Goyal N, Bali S, Ahuja K, Chaudhary S, Barik S, Kandwal P. Posterior Arthrodesis of Atlantoaxial Joint in Congenital Atlantoaxial Instability Under 5 Years of Age: A Systematic Review. J Pediatr Neurosci. 2021 Apr-Jun;16(2):97-105. [PMC free article] [PubMed]

22) Magerl F, Seemann P-S. Stable posterior fusion of the atlas and axis by transarticular screw fixation. Cervical Spine I. 1987: 322-327. doi: 10.1007/978-3-7091-8882-8_59

23) Gluf W M, Brockmeyer D L. Atlantoaxial transarticular screw fixation: a review of surgical indications, fusion rate, complications, and lessons learned in 67 pediatric patients. J Neurosurg Spine. 2005;2:164–169.

24) Goel A, Laheri V. Plate and screw fixation for atlantoaxial subluxation. Acta Neurochir. 1994; 129(1-2): 47-53. doi:10.1007/BF01400872

25) Harms J, Melcher RP. Posterior C1-C2 fusion with polyaxial screw and rod fixation. Spine. 2001; 26(22): 2467-2471.

How to Cite this Article:  Sakhrekar R, Gawande M, Srinivasan S | Recent Review Article on Os Odontoideum | International Journal of Spine | January-June 2020; 7(1): 07-11.

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Detection of Spinal TB Infection: A Retrospective Study Evaluating Comparative Diagnostic Efficacy of AFB Smear, Gene Expert, Histopathology, Culture Sensitivity and LPA Tests From a Biopsy Sample

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Volume 7 | Issue 1 | January-June 2022 | Page: 01-06 | Abhijith Shetty, Saijyot Raut, Manikant Anand, Vishal Kundnani, Praveen Goparaju, Mukul Jain

DOI: 10.13107/ijs.2020.v07i01.031

Authors: Abhijith Shetty [1], Saijyot Raut [1], Manikant Anand [1], Vishal Kundnani [1], Praveen Goparaju [1], Mukul Jain [1]

[1] Department of Orthopaedics, Bombay Hospital and Research Centre, Mumbai, Maharashtra, India.

Address of Correspondence
Dr. Abhijith Shetty,
Spine Surgeon, Department of Orthopaedics, Bombay Hospital and Research
Centre, Mumbai, Maharashtra, India.
E-mail: abhijithshettyabhi03@gmail.com

Abstract

Background: Spinal Tuberculosis (TB) is one of the significant health dangers that affect the general wellbeing of an individual. It is one of the most common form of extra pulmonary tuberculosis that affects the general population. Diagnosis of tuberculosis is done using an array of techniques. The present study has compared the efficacy of these tests used for detecting the spinal TB in biopsy samples.
Material and Methods: The study was conducted on patients who suffered from spondylodiscitis and with biopsy proven spinal TB by one of the following tests and were treated in the study center. The study included a total of 150 patients with spinal TB who visited the department for further treatment. The biopsy samples of these patients were then processed for Line probe assay (LPA), Gene Xpert, liquid culture (bactec MGIT) followed by gram staining and fungal staining, and histopathological examination.
Result: In this study total of 150 patients were included who had ages ranging from 16-77 years with 93male and 57 female patients. When the study results were compared Gene Experts showed a 100% sensitivity and 80% of specificity. When we compared the histopathology results with gene expert, we get a sensitivity of 16.7% and specificity of 50%.
Gram stain with the sensitive gene expert, the sensitivity is 45.5% and specificity is 25%. Similar analysis was done with sensitive gene and now with the resistant gene to identify their sensitivity was 0% and the specificity was at 42.9%. Gram stain when correlated with gene, the sensitivity came out to be 9.1% and specificity at 25%. Fungal stain with resistant gene, when correlated, sensitivity comes to 9.1% and specificity is at 0%.
Conclusion: This study showed that for detection of tuberculosis rather than relying on only single technique it should be done with a combination of techniques.
Keywords: Gene Xpert, LPA, Histopathological examination, Tuberculosis, Gram staining

References

  1. Dhuria M, Sharma N, Ingle G. Impact of tuberculosis on the quality of life. Indian J Community Med Off Publ Indian AssocPrevSoc Med. 2008 Jan;33(1):58–9.
  2. Sulis G, Roggi A, Matteelli A, Raviglione MC. Tuberculosis: epidemiology and control. Mediterr J Hematol Infect Dis. 2014;6(1):e2014070.
  3. Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med. 2011;34(5):440–54.
  4. Steingart KR, Henry M, Ng V, Hopewell PC, Ramsay A, Cunningham J, et al. Fluorescence versus conventional sputum smear microscopy for tuberculosis: a systematic review. Lancet Infect Dis. 2006 Sep;6(9):570–81.
  5. Palomino JC, Martin A, Von Groll A, Portaels F. Rapid culture-based methods for drug-resistance detection in Mycobacterium tuberculosis. J Microbiol Methods. 2008 Oct;75(2):161–6.
  6. Desikan P, Panwalkar N, Mirza SB, Chaturvedi A, Ansari K, Varathe R, et al. Line probe assay for detection of Mycobacterium tuberculosis complex: An experience from Central India. Indian J Med Res. 2017 Jan;145(1):70–3.
  7. Reither K, Manyama C, Clowes P, Rachow A, Mapamba D, Steiner A, et al. Xpert MTB/RIF assay for diagnosis of pulmonary tuberculosis in children: a prospective, multi-centre evaluation. J Infect. 2015 Apr;70(4):392–9.
  8. Opota O, Mazza-Stalder J, Greub G, Jaton K. The rapid molecular test Xpert MTB/RIF ultra: towards improved tuberculosis diagnosis and rifampicin resistance detection. ClinMicrobiol Infect Off PublEurSocClinMicrobiol Infect Dis. 2019 Nov;25(11):1370–6.
  9. Patel J, Upadhyay M, Kundnani V, Merchant Z, Jain S, Kire N. Diagnostic Efficacy, Sensitivity, and Specificity of Xpert MTB/RIF Assay for Spinal Tuberculosis and Rifampicin Resistance. Spine. 2020 Feb 1;45(3):163–9.
  10. Lawn SD, Nicol MP. Xpert® MTB/RIF assay: development, evaluation and implementation of a new rapid molecular diagnostic for tuberculosis and rifampicin resistance. Future Microbiol. 2011 Sep;6(9):1067–82.
  11. Buyankhishig B, Oyuntuya T, Tserelmaa B, Sarantuya J, Lucero MG, Mitarai S. Rapid molecular testing for multi-resistant tuberculosis in Mongolia: A diagnostic accuracy study. Int J Mycobacteriology. 2012 Mar;1(1):40–4.
  12. Caulfield AJ, Wengenack NL. Diagnosis of active tuberculosis disease: From microscopy to molecular techniques. J ClinTubercMycobact Dis. 2016 Aug 1;4:33–43.
  13. Singh BK, Sharma SK, Sharma R, Sreenivas V, Myneedu VP, Kohli M, et al. Diagnostic utility of a line probe assay for multidrug resistant-TB in smear-negative pulmonary tuberculosis. PLOS ONE. 2017 Aug 22;12(8):e0182988.
  14. Crudu V, Stratan E, Romancenco E, Allerheiligen V, Hillemann A, Moraru N. First evaluation of an improved assay for molecular genetic detection of tuberculosis as well as rifampin and isoniazid resistances.J ClinMicrobiol. 2012 Apr;50(4):1264–9.
  15. Zong Z, Huo F, Shi J, Jing W, Ma Y, Liang Q, et al. Relapse Versus Reinfection of Recurrent Tuberculosis Patients in a National Tuberculosis Specialized Hospital in Beijing, China. Front Microbiol. 2018;9:1858.
  16. Rufai SB, Kumar P, Singh A, Prajapati S, Balooni V, Singh S. Comparison of Xpert MTB/RIF with line probe assay for detection of rifampin-monoresistant Mycobacterium tuberculosis. J ClinMicrobiol. 2014 Jun;52(6):1846–52.
  17. Hillemann D, Rusch-Gerdes S, Boehme C, Richter E. Rapid Molecular Detection of Extrapulmonary Tuberculosis by the Automated GeneXpert MTB/RIF System. J ClinMicrobiol. 2011 Apr 1;49(4):1202–5.
How to Cite this Article: Shetty A, Raut S, Anand M, Kundnani V, Goparaju P, Jain M | Detection of Spinal
TB Infection: A Retrospective Study Evaluating Comparative Diagnostic Efficacy of AFB Smear, Gene Expert, Histopathology, Culture Sensitivity and LPA Tests From a Biopsy Sample | International Journal of Spine | January-June 2020; 7(1): 01-06.

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Unusual Association of KBG Syndrome with Scheuermann’s Disease

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Volume 7 | Issue 1 | January-June 2022 | Page: 01-06 | Sanjay N. Murthy, Jaganaathan Srinivasan, Cheryl Honeyman, Rajendra Sakhrekar, Amit Bishnoi, Sriram H. Srinivasan

DOI: 10.13107/ijs.2020.v07i01.036

Authors: Sanjay N. Murthy [1], Jaganaathan Srinivasan [2], Cheryl Honeyman [3], Rajendra Sakhrekar [4], Amit Bishnoi [5], Sriram H. Srinivasan [6]

[1] Department of Orthopaedics, Royal Stoke University Hospital, UK.
[2] Department of Orthopaedics, James Cook University Hospital, Middlesbrough, BW.
[3] Department of Orthopaedic Nursing, James Cook University Hospital, Middlesbrough, BW.
[4] Department of Spinal Surgery, Schoen klinik Neustadt Holestine, Germany.
[5] Department of Spinal Surgery, Leicester University Hospital, UK.
[6] Department of Spinal Surgery, Ipswich University Hospital NHS Trust, UK.

Address of Correspondence
Dr. Sanjay N. Murthy,
Core Trainee, Department of Orthopaedics, Royal Stoke University Hospital, UK.
E-mail: sanjayn293@gmail.com

Abstract

In this paper we discuss a novel case in which a patient had a comorbid diagnosis of KBG syndrome and Scheuermann’s disease. The patient was a 14-year-old boy, referred to orthopaedics for assessment of his spinal deformity. Initial assessment revealed that he had a rib prominence on his right side, which was corrected upon bending forward. SLR examination indicated significantly tight hamstrings. Plantars were upturning, but other reflexes were normal. He had kyphosis measuring up to 59.4 degrees. MRI of the spine depicted features of classic Scheuermann’s disease, from D6-D10. The patient was given conservative treatment consisting of physical therapy and postural training. He remained asymptomatic during the course of a 5-year follow-up period. This case is unique due to the comorbidity of Scheuermann’s disease and KBG syndrome, which has never been reported in the literature. This case report suggests that routine spinal screening in cases of KBG syndrome would contribute to a better understanding of treatment and diagnosis.

Keywords: KBG syndrome, Scheuermann’s disease

References

1.Herrmann J, Pallister PD, Tiddy W, Opitz JM. The KBG syndrome-a syndrome of short stature, characteristic facies, mental retardation, macrodontia and skeletal anomalies. Birth Defects Orig Artic Ser.1975;11:7–18.

2. Li QY, Yang L, Wu J, Lu W, Zhang MY, Luo FH. A case of KBG syndrome caused by mutation of ANKRD11 gene and literature review Clin J Evid Based Pediatr. 2018;13:452–458.

3. Sirmaci A, Spiliopoulos M, Brancati F, Powell E, Duman D, Abrams A, Bademci G, Agolini E, Guo S, Konuk B, Kavaz A, Blanton S, Digilio MC, Dallapiccola B, Young J, Zuchner S, Tekin M. Mutations in ANKRD11 cause KBG syndrome, characterized by intellectual disability, skeletal malformations, and macrodontia

4. Goldenberg, A., Riccardi, F., Tessier, A., Pfundt, R., Busa, T., Cacciagli, P., … Philip, N. (2016). Clinical and molecular findings in 39 patients with KBG syndrome caused by deletion or mutation of ANKRD11. American Journal of Medical Genetics Part A, 170(11), 2847–2859. https://doi. org/10.1002/ajmg.a.37878

5. Damborg F, Engell V, Andersen M, et al. Prevalence, concordance, and heritability of Scheuermann kyphosis based on a study of twins. J Bone Joint Surg Am 2006;88:2133–6.

6. Makurthou AA, Oei L, El Saddy S, et al. Scheuermann disease: Evaluation of radiological criteria and population prevalence. Spine (Phila Pa 1976) 2013;38:1690–4

7. McKenzie L, Sillence D. Familial Scheuermann disease: a genetic and linkage study. J Med Genet 1992;29:41–5.

8. Brancati, F., Sarkozy, A. & Dallapiccola, B. KBG syndrome. Orphanet J Rare Dis 1, 50 (2006). https://doi.org/10.1186/1750-1172-1-50

9. Fotiadis E, Kenanidis E, Samoladas E, Christodoulou A, Akri- topoulos P, Akritopoulou K. Scheuermann’s disease: Focus on weight and height role. Eur Spine J. 2008; 17: 673-678.

10. Lowe TG. Scheuermann’s disease. Orthop Clin North Am 618 1999; 30: 475-487, ix

11. Lowe TG. Scheuermann’s disease. In: Textbook of Spine 655 Surgery, Bridwell KH, DeWald RL Eds. Philadelphia: 656 Lippincott-Raven 1997:1173-1198

12. Horn, Samantha R.; Poorman, Gregory W.; Tishelman, Jared C.; Bortz, Cole A.; Segreto, Frank A.; Moon, John Y.; Zhou, Peter L.; Vaynrub, Max; Vasquez-Montes, Dennis; Beaubrun, Bryan M.; Diebo, Bassel G. (2019-01-01). “Trends in Treatment of Scheuermann Kyphosis: A Study of 1,070 Cases From 2003 to 2012”. Spine Deformity 7 (1): 100–106. doi:10.1016/j.jspd.2018.06.004. ISSN 2212-134X. PMC 7102192. PMID 30587300

13. Huq, Sakibul; Ehresman, Jeffrey; Cottrill, Ethan; Ahmed, A. Karim; Pennington, Zach; Westbroek, Erick M.; Sciubba, Daniel M. (2019-11-01). “Treatment approaches for Scheuermann kyphosis: a systematic review of historic and current management”. Journal of Neurosurgery: Spine. -1 (aop): 235–247. doi:10.3171/2019.8.SPINE19500. PMID 31675699.

14. Riouallon, Guillaume; Morin, Christian; Charles, Yann-Philippe; Roussouly, Pierre; Kreichati, Gaby; Obeid, Ibrahim; Wolff, Stéphane; French Scoliosis Study Group (2018-09-01). “Posterior-only versus combined anterior/posterior fusion in Scheuermann disease: a large retrospective study”. European Spine Journal. 27 (9): 2322–2330. doi:10.1007/s00586-018-5633-x. ISSN 1432-0932. PMID 29779056. S2CID 29169417

15. Hawes, Martha (2006). “Impact of spine surgery on signs and symptoms of spinal deformity”. Developmental Neurorehabilitation. 9 (4): 318–39. doi:10.1080/13638490500402264. PMID 17111548. S2CID 20680230

16. Hawes, Martha C.; O’Brien, Joseph P. (2008). “A century of spine surgery: What can patients expect?”. Disability & Rehabilitation. 30 (10): 808–17. doi:10.1080/09638280801889972. PMID 18432439. S2CID 19443315.

17. Mansfield JT, Bennett M. Scheuermann Disease. [Updated 2020 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499966/

How to Cite this Article: Murthy SN, Srinivasan J, Honeyman C, Sakhrekar R, Swamy G, Srinivasan SH Unusual Association of | KBG Syndrome with Scheuermann’s Disease | International Journal of Spine | January-June 2020; 7(1): 29-32.

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Horner’s Syndrome After Anterior Decompression And Fusion For Cervical Spine Pathologies: Report Of Two Cases

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Volume 5 | Issue 1 | January-June 2020 | Page: 6-8 | Tomotaka Umimura, Satoshi Maki, Masao Koda, Seiji Ohtori

Authors : Tomotaka Umimura [1], Satoshi Maki [1], Masao Koda [2], Seiji Ohtori [1]

[1] Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8677, Japan.
[2] Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaragi, 305-8575 Japan.

Address of Correspondence
Dr. Tomotaka Umimura,
Department of Orthopedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba 260-8677, Japan.
Email : adna4547@gmail.com

Abstract

Introduction: Horner’s syndrome is caused by impairment of the sympathetic trunk, resulting in associated ptosis, miosis, and anhidrosis. The cervical sympathetic trunk is sometimes damaged during an anterior approach to the lower cervical spine. We report two cases of Horner’s syndrome after anterior decompression and fusion for lower cervical spine pathologies.
Case Presentation: Case 1 was in a 58-year-old Japanese woman with a herniated C5-6 intervertebral disc presenting myelopathy who underwent anterior cervical discectomy and fusion of C5–C6. After the operation, miosis, and anhidrosis of the right face occurred and the symptoms continued for more than 15 years. Case 2 was in a 40-year-old Japanese woman whose diagnosis was flexion myelopathy with kyphosis at C5–C6 and canal stenosis, so she underwent anterior cervical C5-6 discectomy and fusion of C5–C6. Immediately after surgery, ptosis and miosis occurred, which lasted for 4 months.
Conclusion: Horner’s syndrome tends to occur during anterior cervical spine procedures, especially at the lower level, and the syndrome may be transient or irreversible. During an anterior approach to the lower cervical spine, taking care not to damage the sympathetic trunk is important to avoid this complication.
Keywords: Horner’s syndrome, Anterior cervical spine surgery, Complication.

References

1. Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, Lee GP, Robinson JS Jr. Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976) 2007 Oct 1;32(21):2310-7.
2. Tew JM Jr, Mayfield FH. Complications of surgery of the anterior cervical spine. Clin Neurosurg 1976;23:424-34.
3. Bertalanffy H, Eggert HR. Complications of anterior cervical discectomy without fusion in 450 consecutive patients. Acta Neurochir (Wien) 1989;99(1-2):41-50.
4. Giombini S, Solero CL. Considerations on 100 Anterior Cervical Discectomies Without Fusion. Surgery of Cervical Myelopathy 1980;302-7.
5. George B, Lot G. Oblique. Transcorporeal Drilling to Treat Anterior Compression of the Spinal Cord at the Cervical Level. Minim Invasive Neurosurg 1994;37(2):48-52.
6. Saylam CY, Ozgiray E, Orhan M, Cagli S, Zileli M. Neuroanatomy of cervical sympathetic trunk: a cadaveric study. Clin Anat 2009 Apr;22(3):324-30.
7. Ebraheim NA, Lu J, Yang H, Heck BE, Yeasting RA. Vulnerability of the sympathetic trunk during the anterior approach to the lower cervical spine. Spine (Phila Pa 1976). 2000 Jul 1;25(13):1603-6.
8. Civelek E, Karasu A, Cansever T, Hepgul K, Kiris T, Sabanci A, Canbolat A. Surgical anatomy of the cervical sympathetic trunk during anterolateral approach to cervical spine. Eur Spine J 2008 Aug;17(8):991-5.

How to Cite this Article: Umimura T, Maki S, Koda M, Ohtori S | Horner’s Syndrome After Anterior Decompression And Fusion For Cervical Spine Pathologies: Report Of Two Cases | International Journal of Spine| January-June 2020; 5(1): 6-8 .

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Wide Open Laminectomy, Posterior Decompression and Discectomy in Lumbar Spine with Preservation of Posterior Ligamentous Complex in Cauda Equina Syndrome – Case Series, Early Outcome and Literature Review

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Volume 5 | Issue 1 | January-June 2020 | Page: 9-11 | Ong Kean Loong, Ng Bing Wui, Thuraikumar Kanniah, Wang Chee Seiang, Lim Sze Wei, Nor Azlin Zainal Abidin

Authors : Ong Kean Loong [1], Ng Bing Wui [2], Thuraikumar Kanniah [1], Wang Chee Seiang [1], Lim Sze Wei [1], Nor Azlin Zainal Abidin [1]

[1] Spine unit, Department of Orthopaedic, Hospital Sungai Buloh, Malaysia.
[2] Department of Orthopaedic, Hospital Segamat, Malaysia.

Address of Correspondence
Dr. Ng Bing Wui,
Spine unit, Department of Orthopaedic, Hospital Sungai Buloh, Malaysia.
Email : bingwuing@gmail.com

Abstract

Introduction: Spinous process osteotomy has been described as an alternative approach to allow better visualization during laminectomy and decompression of the spinal cord in cases of lumbar spinal stenosis.1 In this study, the authors describe the experience and early outcome of using this technique in treatment of Cauda Equina Syndrome.
Method: This is a retrospective study conducted between March 2018 until March 2019. Cases of Cauda Equina Syndrome treated with spinous process osteotomy, wide laminectomy, decompression and discectomy without instrumentation will be included in this study. Owestry Disability Index (ODI) and outcome of patients will be studied.
Result: 5 cases were found during the study period. All patients have shown marked improvement in terms of neurology and ODI score.
Conclusion: Spinous process osteotomy, wide laminectomy and discectomy can be used effectively for the treatment of Cauda Equina Syndrome. This study intend to be a pilot study in understanding the effectiveness and early outcome of patients treated with this approach. Larger prospective study is needed to provide meaningful comparison between this technique with the conventional approach used in treatment of Cauda Equina Syndrome.
Keywords: Cauda Equina Syndrome, Spinous process osteotomy, Posterior ligamentous complex.

References

1. Yong-Hing K, Kirkaldy-Willis WH. Osteotomy of lumbar spinous process to increase surgical exposure. Clinical orthopaedics and related research. 1978(134):218-20.
2. Dhatt S, Tahasildar N, Tripathy SK, et al. Outcome of spinal decompression in cauda equina syndrome presenting late in developing countries: case series of 50 cases. Eur Spine J 2011; 20:2235–2239.
3. GitelmanA,Hishmeh S, Morelli BN, Joseph SA Jr, Casden A, et al. (2008) Caudaequina syndrome: a comprehensive review.Am J Orthop (Belle Mead NJ) 37: 556-562
4. Waschke A, Hartmann C, Walter J, Dünisch P, Wahnschaff F, Kalff R, Ewald C. Denervation and atrophy of paraspinal muscles after open lumbar interbody fusion is associated with clinical outcome—electromyographic and CT-volumetric investigation of 30 patients. Acta neurochirurgica. 2014 Feb 1;156(2):235-44.
5. Kim DY, Lee SH, Chung SK, Lee HY. Comparison of multifidus muscle atrophy and trunk extension muscle strength: percutaneous versus open pedicle screw fixation. Spine. 2005 Jan 1;30(1):123-9.
6. Chen LH, Lai PL, Tai CL, Niu CC, Fu TS, Chen WJ. The effect of interspinous ligament integrity on adjacent segment instability after lumbar instrumentation and laminectomy–an experimental study in porcine model. Bio-medical materials and engineering. 2006 Jan 1;16(4):261-7.
7. Weiner BK, Fraser RD, Peterson M. Spinous process osteotomies to facilitate lumbar decompressive surgery. Spine. 1999 Jan 1;24(1):62-6.
8. Erland Hermansen, Gunnar Moen et al. Spinous Process Osteotomy to Facilitate the access to the spinal canal when decompressing the spinal canal in patients with lumbar spinal stenosis. Asian Spine Journal. 2014 Apr; 8(2): 138-144
9. Gun WL ,Myun WA Comparative study of two spinous process osteotomy techniques for posterior decompression surgery in lumbar spinal stenosis. European spine journal 2018
10. Namboothiri S, Gore S, Raja P (2016) Novel Surgical Technique for Discogenic Cauda Equina Syndrome – Transforaminal Intra Discal Access by Annulotomy outside Central Spinal Canal. J Spine S7:008.doi:10.4172/2165-7939.S7-008.

How to Cite this Article: Loong OK, Wui NB, Kanniah T, Seiang WC, Wei LS, Abidin NAZ | Wide Open Laminectomy, Posterior Decompression and Discectomy in Lumbar Spine with Preservation of Posterior Ligamentous Complex in Cauda Equina Syndrome – Case Series, Early Outcome and Literature Review | International Journal of Spine| January-June 2020; 5(1): 9-11.

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