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JAYPEE JOURNALS
International Scientific Journals from Jaypee
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1.  HISTORY
The Great Neurosurgeon and Spinal Surgery— Professor Vijendra K Jain: The Innovative Spinal Surgeon
Sanjay Behari
[Year:2017] [Month:January-March] [Volume:4 ] [Number:1] [Pages:45] [Pages No:33-37] [No of Hits : 659]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1123 | FREE

ABSTRACT

Dr VK Jain has been one of the most innovative surgeons of this era. His seminal contributions to surgery for spinal diseases, particularly related to the craniovertebral junction (CVJ), have been a great boon for his patients.

 
2.  Case Report
Epidermoid Cyst of the Thoracic Spine: A Rare Case
Nilesh Jain, Sharadendu Narayan, Harshad Patil, Abhishek Songara
[Year:2016] [Month:April-June] [Volume:3 ] [Number:2] [Pages:45] [Pages No:59-62] [No of Hits : 833]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1089 | FREE

ABSTRACT

Intraspinal epidermoid cyst is a rare tumor. The incidence in adults is lesser than 1% and in children lesser than 3%. Epidermoid cyst is predominantly seen at the dorsal spinal level. A large percentage of epidermoid cysts are intradural extramedullary. Intramedullary epidermal cysts are rarer, with about 70 cases reported in the literature. These may be congenital or acquired with known association with spinal dysraphism. We hereby report a case of thoracic epidermoid cyst in a 22-year-old male with an extramedullary exophytic component and intramedullary cyst with accompanying split cord malformation at the level of lesion.

Keywords: Epidermoid cyst, Intramedullary, Intraspinal, Split cord, Thoracic.

How to cite this article: Jain N, Narayan S, Patil H, Songara A. Epidermoid Cyst of the Thoracic Spine: A Rare Case. J Spinal Surg 2016;3(2):59-62.

Source of support: Nil

Conflict of interest: None

 
3.  Reflection
Atlantoaxial Fixation - Anterior or Posterior Approach: Critical Review
Vinu V Gopal
[Year:2016] [Month:April-June] [Volume:3 ] [Number:2] [Pages:45] [Pages No:51-54] [No of Hits : 730]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1087 | FREE

ABSTRACT

Atlantoaxial facet joints have been proposed as the center of mobility and also center for instability of the atlantoaxial region. Because of the high mobility of the atlantoaxial (C1-C2) motion segment, fusion rates at this level have been substantially lower than those at the subaxial spine. The success of craniovertebral junction surgery depends on adequate reduction, decompression of craniovertebral (CV) junction followed by immediate fixation of atlantoaxial joint followed by bone grafting with compression for solid bony fusion. Current options for atlantoaxial fixation include anterior or posterior approaches. The biomechanical stability and fusion rates of posterior fixation surgery had been proved beyond doubt. The main disadvantages of posterior surgery involve disruption of posterior ligamentous complex which are essential for stability. C2 root denervation also aggravates the paraspinal muscle atrophy leading to instability So now advances in spinal surgery made neurosurgeons to think of an anterior technique which can establish fusion and fixation at the same time avoiding the above mentioned complications. The advantages are that there are no anatomical constraints like posterior approach in reaching C1-C2 joint. The risk of neuralgia, bleeding from venous plexus is avoided along with practically no damage to vertebral artery. Newer techniques of anterior transarticular screw and bilateral atlantoaxial fixation and fusion through unilateral right sided retropharyngeal approach had been described in literature. Anterior approach still needs further randomized controlled trials for level 1 evidence, Further research on along with biomechanical feasibility using anatomical ex vivo and in vivo constructs need to be done to further validate the appropriateness and safety of anterior approach for C1-C2 fixation and fusion.

Keywords: Anterior, Atlantoaxial, Posterior.

How to cite this article: Gopal VV. Atlantoaxial Fixation- Anterior or Posterior Approach: Critical Review. J Spinal Surg 2016;3(2):51-54.

Source of support: Nil

Conflict of interest: None

 
4.  Review Article
Minimally Invasive Techniques for the Treatment of Primary Spinal Column Lesions
Gopalakrishnan Balamurali, Ajay Ramesh Kothari, Amjad Nasr Anaizi, Jean-Marc Voyadzis, John O’toole, Richard G Fessler
[Year:2015] [Month:October-December] [Volume:2 ] [Number:4] [Pages:40] [Pages No:132-140] [No of Hits : 1263]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1069 | FREE

ABSTRACT

Minimally invasive spine surgery is becoming more prevalent as surgeons seek to provide definitive treatment without the morbidity and dysfunction associated with traditional, open surgical procedures. Minimally invasive surgery has been applied with success to the treatment of degenerative disease and traumatic injuries of the spine. Approaches to metastatic and primary spinal column tumors have also evolved rapidly as clinicians seek to minimize tissue disruption, postoperative pain and blood loss in these susceptible patient populations who may also require adjuvant therapies. The various noninvasive and minimally invasive techniques available for the treatment of these primary spinal tumors are reviewed, and their indications, benefits, and limitations discussed.

Keywords: Corpectomy, Minimally invasive spinal surgery, Percutaneous, Vertebral tumors.

How to cite this article: Balamurali G, Kothari AR, Anaizi AN, Voyadzis JM, O’toole J, Fessler RG. Minimally Invasive Techniques for the Treatment of Primary Spinal Column Lesions. J Spinal Surg 2015;2(4):132-140.

Source of support: Nil

Conflict of interest: None

 
5.  Original Article
Percutaneous Posterior Stabilization with Vertebroplasty in Painful Thoracolumbar Spinal Metastatic Disease: A Retrospective Study
Anil Chander Vodur Chandrasekar, Vignesh Jayabalan, Karthik Kailash Kannan, Sitsabesan Chokkalaingam
[Year:2015] [Month:October-December] [Volume:2 ] [Number:4] [Pages:40] [Pages No:113-117] [No of Hits : 751]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1066 | FREE

ABSTRACT

Objective: To do a retrospective evaluation of clinical outcome of the patients with spinal metastases treated with minimally invasive posterior spinal stabilization and vertebroplasty.

Methods and results: We retrospectively analyzed 22 patients with biopsy proven metastatic thoracolumbar spinal lesion treated with percutaneous posterior stabilization with pedicle screws and vertebroplasty operated in Ramachandra Medical University from June 2006 to May 2012. Neurologically intact patients with Tokuhashi’s score of 9 or and Spine instability neoplastic score of more than 6 were included. Average age group was 61.8 years with 14 males and eight females. Clinical outcome was assessed using pre- and postoperative visual analog score (VAS), intraoperative blood loss, duration of surgery, time taken to mobilize the patients after surgery and length of hospital stay.
The average VAS decreased from 9.2 preoperatively to 4.1 postoperatively (p < 0.001) and 2.2 (< 0.04) at 3 months postoperative period. The mean Karnofsky’s performance index increased from 45% preoperatively to 70% postoperatively. Average blood loss was 80 ml and the average duration of surgery was 85 minutes. Fifteen patients were mobilized on the second postoperative day with most patients discharged on 4th day. No patients had evidence of implant loosening and failure. Three patients had radiological evidence of cement extravasation. No patient had neurological deficit postoperatively and none had radiological evidence of deformity or adjacent level fracture in follow-up X-rays.

Conclusion: Percutaneous pedicle screw stabilization with vertebroplasty provided good pain relief and short-term clinical improvement in patients with thoracolumbar spinal metastasis with minimal postoperative morbidity.

Keywords: Metastasis, Pedicle screws, Percutaneous, Stabilization, Vertebroplasty.

How to cite this article: Chandrasekar ACV, Jayabalan V, Kannan KK, Chokkalaingam S. Percutaneous Posterior Stabilization with Vertebroplasty in Painful Thoracolumbar Spinal Meta- static Disease: A Retrospective Study. J Spinal Surg 2015;2(4): 113-117.

Source of support: Nil

Conflict of interest: None

 
6.  Research Article
Timing of Surgery in Bladder Functional Outcome of Cauda Equina Syndrome of Lumbar Disk Disease: A Prospective Study
Rajesh Kumar Barooah, Zakir Hussain
[Year:2015] [Month:October-December] [Volume:2 ] [Number:4] [Pages:40] [Pages No:125-131] [No of Hits : 550]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1068 | FREE

ABSTRACT

Objectives: Cauda equina syndrome (CES) is a complex of clinical symptoms/signs secondary to prolapsed intervertebral disk. The clinical presentation depends on varying combinations of lower extremity weakness, sensory loss in the lower extremities and/or saddle area, pain in the low back and/or lower extremities, and visceral impairment of bladder, rectal and/or sexual function. Although CES is sometimes used to describe a syndrome without impairment of bladder and bowel function, generally in the literature the term ‘cauda equina syndrome’ means a syndrome that includes impairment of urinary function and saddle sensory deficits.

Materials and methods: We have taken all the discogenic CES cases that presented to the Department of Neurosurgery at Gauhati Medical College and Hospital for a period of 2 years. All the patients were subjected to thorough clinical evaluation and requisite investigations specifically magnetic resonance imaging (MRI). All underwent surgery followed by analysis of the surgical outcome.

Results: Out of the total of 30 patients, male outnumber female, maximum incidence being 4th decade, age incidence ranging from 17 to 70 years. Clinically, patients presented with history of recent onset and an earlier less well-defined history of pre-existing symptoms. Low backache being the most common symptoms followed by radiculopathy, saddle anesthesia. Urinary straining/retention was the most common autonomic disturbance followed by incontinence urinary function outcome was poor in two patients, fair 10 patients, normal 18 patients. Time interval to surgery after autonomic involvement range from 5 to 200 days, mainly due to delayed referral. The most common level was L4-L5 followed by L5-S1, laminectomy single level done in 17 cases, fenestration one cases followed by discectomy.

Conclusion: Surgical intervention should be done in CES irrespective of the duration and severity of clinical symptom and autonomic symptoms. Timing of surgical intervention from autonomic involvement does not affect outcome. It is the severity of deficit which is the major determinant of outcome.

Keywords: Autonomic, Cauda equina syndrome, Discogenic.

How to cite this article: Barooah RK, Hussain Z. Timing of Surgery in Bladder Functional Outcome of Cauda Equina Syndrome of Lumbar Disk Disease: A Prospective Study. J Spinal Surg 2015;2(4):125-131.

Source of support: Nil

Conflict of interest: None

 
7.  HISTORY
The Great Neurosurgeon and Spinal Surgery—Vijay Kumar Kak
Manoj K Tewari
[Year:2015] [Month:April-June] [Volume:2 ] [Number:2] [Pages:33] [Pages No:61-64] [No of Hits : 546]
Full Text PDF | Abstract | FREE

ABSTRACT

Prof Vijay Kumar Kak was born on 15 October 1938 at Saharanpur in Uttar Pradesh. He had his initial schooling in DAV institutions at Muzaffarnagar, Kanpur and Allahabad. He joined SN Medical College, Agra, in 1955, and graduated in 1960 with distinctions in seven subjects, several gold medals and first position at all the three professional examinations. He was awarded the Chancellor’s Medal for the best graduate in Faculty of Medicine of Agra University.

 
8.  Review Article
Scaffolds for Cell Transplantation in Neurology — The Suitability of a Thermoreversible Gelation Polymer: Our Perspectives
Vidyasagar Devaprasad Dedeepiya, Justin Benjamin William, Jutty KBC Parthiban, Hiroshi Yoshioka, Yuichi Mori, Satoshi Kuroda, Masaru Iwasaki, Senthilkumar Preethy, Samuel JK Abraham
[Year:2014] [Month:January-March] [Volume:1 ] [Number:1] [Pages:52] [Pages No:16-24] [No of Hits : 2037]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1003 | FREE

ABSTRACT

Clinical translation of cell-based therapies in neurology, especially the spinal cord injury and damage to the brain, have been marred by several hurdles [Dedeepiya VD et al Expert Opinion on Biological Therapy (In print)] and one significant among them is the need for a suitable biocompatible scaffold, which can retain the transplanted cells, give an active or passive support to the cells, enable their proliferation, differentiation when needed and integration into the local niche until the restoration of the damage are complete, without any adverse reactions to the vicinity or to any of the systems of the animal or human being where it is applied. Scaffolds for neurological applications need to be biocompatible, biodegradable, non-immunogenic, must provide contact guidance for neurite outgrowth, should have porosity for vascularization and cell migration. Several natural scaffolds like collagen, alginate, silk fibroin, hyaluronic acid, chitosan, etc. and synthetic scaffolds like poly (lactic acid) (PLA), poly (glycolic acid) (PGA), poly (lactic-co-glycolic acid) (PLGA), polyethylene glycol (PEG), poly (lactide-co-caprolactone) (PLCL) have been employed for cell transplantation in neurology primarily for nerve injuries and stroke. In this review, we briefly outline the different studies utilizing these scaffolds employed for cell transplantation in neurology and we document the suitability of a unique poly (N-isopropylacrylamide-co-n-butyl methacrylate) (poly NIPAAmco- BMA) and polyethylene glycol (PEG)-based thermoreversible gelation polymer for cell therapy applications in neurology.

Keywords: Scaffolds, Neurology, Regenerative medicine, Cell therapy, Thermoreversible gelation polymer (TGP).

How to cite this article: Dedeepiya VD, William JB, Parthiban JKBC, Yoshioka H, Mori Y, Kuroda S, Iwasaki M, Preethy S, Abraham SJK. Scaffolds for cell Transplantation in Neurology- The Suitability of a Thermoreversible Gelation Polymer: Our Perspectives. J Spinal Surg 2014;1(1):16-24.

Source of support: Nil

Conflict of interest: Prof Yuichi Mori, Dr Hiroshi Yoshioka and Dr Samuel JK Abraham are applicants to and/or assignees of patents on the Thermoreversible gelation polymer.

 
9.  Original Article
Dilemma in the Surgical Management of Lumbar Canal Stenosis
PS Ramani, Sumeet Pawar, Sudhendoo Babhulkar
[Year:2014] [Month:January-March] [Volume:1 ] [Number:1] [Pages:52] [Pages No:1-11] [No of Hits : 1796]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1001 | FREE

ABSTRACT

For a long time wide decompressive laminectomy, direct visualization and decompression of affected nerve roots, foraminotomy and when necessary discectomy had remained the gold standard to operate patients with lumbar canal stenosis. There was confusion in the literature concerning the role of fusion even in the presence of instability in degenerative lumbar canal stenosis due to absence of prospective randomized clinical trials. This has led to uncertainty about the correct choice of surgical strategy as no evidence based recommendations on the role of instrumented PLIF in older patients. Such thoughts have compelled some to try minimally invasive instrumentation with micro decompression, transforaminal interbody fusion and percutaneous pedicle screws. It has the advantage of short incision, less morbidity, shortened bed rest and early ambulation which is so essential in older patients with comorbid conditions. In this study we discuss the pathogenesis of development of spinal conditions and their treatment options through the history of spinal surgery. Also discussed is the dilemma that exists in spinal surgeons regarding the selection of appropriate treatment strategy for stenosis amongst the elderly.

Keywords: Lumbar canal stenosis, elderly, surgical management, IDSS, PLIF.

How to cite this article: Ramani PS, Pawar S, Babhulkar S. Dilemma in the Surgical Management of Lumbar Canal Stenosis. J Spinal Surg 2014;1(1):1-11.

Source of support: Nil

Conflict of interest: None

 
10.  Case Report
Concurrent Miller Fisher Syndrome Variant in Ossification of Posterior Longitudinal Ligament
Alexander Cahyadi, Arwinder Singh, PS Ramani, Sudhendoo Babhulkar, Sumeet Pawar, Amrita Shenoy
[Year:2014] [Month:January-March] [Volume:1 ] [Number:1] [Pages:52] [Pages No:32-34] [No of Hits : 1406]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1006 | FREE

ABSTRACT

Introduction: Miller fisher syndrome (MFS) could be found in coincidence with ossification of posterior longitudinal ligament. High index of suspicion is required that lead to further investigation.

Case report: A 56-year-old male presented with four days history of loss of sensation on both lower and upper extremity. The complaint was felt more on the lower than upper extremity. The patient felt imbalance during walking. Muscle strengh of all extremity was normal, but sensory lost was found in all extremity. Deep tendon reflexes were absent in all extremity.

Investigations: Computed tomography (CT) scan and MRI showed canal stenosis due to of the posterior longitudinal ligament. Nerve conduction velocity suggested peripheral neuropathy on both upper and lower extremity. Antibody anti GQ1b was positive. Cerebrospinal fluid examination showed cytoalbuminemic dissociation.

Treatment: Patient was treated conservatively.

Results: Improvement was achieved in 5 days, and progressively return to normal condition.

Conclusion: Peripheral polineuropathy could be found in coincident with of the posterior longitudinal ligament and required specific management.

Keywords: Ossification, posterior longitudinal ligament, Miller fisher syndrome.

How to cite this article: Cahyadi A, Singh A, Ramani PS, Babhulkar S, Pawar S, Shenoy A. Concurrent Miller Fisher Syndrome Variant in Ossification of Posterior Longitudinal Ligament. J Spinal Surg 2014;1(1):32-34.

Source of support: Nil

Conflict of interest: None

 
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