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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 : 1007]
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.  TECHNICAL NOTE
C1-C2 Posterior Cervical Fixation by a Harms Technique Modification
Ioannis Siasios, Kunal Vakharia, Joseph M Kowalski, Vassilios G Dimopoulos, John Pollina
[Year:2017] [Month:January-March] [Volume:4 ] [Number:1] [Pages:45] [Pages No:14-18] [No of Hits : 587]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1118 | FREE

ABSTRACT

Introduction: The unique anatomy of the upper cervical spine in conjunction with its supportive role in the axial stabilization and rotatory function of the head increases the surgical risk and associated complications for corrective surgeries performed in this spinal region. C1-C2 posterior fixation is indicated in the occurrence of instability at the craniocervical junction; and it can be performed by specific surgical techniques, such as the Harms and Magerl techniques. In this technical note, the authors present a simplified modification of the Harms technique that increases the accuracy of screw placement in the lateral mass of the C1 vertebra and in the pedicle of the C2 vertebra. This modification provides a secure path for screw placement by obtaining fluoroscopic images of K-wires inserted in the lateral masses of C1 and the pedicles of C2 as in the original technique. According to this technique, a pin driver is used to guide a K-wire through the initially marked entry point to the lateral mass of C1. After fluoroscopic confirmation of the optimal position of the guide wire, a cannulated hand drill is placed over the guidewire. A pilot hole is drilled in the same trajectory for the screw placement under fluoroscopic control. Then the guidewire and the hand drill are removed and an appropriately sized 3.5 mm polyaxial screw is placed with a hand drill under confirmation of the correct position with anteroposterior and lateral fluoroscopy. The same procedure is followed for the placement of the C2 pedicle screws. Then, a small rod is placed and secured within the polyaxial screw heads of the C1 and C2 screws bilaterally. Decortication of the spinous processes of the involved vertebrae and the occiput is the final step before closure of the fascia, cervical muscle layer, subcutaneous tissue, and skin.

Keywords: Atlantoaxial posterior fixation, C1 lateral mass, C2 pedicle screws, Harms technique.

How to cite this article: Siasios I, Vakharia K, Kowalski JM, Dimopoulos VG, Pollina J. C1-C2 Posterior Cervical Fixation by a Harms Technique Modification. J Spinal Surg 2017;4(1):14-18.

Source of support: Nil

Conflict of interest: None

 
3.  Original Article
Clinical Methods of Spinal-level Localization in Lumbar and Lumbosacral Spine Surgeries through Posterior Approach
Deepak K Jha, Pranjal Pandey, Mukul Jain, Arvind Arya, Suman Kushwaha, Rima Kumari
[Year:2016] [Month:April-June] [Volume:3 ] [Number:2] [Pages:45] [Pages No:34-39] [No of Hits : 1566]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1083 | FREE

ABSTRACT

Aims: Clinical methods of palpations of iliac crests and spinous processes for spinal-level localization (SLL) were evaluated for accuracy in lumbar and lumbosacral (LS) spinal surgeries through the posterior approach.

Materials and methods: Hundred and seven successive patients operated for lumbar and LS diseases operated through the posterior approach in the last 2 years were evaluated prospectively for the accuracy of clinical methods for SLL. There were 76 males and 31 females. Age ranged from 16 to 70 years (average 43.5 years). Clinical methods for SLL included palpation of iliac crests and spinal processes in correlation with midline sagittal MR images. Surgical incision and further surgery were undertaken after confirmation of spinal level by intraoperative lateral radiograph of LS spine. Accuracy of SLL by clinical methods and surgical findings at various spinal levels was observed.

Results: Spinous processes for SLL were accurate in 94.39% (n = 101) cases. The level of iliac crests were seen at or just below L3 and L4 spinous processes in 89.71% (n = 96) and 10.29% (n = 11) cases respectively. Various anatomical features like posterior surfaces of laminae, thecal sac, and positions of roots in the spinal canal were helpful in differentiating L5 to S1 level than levels above. Six errors in SLL in the study included five females with L4 to L5 prolapsed inter-vertebral disk (PIVD) and one male with L5 to S1 PIVD.

Conclusion: Spinal-level localization by clinical methods in correlation with MR images is unreliable especially in women and L4 to 5 level. Intraoperative findings of L5 to S1 interspace and S1 lamina show features that may help in SLL during surgery.

Keywords: Herniated lumbar disk, Lumbar spine, Spine, Wrong-level disk surgery, Wrong-level surgery.

How to cite this article: Jha DK, Pandey P, Jain M, Arya A, Kushwaha S, Kumari R. Clinical Methods of Spinal-level Localization in Lumbar and Lumbosacral Spine Surgeries through Posterior Approach. J Spinal Surg 2016;3(2):34-39.

Source of support: Nil

Conflict of interest: None

 
4.  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 : 1220]
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

 
5.  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 : 1108]
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

 
6.  Original Article
A Report on the early Results of the BacJac Interspinous Distraction Device: A Prospective Study in Patients with Lumbar Spinal Stenosis
Sriram H Srinivasan, Martyn Newey
[Year:2016] [Month:April-June] [Volume:3 ] [Number:2] [Pages:45] [Pages No:40-43] [No of Hits : 920]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1084 | FREE

ABSTRACT

Aims: This is a report on the early clinical outcome of the BacJac interspinous distraction device in patients with lumbar spinal stenosis.

Materials and methods: This is a prospective study on a group of patients who underwent surgery from February 2010 to December 2012. There were 21 consecutive patients who had insertion of a BacJac. Data prospectively recorded included Visual Analogue Scores for leg pain (VL), back pain (VB), the Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and walking distance (WD). Scores were recorded pre- and postoperatively and at final review. The follow-up period varied from 6 to 40 months.

Results: We found all clinical outcome measures improved following surgery. Mean scores for VL improved from 76 to 27, for VB from 49 to 24, and for ODI from 42 to 26 at final follow-up. There were also improvements noted in ZCQ scores and patient-reported WD. We also noted a high rate of osteolysis (76%) around the implant at 1 year from insertion.

Conclusion: This small prospective study suggests that there is a role for the use of the BacJac interspinous distraction devices in selected patients. Osteolysis around the implant remains an issue although this did not appear to compromise the early outcome in this study.

Keywords: Clinical outcome, Interspinous distraction device, Lumbar spinal stenosis, Surgical treatment.

How to cite this article: Srinivasan SH, Newey M. A Report on the early Results of the BacJac Interspinous Distraction Device: A Prospective Study in Patients with Lumbar Spinal Stenosis. J Spinal Surg 2016;3(2):40-43.

Source of support: Nil

Conflict of interest: None

 
7.  Spine Image
Dysphagia caused by Anterior Cervical Osteophytes at C2-C3: Unusual Location and Presentation
G Murugesan
[Year:2016] [Month:April-June] [Volume:3 ] [Number:2] [Pages:45] [Pages No:70-71] [No of Hits : 848]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1093 | FREE

ABSTRACT

Anterior cervical osteophytes are common in old age due to degenerative process; it is usually asymptomatic in elderly people. Due to mechanical compressions, few patients may present with multiple complications, such as dysphagia, dysarthria, and dyspnea. The osteophytes commonly involve lower cervical spine and usually present with neurological symptoms.
This case is unusual as it presented with C2-C3 osteophyte with dysphagia, which was completely relieved by excision.

Keywords: Anterior cervical osteophytes, Complete excision, Compression of pharynx, Dysphagia.

How to cite this article: Murugesan G. Dysphagia caused by Anterior Cervical Osteophytes at C2-C3: Unusual Location and Presentation. J Spinal Surg 2016;3(2):70-71.

Source of support: Nil

Conflict of interest: None

 
8.  History
The Great Neurosurgeon and Spinal Surgery
Anil Kumar Peethambaran, Thomas Varghese
[Year:2016] [Month:April-June] [Volume:3 ] [Number:2] [Pages:45] [Pages No:66-67] [No of Hits : 817]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1091 | FREE

ABSTRACT

Padmashree Dr. A Marthanda Pillai: A Neurosurgeon Par Excellence

Padmashree (Dr.) Ananthanarayanan Marthanda Pillai is the current Chairman and Managing Director of Ananthapuri Hospitals and Research Institute, a 300-bedded superspecialty hospital in Thiruvananthapuram, the capital city of Kerala. He was awarded the Padmashree award for his excellence in the field of neurosurgery and social work by IMA, in the year 2011.

 
9.  ORIGINAL ARTICLE
Pedicle Screw Placement in the Thoracic and Lumbar Spine by the C-arm Guided Navigation and the Free Hand Method: A Technical and Outcome Analysis
Anantha Gabbita, Mohamed M Usman, Anantha Kishan, DN Varadaraju, Shivalinge G Patil, Amrut V Hosmath
[Year:2016] [Month:July-September] [Volume:3 ] [Number:3] [Pages:43] [Pages No:90-95] [No of Hits : 812]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1098 | FREE

ABSTRACT

Introduction: The use of pedicle screws in stabilizing all three columns of the spine is a well-known but technically demanding procedure. Various assisted techniques like intraoperative fluoroscopy and stereotaxy-guided techniques have marginally increased placement accuracy along with increased radiation exposure to the surgeon and the patient, with an increased operative time.

Over the last two decades, a detailed understanding of the anatomy of the thoracolumbar pedicles has led to the emergence of the “free-hand” technique.

Objectives: To analyze the pedicle screw placement in thoracic, lumbar, and sacral spine over a 3-year period in terms of the intraoperative and immediate postoperative procedural results using navigation-guided and free hand techniques.

Materials and methods: A retrospective study was done over a period of 3 years from November 2012 to December 2015 in a tertiary care center by a single surgeon, involving 118 cases that were done using the C-arm navigation and the free hand technique.

Results: The study involved a total of 118 patients and 546 screws over a period of 3 years. The indications consisted of degenerative diseases (72%), infection (12.7%), trauma (12.7%), and malignancy (2.54%). The initial 77 cases were done by image guidance under C arm navigation and the later 41 cases with free hand techniques. Among these, there were eight breaches noted (6.72%), five (6.49%) in the image-guided technique vs three (7.3%) in the freehand technique. The direction of breach was lateral in one case (12.5%) and medial in seven cases (87.5%). Three patients (37.5%) with suboptimal screw placement underwent revision surgery. Four patients (3.36%) in the present study had postoperative neurological deficit in the form of foot drop and preoperative durotomies noted in nine patients (7.62%). Postoperative surgical site infections were noted in four cases (3.38%).

Conclusion: Free hand pedicle screw placement based on external anatomy alone can be performed with acceptable safety and accuracy in experienced hands and allows avoidance of radiation exposure encountered in fluoroscopic techniques.

Keywords: A ccuracy, B reach, F ree h and, I mage g uided, Lumbar, Pedicle screw, Sacral, Thoracic.

How to cite this article: Gabbita A, Usman MM, Kishan A, Varadaraju DN, Patil SG, Hosmath AV. Pedicle Screw Placement in the Thoracic and Lumbar Spine by the C-arm Guided Navigation and the Free Hand Method: A Technical and Outcome Analysis. J Spinal Surg 2016;3(3):90-95.

Source of support: Nil

Conflict of interest: None

 
10.  CASE REPORT
Reverse Latissimus Dorsi Turnover Muscle Flap for Coverage of a Secondary Midline Lumbar Defect following Spinal Surgery
Darshansingh U Rajput, Sudhir Beglihosahalli Muniswamy
[Year:2016] [Month:January-March] [Volume:3 ] [Number:1] [Pages:28] [Pages No:12-14] [No of Hits : 732]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10039-1077 | FREE

ABSTRACT

The reconstruction of defects located in the midline lumbar region area is difficult, especially when occurring following a neurosurgical procedure. They display a high level of complexity with respect to dural exposure, exposure of implants, deep irregular contours and bacterial contamination of the wound. The difficulty is made more challenging by the fewer possible options of regional flaps available in the vicinity. In order to obtain a well-vascularized tissue, with good resistance to bacterial contamination and easy to shape into such defects, the reverse latissimus dorsi turnover muscle flap is a useful surgical option. In this article, we are reporting a case of post-traumatic spine surgery wound complication resulting in a midline lumar defect that was reconstructed with a reverse latissimus dorsi (LD) turnover muscle flap.

Keywords: Midline lumbar defect, Reverse LD, Turnover flap.

How to cite this article: Rajput DU, Muniswamy SB. Reverse Latissimus Dorsi Turnover Muscle Flap for Coverage of a Secondary Midline Lumbar Defect following Spinal Surgery. J Spinal Surg 2016;3(1):12-14.

Source of support: Nil

Conflict of interest: None

 
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