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  Citation statistics : Table of Contents
   2014| April-June  | Volume 1 | Issue 2  
    Online since August 24, 2020

 
 
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PROSPECTIVE STUDY
Laminoplasty for cervical spondylotic myelopathy
Patrick Fransen
April-June 2014, 1(2):77-80
DOI:10.5005/jp-journals-10039-1015  
Cervical spondylotic myelopathy (CSM) is a commonly treated either by uninstrumented laminectomy, carrying the risk of postoperative instability, or by anterior or posterior decompression with fusion resulting in postoperative stiffness and possibly adjacent segment degeneration. Cervical laminoplasty, initially developed for pediatric or OPLL patients could be an interesting surgical alternative to decompress and reconstruct cervical anatomy without fusion. Sixteen patients, mean age 63, who presented with CSM were treated surgically using multilevel laminoplasty, and reviewed after 1 month, 6 months, 1 and 2 years. Clinical evaluation was performed based on the Benzel-JOA and Nurick scores. The preoperative mean Benzel-JOA score was 13.43; preoperative mean Nurick score was 1.81. Intramedullary hyperintensity in T2 MRI was observed in five patients. The operation was performed on 2 levels (19%) 3 levels (69%) and 4 levels (12%). We used the open-door hinged laminoplasty technique, using metallic implants, without bone graft. At one month FU, mean JOA score was 15.44, and Nurick dropped to 1.05. At 6 months, mean JOA was 16.36 and Nurick was 0.72. At one year, the mean JOA score was 16.16, and Nurick was 0.83. At 2 years, mean JOA was 17.5 and Nurick was 0.25. We reviewed the possible advantages and complications of spinal cord decompression by open-door laminoplasty for CSM. We conclude that this technique allows significant clinical improvement observed progressively in the two years following surgery without increased rigidity or instability.
[ABSTRACT]   Full text not available  [PDF] [CITATIONS]
  1 193 28
CASE REPORTS
Missed chance fracture of lumbar vertebra presenting as cauda equina syndrome: A case report and review of literature
A Shiju Majeed, Y Sherafudeen
April-June 2014, 1(2):81-83
DOI:10.5005/jp-journals-10039-1016  
Chance fractures of the thoracolumbar spine are being increasingly reported due to the increase in motor vehicle accidents. These are often missed injuries unless careful attention is paid to clinical examination and analysis of various imaging modalities. This can result in grave neurological complications. Here, we report a case of missed Chance fracture in a 55-year-old male which went on to develop cauda equina syndrome. A review of literature and radiological signs which should be looked into for avoiding missing such injuries are presented.
[ABSTRACT]   Full text not available  [PDF]
  - 209 42
Microsurgical management of intraspinal tumors in the lumbar spine: Hemilaminectomy as an alternative to laminectomy
Don Mathew, Tinu Ravi Abraham, Ajith R Nair
April-June 2014, 1(2):84-90
DOI:10.5005/jp-journals-10039-1017  
Introduction: Laminectomy is the classical surgical technique done for exposure of the spinal cord in the removal of intraspinal lesions. Here, we report a case where multilevel hemilaminectomy has been done to remove a long segment intraspinal tumor extending from D11 to L5. Case report: A 47-year-old lady who had backache for 5 years, difficulty in walking for 6 month. She came to us with paraplegia (grade 0 power of both lower limbs), decreased sensation of both lower limbs and bladder incontinence. MRI revealed an intradural mass lesion extending from D11 to L5 level. multilevel hemilaminectomy was performed from D11 to L5 and near total resection of the tumor was done. Postoperatively, patient showed improvement with grade 1-2 power in lower limbs at the end of 3 months. Advantages of hemilaminectomy: The main advantage of hemilaminectomy is the complete preservation of dorsal static structure of the vertebral column; such as the spinous process, the interspinous and supraspinous ligaments, and the unilateral preservation of the intervertebral joints, laminae, ligamentum flavae and the paraspinal muscles. Conclusion: It is without doubt that patient morbidity and spine stability is better when surgery is performed through a narrow corridor. It can be concluded that hemilaminectomy is a safe and better alternative to laminectomy in the removal of long segment intradural tumors.
[ABSTRACT]   Full text not available  [PDF]
  - 250 35
Tumor-to-tumor metastasis in the spine
Robert S Laidlaw, John Turchini, Jonathan R Ball
April-June 2014, 1(2):91-93
DOI:10.5005/jp-journals-10039-1018  
Tumor-to-tumor metastasis (TTM) is a rare phenomenon and usually involves urological malignancies. This case report describes a 68-year-old female with end stage metastatic breast cancer that underwent excision of thoracic intradural tumor. Histopathological analysis of the lesion revealed two separate cell population. This is the first documented case of ttm seen going to the spine.
[ABSTRACT]   Full text not available  [PDF]
  - 229 40
Langerhan's cell histiocytosis of the lumbar spine during pregnancy: A rare case with literature review
Rully H Dahlan, Farid Yudoyono, Sevline E Ompusunggu, Akhmad Y Pramatirta, Agung B Sutiono, Ahmad Faried, Muhammad Z Arifin
April-June 2014, 1(2):94-97
DOI:10.5005/jp-journals-10039-1019  
Background: Langerhan's cell histiocytosis (LCH), previously known as histiocytosis X, is a reactive proliferative dendritic cells of unknown pathogenesis characterized by the proliferation of Langerhan's cells and is extremely rare in the lumbar spines of adults. This condition is most common among young males under the age of 15 years old (with a peak incidence at 2-4 years old), and the most frequent site of these osteolytic bony lesions of the spine is the thoracic region. Purpose: To highlight an interesting and rare presentation for Langerhans cell histiocytosis of the spinal cord in pregnant woman. Study design: This is a case report of a single patient in whom a Langerhans cell histiocytosis was resected from the lumbal spine in pregnant woman with return to normal functioning. Patient sample: A 26-year-old pregnant woman at 20 to 22 weeks presenting with acute cauda equina syndrome, a 1-month history of pain and numbness and paraparese of right limb had gradually progressed to involve all the lower limbs. Outcome measures: Frankel grading of neural function and Visual Analogue Score are included to evaluate the therapeutic efficiency. Methods: Magnetic resonance imaging revealed the widespread involvement of an extradural contrast-enhancing mass in the lumbar spine of L2-L5. Results: The patient underwent decompression and surgical resection of the tumor in a three-quarters prone position, fetal heart monitoring was performed by our obstetrician; there was no fetal distress during the surgery. The diagnosis was confirmed by histological analysis. She entered spontaneous labor at 36 to 37 weeks and birthed a baby weighing 3000 gm. The child began crying immediately and had Apgar scores of 8 and 10 in the 1st and 5th minutes respectively. No residual disease or recurrence was noted at follow-up longer than 1 year. Conclusion: Our case's unique presentation involves LCH in an adult pregnant patient at the lumbar spine with no osteolytic activity. The management of pregnant women and maintenance of fetal well-being should be coordinated among the spinal neurosurgeon, obstetrician and anesthesiologist.
[ABSTRACT]   Full text not available  [PDF]
  - 199 45
A rare case of extraforaminal schwannoma in lumbar region in an elderly male without neurofibromatosis operated by transparaspinal approach
Vishwanath Sidram, PC Chandrakumar, M Varunkumar, Bellara Raghavendra
April-June 2014, 1(2):98-100
DOI:10.5005/jp-journals-10039-1020  
Introduction: Schwannoma is a benign tumor arising from the neural crest-derived Schwann cells. These tumors usually grow within the spinal canal and produce compression of spinal cord and nerve root of origin. Aim: To report a rare case of extraforaminal schwannoma in lumbar region in an elderly male operated by transparaspinal approach. Case: A 65-year-old male, presented with pain which is characterized by radiation to right thigh and associated with pins and needles sensation, intermittent type. Investigation: MRI scan demonstrated mixed intensity lesion in right paravertebral region L345 suggestive of extraforaminal schwannoma and disc bulge L3-4, L4-5 compressing anterior thecal sac and bilateral traversing nerve roots. Histology showed a tumor with features of schwannoma. The stroma at places shows myxoid change and hyalinization. Mononuclear cell infiltration is seen into the stroma. Treatment: Complete removal of the mass done by transparaspinal approach. Results: No residual tumor on follow-up scan and pain disappeared. Conclusion: Extraforaminal schwannoma in lumbar region in an elderly male ia a rare condition. The rarity of extraforaminal schwannoma and transparaspinal excision was highlighted. Transparaspinal approach is the most feasible and directly accessible approach to remove tumor and relieve pressure symptoms and rare possibility of malignancy.
[ABSTRACT]   Full text not available  [PDF]
  - 235 30
A C7 chordoma masquerading as spinal tuberculosis
Phani Kiran Surapuraju, JKBC Parthiban
April-June 2014, 1(2):101-103
DOI:10.5005/jp-journals-10039-1021  
Tuberculosis of cervical spine is a fairly common pathology encountered by the spine surgeon in India. It is not uncommon to find that empirical treatment with anti-tubercular drugs is started based on clinical, hematological and radiological features. We present one such patient who presented to us with dysphagia and was on anti-tubercular treatment for 18 months. It was later diagnosed as a C7 chordoma after an intralesional excision. This emphasizes the fact that a tissue diagnosis is imperative for starting any antimicrobial therapy. The purpose of this report is to highlight the fact that a chordoma should be considered as an important differential diagnosis in the axial skeleton lesions anywhere from the craniovertebral junction to the sacrum; as an early diagnosis has significant impact on the tumor recurrence and long-term survival. This report re-emphasizes the importance of tissue diagnosis by needle aspiration or biopsy before starting the definitive treatment.
[ABSTRACT]   Full text not available  [PDF]
  - 185 39
Thoracic solitary plasmacytoma: Single Indonesian teaching hospital experience
Farid Yudoyono, Rully Hanafi Dahlan, Sevline Esthetia Ompusunggu, Muhammad Zafrullah Arifin
April-June 2014, 1(2):104-106
DOI:10.5005/jp-journals-10039-1022  
Plasmacytoma is a rare disease, which afflicts two to three people per every 100,000 of the general population. Solitary plasmacytoma accounts for 5% of the plasma cell neoplasm. Solitary plasmacytoma of the bone appears more vividly in the axial skeleton (25-60%), which has the red marrow and usually affects the thoracic vertebrae. We report two cases who has a bilateral weakness inferior extremity. After being treated for the muscle pain, his symptoms of pain were changed into weakness and allesthesia. We checked the MRI and found a mass lesion in the T9 vertebra, but there were no significant laboratory findings, in blood and urine samples. Finally, he got a laminectomy due to the aggravation of the weakness. The result of biopsy indicated that it was a solitary plasmacytoma of the spine. After 5 months later, the weakness had disappeared.
[ABSTRACT]   Full text not available  [PDF]
  - 208 33
Osteoid osteoma of cervical spine: A rare presentation
Vinod Agrawal, Sanjay Tripathi, Saurav Narayan Nanda, Himanshu Parmar
April-June 2014, 1(2):107-109
DOI:10.5005/jp-journals-10039-1023  
Osteoid osteoma of cervical spine is rare, and only few cases are reported in scientific literature. We report a case of osteoid osteoma of cervical spine treated at our tertiary care hospital in Mumbai.
[ABSTRACT]   Full text not available  [PDF]
  - 196 38
EDITORIAL
Editorial
JKBC Parthiban
April-June 2014, 1(2):0-0
Full text not available  [PDF]
  - 181 33
LETTER-TO-EDITOR
Can research in spinal cord injury will blossom in India?
Amaresh Deginald
April-June 2014, 1(2):110-110
Full text not available  [PDF]
  - 171 26
ORIGINAL ARTICLES
Anterior deformity correction in cervical spondylotic myelopathy
Anil Pande, Rajesh Daniel Babbu, Siddhartha Ghosh
April-June 2014, 1(2):53-59
DOI:10.5005/jp-journals-10039-1012  
Deformity in the cervical spine is ascribed to congenital, degenerative, traumatic, infective, neoplastic, iatrogenic causes. The deformity can be in the sagittal and coronal plane and is an important factor in the generation of symptoms in cervical spondylotic myelopathy (CSM). Better understanding of the etiopathogenesis, imaging and improving instrumentation allows for the tackling of these deformities. Correction requires to be tailored to each patient and may require anterior, posterior or combined approaches.
[ABSTRACT]   Full text not available  [PDF]
  - 224 40
Anterior fixation of atlantoaxial joints: Technique and pitfalls
Sushil Patkar
April-June 2014, 1(2):60-68
DOI:10.5005/jp-journals-10039-1013  
Both the atlantoaxial joints can be exposed adequately by an unilateral extrapharyngeal approach from the right side. The atlantoaxial dislocation can be reduced, joints can be decorticated and bone graft can be introduced into the joint. The odontoid process can be drilled and removed. The C1-C2 joint can be fixed either by (1) C1 lateral mass and C2 body screw plate bilaterally, or (2) bilateral anterior C2-C1 transarticular screws.
[ABSTRACT]   Full text not available  [PDF]
  - 295 63
REVIEW ARTICLE
Odontoid fractures: Management
P Sai Sudarsan, I Dinakar
April-June 2014, 1(2):69-76
DOI:10.5005/jp-journals-10039-1014  
Odontoid fractures account for approximately 20% of all cervical fractures, majority of them being type II. Treatment of odontoid fractures is determined by multiple factors, including fracture type, presence of associated injuries, patient's age and comorbidities. Majority of type I and III fractures do not warrant surgical correction. However, management of type II fractures still remains controversial. Of late internal fixation has become an accepted treatment. Multiple surgical options have been proposed. This article reviews various alternatives of treating odontoid fractures.
[ABSTRACT]   Full text not available  [PDF]
  - 206 28