The Journal of Spinal Surgery

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2015 | April-June | Volume 2 | Issue 2

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EDITORIAL

Editorial

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/joss-2-2-v  |  Open Access |  How to cite  | 

798

RESEARCH ARTICLE

S Balaji Pai, G Raghuram, BG Srihari

Posterior Cervical Microdiscectomy

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:4] [Pages No:33 - 36]

   DOI: 10.5005/jp-journals-10039-1052  |  Open Access |  How to cite  | 

Abstract

Background

Posterior cervical foraminotomy was first described by Spurling and Scoville. With the incorporation of the operating microscope and microsurgical techniques, there has been renewed interest in this approach for laterally placed cervical disk prolapse.

Materials and methods

Twenty-nine patients (20 males and 9 females) with ages varying from 31 to 55 years underwent posterior cervical microdiscectomy for laterally placed cervical disk prolapse at 30 levels. Surgical procedure employed by us for the posterior cervical microdiscectomy is described in the article.

Results

All the patients had relief from radiculopathy following the surgery. No major complication was noted in our series. One patient developed transient nerve root deficit which improved, over 6 weeks. No fusion was required in any case. Hence, all the complications of anterior approach and fusion could be avoided.

Conclusion

Posterior cervical microdiscectomy is a safe and effective approach for the treatment of laterally placed cervical disk prolapse. In selected cases, this approach provides excellent results with minimal complications.

How to cite this article

Pai SB, Raghuram G, Srihari BG. Posterior Cervical Microdiscectomy. J Spinal Surg 2015;2(2):33-36.

5,847

RESEARCH ARTICLE

Shivalingegouda Rayagouda Patil, Anantha Kishan, Anantha Gabbita, DN Varadharaju, PM Jagannath

Anterior Cervical Surgery: Drain Needed or Not?

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:5] [Pages No:37 - 41]

   DOI: 10.5005/jp-journals-10039-1053  |  Open Access |  How to cite  | 

Abstract

Study design

Retrospective cohort study.

Objective

To recognize the factors that influence drain output and based on the results to formulate certain guidelines which help in deciding drain placement in patients who have undergone anterior cervical discectomy (ACD) surgeries.

Summary of background data

The common worry of operating surgeon after anterior cervical discectomy and fusion (ACDF) surgery is postoperative neck hematoma. To avoid this, there has been a traditional practice to keep the drain postoperatively. Drain placement has got inherent complications, like infection risk, postoperative pain, increased analgesic use and increased length of hospital stay.

Materials and methods

All patients who underwent elective ACD surgeries with surgical drain placement in our institution between from Jan 2011 and July 2014 were identified using operation theater (OT) records. Patient information was abstracted from the medical records section. Patients were categorized on the basis of normal or increased total drain output, with increased drain output defined as total drain output 50th percentile (20 ml) or more. A multivariate logistic regression was used to determine which factors were independently associated with increased drain output.

Results

A total of 161 patients with ACDF met inclusion criteria. Total drain output was in the range from 0 to 300 ml. Among all patients in the study, 67 patients had increased drain output (drain output ≥50th percentile or 20 ml). Multivariate analysis identified three independent predictors of increased drain output: BMI, number of levels (≥2 levels) and implants.

Conclusion

Patients with the factors, like increased BMI, two or more level surgery and implants placed may benefit from surgical drain placement after ACD surgeries.

How to cite this article

Patil SR, Kishan A, Gabbita A, Varadharaju DN, Jagannath PM. Anterior Cervical Surgery: Drain Needed or Not? J Spinal Surg 2015;2(2):37-41.

3,956

RESEARCH ARTICLE

K Mahadevan

Importance of Hyaline Material in Herniated Lumbar Disk Pathology: Predicting the Presence of Hyaline from Preoperative Magnetic Resonance Imaging and its Clinical Significance

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:6] [Pages No:42 - 47]

   DOI: 10.5005/jp-journals-10039-1054  |  Open Access |  How to cite  | 

Abstract

Aim

To conduct a prospective study to assess whether we can predict the presence of hyaline material in the extruded disk from preoperative magnetic resonance imaging (MRI) in patients with lumbar disk herniations and its clinical significance.

Materials and methods

Hundred patients posted for microlumbar discectomy were included in the study. They were assessed preoperatively for severity of symptoms using visual analog scale (VAS). Detailed radiological assessment was done using MRI. Following surgery, extruded disk specimens were sent for histopathological examination. The presence of hyaline material in biopsy was correlated with specific MRI findings and postoperative outcome assessed based on the VAS score.

Results

Out of the 100 patients, there were 58 males and 42 females between the age of 18 and 55 years. Histopathology of herniated disk material showed annulus fibrosis in 15% of patients, nucleus pulposus in 78% and a combination of both in 7%. Hyaline cartilage was found in 24% of patients. Extend of Modic changes more than 50% of vertebral end plate in MRI was indicative of the presence of hyaline in biopsy (p < 0.001). Preoperative MRI finding of vertebral end plate defect (VEPD) was associated with the presence of hyaline in 92.8% of cases. Presence of hyaline was correlated with the improvement in mean VAS score postoperatively.

Conclusion

In this study, the importance of hyaline in the extruded disk with its clinical significance is emphasized. We conclude that the presence of hyaline, as predicted from MRI findings like VEPD and extend of Modic changes, is a predictor of good postoperative outcome.

How to cite this article

Gopal VV, Mahadevan K. Importance of Hyaline Material in Herniated Lumbar Disk Pathology: Predicting the Presence of Hyaline from Preoperative Magnetic Resonance Imaging and its Clinical Significance. J Spinal Surg 2015;2(2):42-47.

2,424

REVIEW ARTICLE

Sanjitha Sivasubramanian, Mathew Cherian, Pankaj Mehta

Imaging of Spinal Cord Compression: Magnetic Resonance Imaging and Beyond

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:4] [Pages No:48 - 51]

   DOI: 10.5005/jp-journals-10039-1055  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Sivasubramanian S, Cherian M, Mehta P, Parthiban JKBC. Imaging of Spinal Cord Compression: Magnetic Resonance Imaging and Beyond. J Spinal Surg 2015;2(2):48-51.

3,876

CASE REPORT

Vikas Naik, GC Keshav, SA Santhosh Kumar, Sanjeev Balaji Pai

Aneurysmal Bone Cyst of C2, C3 Cervical Spine: A Rare Case Report and Review of Literature

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:3] [Pages No:52 - 54]

   DOI: 10.5005/jp-journals-10039-1056  |  Open Access |  How to cite  | 

Abstract

Conclusion

Aneurysmal bone cyst of the cervical spine is very rare. It requires thorough neural decompression and 360° fusion for better stability and outcome.

How to cite this article

Naveen MA, Naik V, Keshav GC, Kumar SAS, Pai SB. Aneurysmal Bone Cyst of C2, C3 Cervical Spine: A Rare Case Report and Review of Literature. J Spinal Surg 2015;2(2):52-54.

3,666

CASE REPORT

Tarang Kamalkishore Vora, RR Ravi

Split Cord Malformation Type 2 Complicated by Presence of Tuberculous Arachnoiditis

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:3] [Pages No:55 - 57]

   DOI: 10.5005/jp-journals-10039-1057  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Vora TK, Ravi RR. Split Cord Malformation Type 2 Complicated by Presence of Tuberculous Arachnoiditis. J Spinal Surg 2015;2(2):55-57.

14,328

CASE REPORT

BL Chandrakar, Rakesh Thakkar, Ankit Arunbhai Desai, Adarsh Trivedi

Isolated Giant Cell Tumor of the Lumbar Spine

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:3] [Pages No:58 - 60]

   DOI: 10.5005/jp-journals-10039-1058  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Desai AA, Trivedi A, Chandrakar Bl, Thakkar R. Isolated Giant Cell Tumor of the Lumbar Spine. J Spinal Surg 2015;2(2):58-60.

5,753

RESEARCH ARTICLE

Manoj K Tewari

The Great Neurosurgeon and Spinal Surgery–Vijay Kumar Kak

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:4] [Pages No:61 - 64]

   DOI: 10.5005/joss-2-2-61  |  Open Access |  How to cite  | 

1,594

RESEARCH ARTICLE

K Rajendran

Eye Guard

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:1] [Pages No:65 - 65]

   DOI: 10.5005/joss-2-2-65  |  Open Access |  How to cite  | 

349

LETTER

Rajesh Meena

Uterus Sign

[Year:2015] [Month:April-June] [Volume:2] [Number:2] [Pages:1] [Pages No:66 - 66]

   DOI: 10.5005/joss-2-2-66  |  Open Access |  How to cite  | 

1,347

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