The Journal of Spinal Surgery

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2015 | October-December | Volume 2 | Issue 4

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EDITORIAL

Editorial

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:1] [Pages No:0 - 0]

   DOI: 10.5005/joss-2-4-V  |  Open Access |  How to cite  | 

706

RESEARCH ARTICLE

Karthik Kailash Kannan, Anil Chander Vodur Chandrasekar, Vignesh Jayabalan, Sitsabesan Chokkalaingam

Percutaneous Posterior Stabilization with Vertebroplasty in Painful Thoracolumbar Spinal Metastatic Disease: A Retrospective Study

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:5] [Pages No:113 - 117]

   DOI: 10.5005/jp-journals-10039-1066  |  Open Access |  How to cite  | 

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.

How to cite this article

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

5,170

RESEARCH ARTICLE

Gaurav Jaiswal, Tarun Kumar Gupta

Surgical Outcome of Intradural Extramedullary Tumors: Single Institutional Experience—Assessment using Frankel Grading

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:7] [Pages No:118 - 124]

   DOI: 10.5005/jp-journals-10039-1067  |  Open Access |  How to cite  | 

Abstract

Background

To report the surgical outcome of intradural extramedullary (IDEM) tumors in 52 patients. Clinical effect was evaluated based on Frankel grade.

Purpose

The results of a single neurosurgery institution are reported to highlight the peculiarities and pitfalls of the management of this disease. Tumors are analyzed from the point of view of their localization, histology, surgical technique and outcome was evaluated in term of Frankle classification.

Methods

Fifty-two cases of histopathologically confirmed IDEM were treated laminectomy with complete resection of tumors between January 2011 and February 2014. There were 34 males and 18 females with an average age of 41.53 years. The mean postoperative follow-up period was 22.44 months. The histopathological findings, locations of the tumors, and clinical results were analyzed. The neurological findings obtained during the preoperative stage and the postoperative follow-up was evaluated according to the Frankel grading.

Results

The histopathological results are as follows: 14 cases of a meningioma, 30 cases of nerve sheath tumors (28 cases schwannoma and 2 cases neurofibroma), 4 cases of an arachnoid cyst, 3 cases of tarlov cyst, and one case of benign cystic teratoma. The locations of the tumors were as follows: 40 cases in the thoracic region, eight cases in the cervical region, and two cases in the lumbar and two cases of sacral region. The most common diagnosis was nerve sheath tumors (57.69%), followed by meningioma (26.92%). At the final follow-up, a 3-grade, 2-grade and 1-grade improvement was observed in 6, 22 and 24 cases, respectively. There were changes in the Frankel grade in every case. The preoperative neurological deficit improved within 6 postoperative weeks in most cases. Postoperatively, there were one case of cerebrospinal fluid leakage.

Conclusion

intradural extramedullary tumors detected by magnetic resonance imaging (MRI) are mostly benign and good clinical results can be obtained when treated surgically. Therefore, more dynamic surgical approaches by neurosurgeons are suggested to decline morbidity.

How to cite this article

Kankane VK, Jaiswal G, Gupta TK. Surgical Outcome of Intradural Extramedullary Tumors: Single Institutional Experience—Assessment using Frankel Grading. J Spinal Surg 2015;2(4):118-124.

508

RESEARCH ARTICLE

Rajesh Kumar Barooah, Zakir Hussain

Timing of Surgery in Bladder Functional Outcome of Cauda Equina Syndrome of Lumbar Disk Disease: A Prospective Study

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:7] [Pages No:125 - 131]

   DOI: 10.5005/jp-journals-10039-1068  |  Open Access |  How to cite  | 

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.

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.

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REVIEW ARTICLE

Gopalakrishnan Balamurali, Ajay Ramesh Kothari, Amjad Nasr Anaizi, Jean-Marc Voyadzis, John O'toole, Richard G Fessler

Minimally Invasive Techniques for the Treatment of Primary Spinal Column Lesions

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:9] [Pages No:132 - 140]

   DOI: 10.5005/jp-journals-10039-1069  |  Open Access |  How to cite  | 

Abstract

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.

2,255

CASE REPORT

Ankit Arunbhai Desai, Adarsh Triwedi

Osteoid Osteoma of the Cervical Spine in Nine Years Female Child: A Case Report and Review of Literature

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:3] [Pages No:141 - 143]

   DOI: 10.5005/jp-journals-10039-1070  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Desai AA, Triwedi A. Osteoid Osteoma of the Cervical Spine in Nine Years Female Child: A Case Report and Review of Literature. J Spinal Surg 2015;2(4):141-143.

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CASE REPORT

Sachin Ashok Giri, Manish Tapase, Batuk Damjibhai Diyora

Spinal Tuberculosis Mimicking Metastasis in a Case of Basal Cell Carcinoma

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:4] [Pages No:144 - 147]

   DOI: 10.5005/jp-journals-10039-1071  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Giri SA, Giri D, Tapase M, Patil S, Diyora BD, Sharma A. Spinal Tuberculosis Mimicking Metastasis in a Case of Basal Cell Carcinoma. J Spinal Surg 2015;2(4):144-147.

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CASE REPORT

Sachin Ashokrao Giri, Nitin Kotecha

An Unusual Case of Conus Nonfunctioning Paraganglioma

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:3] [Pages No:148 - 150]

   DOI: 10.5005/jp-journals-10039-1072  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Diyora BD, Giri SA, Kotecha N, Giri D. An Unusual Case of Conus Nonfunctioning Paraganglioma. J Spinal Surg 2015;2(4):148-150.

3,283

CASE REPORT

Sreedharan PE Namboothiri, Arvind K Kumar

Percutaneous Endoscopic Lumbar Discectomy in a High Risk Cardiac Patient

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:3] [Pages No:151 - 153]

   DOI: 10.5005/jp-journals-10039-1073  |  Open Access |  How to cite  | 

Abstract

How to cite this article

Namboothiri SPE, Rangasamy K, Kumar AK. Percutaneous Endoscopic Lumbar Discectomy in a High Risk Cardiac Patient. J Spinal Surg 2015;2(4):151-153.

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Book Review

Neuro spinal Surgery—Operative Techniques: Lateral Mass Fixation in Subaxial cervical spine

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:2] [Pages No:154 - 155]

   DOI: 10.5005/joss-2-4-154  |  Open Access |  How to cite  | 

621

RESEARCH ARTICLE

SPINE 2015: Annual Conference of Neuro Spinal Surgeons Association, India

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:2] [Pages No:156 - 157]

   DOI: 10.5005/joss-2-4-156  |  Open Access |  How to cite  | 

4,252

RESEARCH ARTICLE

Neuro Spinal Day Celebrations

[Year:2015] [Month:October-December] [Volume:2] [Number:4] [Pages:3] [Pages No:158 - 160]

   DOI: 10.5005/joss-2-4-158  |  Open Access |  How to cite  | 

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