ABSTRACT
Background: Stabilization in tubercular spine is very often employed for various indications. Many papers have detailed the management strategies and outcome in the management of spinal tuberculosis. There are not many papers detailing the complications that followed stabilization in tubercular spine, which are very essential in the development of safe surgical procedures and avoiding complications. In the present study 50 patients who were stabilized for tubercular spine were followed up for a period of 2 years. Various complications encountered during this period were detailed with a possible mechanism for the same and a strategy to address such a complication. Methods: 50 consecutively available patients who underwent a standard stabilization procedure for spinal tuberculosis and were available for follow-up for a period of 2 years were subjects of the study. All the complications encountered in these patients during the follow-up period were noted and were managed. Results: Mechanical failure of the implant was the most commonly encountered complication. Neurological complications included progressive neurologic deterioration, hoarseness of voice, cauda equina syndrome, foot drop. Persistent worsening of pain, DVT and pressure ulcers were the complications encountered that are not specific to a region of spine. Conclusions: Stabilization is not without complications in tubercular spine. But with strict adherence to guidelines the complications can be minimal and are not dismal.
ABSTRACT
Background: Trigeminal neuralgia is the most common facial pain syndrome characterized by severe, brief recurrent episodes of electric shock like pain in the distribution of one or more branches of trigeminal nerve on one side of the face. In the present paper we present our experience with MVD for trigeminal neuralgia in a series of 20 patients during the last 4 years. Methods: All the patients presented to the neurosurgery department with features suggestive of Trigeminal Neuralgia during the last 4 years were evaluated with 3D FIESTA imaging. All those patients eligible for surgical decompression underwent a standard MVD in the form of a small retromastoid suboccipital craniotomy and Microvascular decompression done using a sheet of Teflon to intervene between the vessel and the Vth nerve. Any arachnoid bands across the nerve were carefully divided. Standard post-operative care given. The results were evaluated and tabulated. Results: 65% (N=13) of the patients had immediate postoperative relief. 15% (N=3) showed delayed but good pain relief in 3 weeks period. 20% (N=4) 20% pts did not show any pain relief at all post operatively. There were no mortalities in the series and no redo surgeries were performed in the series. Conclusion: Micro-vascular decompression is safe and effective in producing good pain relief over a long term in patients with Trigeminal neuralgias refractive to medical treatment.