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1.
J Spinal Disord Tech ; 27(7): 401-8, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25144206

ABSTRACT

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To study the relationship between the proximal spine and shoulder levels in adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: It has been frequently observed that the shoulder levels do not correspond to the spinal curve direction in AIS. MATERIALS AND METHODS: Eighty-five operated cases of AIS were analyzed retrospectively of which 69 were Lenke type I and II curves. Preoperative anteroposterior standing x-rays of the spine and clinical photographs were studied. T1 tilt and intercoracoid line (ICL) tilt and their mutual relationship were documented. The curve type (Lenke), magnitude, and direction of the proximal and main thoracic (PT and MT) curves were also noted. RESULTS: The shoulder level as depicted by the ICL showed 3 patterns-horizontal, left side elevated, or right side elevated. The T1-ICL relationship was either concordant or discordant. In the concordant case the T1 was tilted to the same side as the ICL; and vice versa in the discordant. The shoulder level was dependent on the MT curve if the ICL tilted to the same side as the MT curve and it was dependent on the PT curve if it tilted to the same side as the PT curve. This relationship appeared unrelated to curve type. CONCLUSIONS: Preoperative shoulder levels in AIS may be concordant with the T1 or discordant-each can have left or right shoulder elevation or balanced shoulders. Further, the shoulder might be MT dependent or PT dependent. Theoretically therefore, surgical balancing of the shoulder and upper instrumented vertebra placement should not depend only on the magnitude and stiffness of the PT curve.


Subject(s)
Posture , Scoliosis/diagnostic imaging , Scoliosis/surgery , Shoulder/diagnostic imaging , Spinal Fusion/methods , Thoracic Vertebrae/surgery , Adolescent , Cohort Studies , Female , Humans , Male , Radiography , Retrospective Studies , Spine/diagnostic imaging , Spine/surgery , Thoracic Vertebrae/diagnostic imaging , Treatment Outcome
2.
J Clin Neurosci ; 12(1): 90-2, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15639423

ABSTRACT

The clinical presentation, investigation, management and outcome of two patients with spontaneous spinal epidural haematoma (SSEH) are presented. CT myelogram revealed an extradural compressive lesion in one patient and MRI confirmed extradural haemorrhage in the second. Both the cases were treated surgically. One patient made a complete recovery and the other made no neurological recovery. The clinical presentation, diagnosis, treatment and factors determining the outcome of SSEH are discussed and the literature reviewed.


Subject(s)
Hematoma, Epidural, Spinal/pathology , Adult , Female , Hematoma, Epidural, Spinal/diagnostic imaging , Hematoma, Epidural, Spinal/surgery , Humans , Laminectomy , Magnetic Resonance Imaging , Male , Middle Aged , Neurosurgical Procedures , Paraplegia/etiology , Quadriplegia/etiology , Tomography, X-Ray Computed
3.
Neurol India ; 45(1): 34-37, 1997.
Article in English | MEDLINE | ID: mdl-29509158

ABSTRACT

We report a female infant with features suggestive of Oral Facial Digital Syndrome (OFDS) Type I and associated cerebellar anomalies with Dandy-Walker malformation which suggest OFDS Type VI. The phenotypic overlap in this child OFDS type I and TypeVI raises the question as to whether they represent separate genetic entities. This pattern of abnormalities appears to be unique.

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