Osteoporotic Vertebral Compression Fracture and Single Balloon Extrapedicular Kyphoplasty: Findings and Technical Considerations.

OBJECTIVE: To evaluate the functional and radiological outcome of balloon kyphoplasty and to endorse the unilateral single balloon extrapedicular kyphoplasty as practically more feasible and safer method in comparison to the conventional methods. METHODS: Totally, 81 patients were presented to our center with osteoporotic vertebral compression fracture. Among these, 59 patients (61 vertebrae) were enrolled with stable wedge osteoporotic compression fracture. Pre-operatively percentage of vertebral height loss and kyphotic angle were calculated and single balloon extrapedicular kyphoplasty was performed in all cases. RESULTS: Postoperatively, anterior vertebral height improved to 79.61% of normal subjects. In our study, the mean segmental kyphosis correction following balloon kyphoplasty was 14.27°. Overall incidence of cement leak in our study was 15.25%. CONCLUSION: Although we encountered the few difficulties, but this technique holds the safety and feasibility measures. Furthermore, it is effective in restoring anterior vertebral height, alignment and angle of kyphosis.

Rare Case of Bilateral Pure Facet Joint Dislocation of Upper Lumbar Spine without Facet Fracture: A Case Report.

INTRODUCTION: Bilateral facetal dislocation without facet fracture, although common in cervical spine, is a very rare entity in lumbar spine with <15 cases reported so far. Such injuries are very unstable involving all the three columns. Neurological insult and visceral affection are commonly associated with bilateral facetal dislocation. CASE REPORT: A 22-year-old gentleman presented with ASIA Aparaplegia following road traffic accident. Radiographs/computed tomography scan revealed pure facetal dislocation L1-L2 with no evidence of facet fracture. The patient also had liver laceration. The patient underwent open instrumented reduction along with left-sidedtransforaminal removal of damaged disc and inter body fusion. The patient improved significantly to ASIA C neurological status at 6-month follow-up. CONCLUSION: Pure facetal dislocation, although rarely seen in lumbar region, is a very unstable injury. Prompt recognition and early intervention facilitate nursing care and neurological recovery. Recognition of associated injuries is also important.

Outcomes of Unstable Subaxial Cervical Spine Fractures Managed by Posteroanterior Stabilization and Fusion.

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate clinical and radiological outcomes of unstable subaxial cervical spine injuries managed by both posterior tension band column stabilization and anterior decompression, stabilization, and fusion. OVERVIEW OF LITERATURE: Unstable subaxial cervical spine injuries often involve disruption of the anterior column and posterior tension band osteoligamentous complex. Such injuries need immediate surgical intervention. Different methods of reduction and surgical approaches have been published in the literature, with lack of consensus on a uniform or standardized method. Controversy still exists regarding stabilization of unstable cervical fractures by anterior or posterior approach alone or combined approaches. METHODS: We retrospectively evaluated 24 patients with post-traumatic unstable subaxial cervical spine injuries with their preoperative clinical details, X-ray, computed tomography, and magnetic resonance imaging of the cervical spine for fracture classification based on the mechanism of injury with status of disc herniation and posterior tension band disruption. All patients were managed by immediate reduction, posterior and anterior stabilization, and fusion in a single session of anesthesia. Data of all patients were analyzed with respect to pre- and postoperative neurological status based on American Spinal Injury Association grading, Visual Analog Scale score, the observation of bony fusion, and implant failure at 1, 3, 6, and 12 months. Data were analyzed using paired t-test. RESULTS: All patients had solid fusion at the desired level with considerable neurological improvement at the 1-year follow-up. CONCLUSIONS: In unstable cervical injuries, stabilization of disrupted posterior tension band increases the stability of anterior plating and fusion. This method of immediate reduction and circumferential stabilization is rapid, safe, and effective and has a low rate of complications.

Reverse V osteotomy and treatment of cubitus varus deformity - Results and experience.

INTRODUCTION: Cubitus varus is a most common repercussion of malunited supracondylar fracture of humerus in paediatric age group. Initially, valgus osteotomies were in trend, but due to higher rate of complications, these procedures are not in trends today, as they were earlier. Here, we are sharing our experience and results of reverse V osteotomy done for cubitus varus. MATERIAL AND METHOD: Reverse V osteotomy was done on 20 patients of cubitus varus (due to malunited supracondylar fracture of humerus). After correcting the deformity, cross K-wires and wiring (from lateral side) or Y-shaped plate was used for internal fixation. Y-shaped plate was used in older (in 20% cases) and K-wire was used for internal fixation in younger patients. All the patients underwent follow-up by clinical-radiological means and the analysis of functional outcome was done by the criteria of Oppenheim et al. RESULTS: Based on the Oppenheim's criteria, our results were 90% excellent and 10% good, among the 20 cases. CONCLUSION: We concluded in this study that reverse V osteotomy provides inherent stability and its stable behaviour further strengthened by internal fixation. It is a safe technique for correcting cubitus varus with aesthetic satisfaction.

Isolated plexiform neurofibroma of arm with unusual presentation - a rare case report.

Plexiform neurofibroma (PNF) arises as a diffuse mass from nerve trunk and leads to overgrowth of cutis and subcutis structure. This is a case report of 20-year-old male, presented to our hospital with a giant ulcerated swelling over his left arm. Differential diagnosis of sarcoma, neurofibroma, hemangioma and angiolipoma was made but biopsy confirmed the diagnosis of plexiform neurofibroma. Isolated PNF with ulceration of overlying skin over arm is a rare presentation and here we are presenting it as a perusal of rare entity.

Non-Traumatic Fracture Of Pedunculated Osteochondroma - A case report and brief review of literature.

INTRODUCTION: Non-traumatic fracture of pedunculated osteochondroma is a known, but rare complication. Treatment protocols for such complication are debatable, however, surgical intervene have been advocated. CASE REPORT: 14 years old male presented with pain and redness around the knee with no history of injury. Radiograph showed fracture of solitary osteochondroma of femur. Excision was done through posterolateral approach and confirmed with histopathology. Patient returned to activities at 2 weeks post surgery. CONCLUSION: Atraumatic fractures may occur due to strong muscular contractions in cases of pedunculated osteochondroma. Surgical excision gives prompt relief from symtoms.