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1.
J Orthop ; 44: 31-32, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37664558

ABSTRACT

In recent years, spine surgery has undergone remarkable advancements, revolutionized the field, and transformed patient care. This special issue of the Journal of Orthopedics provides the best possible knowledge for its readers about the current trends and recent innovations in the field of spine surgery and supports clinicians and surgeons in their daily practice and decision-making process. It covers various topics like artificial intelligence in spine surgery, 3D printing, minimally invasive spine surgery. It also provides needed information on modic changes, management of eary onset scoliosis and recent trends in spinal cord injury management.

2.
J Orthop ; 41: 1-7, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37216021

ABSTRACT

Background: Spine surgery has always been considered technically demanding even in the hands of the most experienced surgeon on account of close proximity of vital soft tissue structures. Technical advancements over the last few decades have been crucial for the progress of this complex speciality which not only increased the surgical accuracy, but patient safety as well. Ultrasonic devices are one such innovation based on piezoelectric vibrations, patented by Fernando Bianchetti, Domenico Vercellotti, and Tomaso Vercellotti in 1988. Methods: We did an extensive literature search on ultrasonic devices and their applications in the field of spine surgery. Results: We present the various ultrasonic bone devices available including their physical, technologic and clinical aspects in spine surgery. We also attempt to cover the limitations and future advances of Ultrasonic bone scalpel (UBS) in particular, which would be interesting and informative for any spine surgeon who is novice in this field. Conclusion: UBS has been found to be safe and effective in all forms of spine surgeries offering distinct advantages over conventional instruments, although limited by an inherent learning curve.

3.
JBJS Case Connect ; 12(2)2022 04 01.
Article in English | MEDLINE | ID: mdl-35703159

ABSTRACT

CASE: An elderly obese woman with comorbidities presented with acute-onset altered sensorium. She was diagnosed with meningitis and started on empirical antibiotics. She became oriented after 48 hours and mentioned that she had severe low backache in the previous week. Examination revealed bilateral lower limb weakness. Magnetic resonance imaging showed L3-L4 lumbar facetal abscess (LFA) with epidural extension. Posterior instrumented decompression was performed. Tissue culture grew Enterococcus, and the patient was administered vancomycin and linezolid. At 3 months, there was complete neurological recovery, and she was normal at the 1-year follow-up. CONCLUSION: This report highlights the rare presentation of LFA complicating meningitis and its treatment.


Subject(s)
Epidural Abscess , Low Back Pain , Meningitis , Aged , Epidural Abscess/complications , Epidural Abscess/diagnostic imaging , Female , Humans , Low Back Pain/etiology , Lumbosacral Region , Magnetic Resonance Imaging , Meningitis/complications
4.
Global Spine J ; 11(1): 63-70, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32875839

ABSTRACT

STUDY DESIGN: Retrospective cohort study. OBJECTIVES: Thoracic and lumbar fracture dislocations (TLFD) are high-velocity injuries and frequently result in gross neurological deficit. Very rarely, such patients present with intact neurology. Pathomechanics of injury, radiological assessment, surgical techniques, and principles of fixation in such challenging situations have not been described previously. METHODS: Retrospective review of 36 patients of TLFD without cord injury was performed for demographics, clinical and radiological data, and management. The injuries were classified based on the direction of translation into 4 types: coronal translation (type 1), sagittal translation (type 2), combined translation-antero (type 3a), and combined translation-retro (type 3b). The injuries were managed by meticulous unilateral exposure and temporary fixation, decompression, gradual reduction of dislocation, and long segment fixation. RESULTS: In 36 patients, the injuries were classified as type 1 (n = 9), type 2 (n = 10), type 3a (n = 14), and type 3b (n = 3). Imaging/intraoperative observation showed varying degrees of disintegrity of disc, facet joints, and posterior ligamentous complex in the 4 different injury types. Patients with the different injury types also needed individualistic surgical approaches to aid safe reduction of dislocation. Neurological assessment was performed using American Spinal Injury Association score (ASIA), and 16 patients had minimal neurological deficits (ASIA-D) and all were type 3 injury. The mean anteroposterior and lateral translation were corrected from 8.3 ± 3.4 to 1.7 ± 1.3 mm, and 4.7 ± 4.8 to 0.7 ± 0.8 mm respectively. CONCLUSION: This is the largest case series of TLFD without cord injury. Knowledge of the different injury types and principles of safe surgical reduction of the dislocation are important for the treating surgeon to ensure successful outcomes.

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