RESUMO
BACKGROUND: "Cervical spondylosis" (CS) is a collective term used for non-specific neck pain post 30 age group. Management of CS is mainly non-surgical, particularly in mild to moderate severity that includes the oral anti-inflammatory drugs, exercises, manipulation, mobilization, or combination of these. OBJECTIVE: The objective of the study is to assess the possible benefit of a selected group of asana in a group of patients over a short time frame and assess their functional outcome. MATERIALS AND METHODS: An observational study of cohort of patients having mild to moderate CS, who visited the AYUSH department between May 2016 and November 2016 were included. "Selected group of Asana (SGOA)" was practiced for 30 min supervised and then home-based for a period of 8 weeks with usual standard treatment. Patients followed up fortnightly, and their degree of severity & disability assessed. RESULTS: Thirty patients with 19 males and 11 females having ages mean ± SD 45.61 ± 8.3 and 44.18 ± 9.78 having NDI score of mean ± SD 17.83 ± 4.749 at baseline (0 weeks) were included. Patients showed an improvement in NDI score to finally 7.40 ± 3.180, p-value = 0.0001. This improvement was also noted at various time intervals (p-value = 0.0001 each time), as seen in the post hoc analysis. CONCLUSION: Yogic practices "Specific Group of Asana" done for eight weeks on a home-based program could be useful in reducing pain and disability in people suffering from CS of mild to a moderate degree. However, more extensive, comparative, and multi-centric trials are required for establishing this as a treatment modality.
RESUMO
Hydatid cyst disease of the spine is rare, and only a few are reported in the scientific literature. This infection is caused by the larvae of Echinococcus granulosus cestode. The presentation is usually late because the patient remains asymptomatic for a longer duration after the infection. The initial form of treatment is always surgical in a symptomatic patient for excision of the diseased tissue. A 35-year-old male presented in the outpatient department with a chief complaint of mid-back pain and intermittent history of fever following his back surgery for 4 years. The patient has taken presumptive treatment for tuberculosis before presenting it to us. Radiological investigations dictate the presence of hydatid cyst in the D4 vertebra. Intact cysts were excised with perioperative albendazole coverage. The patient was mobilized on postoperative day-1 with Taylor's brace, and the brace was continued for 6 weeks. The patient was followed up at regular intervals for 1 year, and no recurrence was found. Hydatid cyst disease in the spine is a rare disease but associated with high morbidity despite significant advances in diagnostic imaging techniques and surgical treatment. For a provisional diagnosis, magnetic resonance imaging is the investigation of choice. Surgical decompression is the main stray of treatment along with antihelminthic therapy. A close follow-up is required after the initial treatment to find the recurrence at the earliest.
RESUMO
Introduction: Neglected hip dislocation in adults may present as a dilemma to an orthopedic surgeon and is an uncommon occurrence. Literature mentions both closed reduction and open reduction as methods of management but mostly in children. Few cases have been present in the literature regarding adults with neglected hip dislocations. While almost all have failed in closed reduction, the open reduction has not yielded good results and total hip arthroplasty (THA) as a single stage procedure has not been explored much in regard to neglected isolated posterior dislocations of the hip. We report a series of three cases all with neglected dislocation of over 1 year which was managed with single stage total hip replacement. Case Series: Three cases of neglected posterior dislocation of the hip of more than 1 year (26 years, 28 years, and 32 years of age all males) presented with right leg in adduction, flexion, and internal rotation deformity and painful limp. They were all managed inadequately by traditional bonesetters. No signs of acetabular fracture or avascular necrosis (AVN) were present in radiography and computer tomography. A global softening of the femoral head was encountered in all the cases and uncemented THA was done. All patients did well with good to excellent functional outcomes (Harris hip score [HHS] of 81, 91, and modified HHS of 83) with a minimum of 1 year follow-up. No post-operative complications were encountered. Conclusion: We want to emphasize the lack of literature concerning adult patients with neglected dislocations. Single stage THA is the best option considering the occurrence of AVN of the femoral head with global softening in such cases. A single stage THA attains good to excellent functional outcomes without any early post-operative complications.