Double trouble: Concurrent ossification of ligamentum flavum with infective spondylodiscitis in the thoracic spine resulting in paraplegia: A case report.

Background: Thoracic ossification of the ligamentum flavum (OLF) and tuberculous infective spondylodiscitis rarely combine to cause paraplegia. Here, a 48-year-old female with both thoracic OLF and tuberculous spondylodiscitis experienced the acute onset of paraplegia successfully managed with a T8-L1 laminectomy with fusion.

Case Description: A 48-year-old female presented with the acute onset of paraplegia attributed to magnetic resonance-documented thoracic OLF and infective spondylodiscitis.

The objective measurement of hypoaesthesia after Total Knee Arthroplasty and its correlation with skin incision length: a prospective study.

Purpose: This study aims to measure the peri-incisional numbness developing after Total Knee Arthroplasty (TKA) performed using the midline skin incision. It studies the natural course of the numbness and determines its correlation with the skin incision length (SIL).

Materials & Methods: 66 knees undergoing primary TKA with a standard midline incision were evaluated.

Aspergilloma Superinfection in the Spinal Canal of an 18-Year-Old Man: A Case Report.

Case: An 18-year-old immunocompetent man presented with symptomatic lumbar canal stenosis, discharging sinuses, and cold abscess for 3 years treated with multiple incision drainage procedures with cottonoid packing antibiotic therapy. Radiographic imaging showed a soft tissue mass in the canal causing bony destruction. Postoperative histopathological examination showed an Aspergillus fungal ball.

Delayed presentation of Wilkie's syndrome after scoliotic curve correction surgery: a case report.

Background: Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, is a rare but serious complication following scoliosis correction surgery. It occurs as a result of mechanical compression of third part of duodenum between the SMA and aorta. This condition occurs most commonly in significantly underweight patients with deformities, and usually during the first week following spinal deformity corrective surgeries.

Functional and radiological outcomes following craniovertebral junction surgery.

Background: Craniovertebral junction (CVJ) pathologies include atlantoaxial instability/deformities resulting in myelopathy, respiratory failure, and even death. Here, we describe the indications, preoperative planning, and intra-operative/postoperative complications following surgical management of CVJ anomalies.

Methods: A prospective analysis of 34 patients with CVJ pathology was evaluated between 2015 and 2022.

Tibial lengthening for massive distal femoral bone loss.

A man in his 30s was involved in a road traffic accident (RTA) and sustained a grade-IIIA distal femur fracture with acute loss of distal two-third of the femur. Initially, damage control surgery was done by an external fixator application. Later, staged limb reconstruction surgery was undertaken as a definitive procedure that involved bifocal distraction osteogenesis involving the proximal tibia and femur along with docking of the corticotomised femoral fragment onto the tibial plateau to achieve knee arthrodesis.

A novel technique of managing an irreducible posteriorly displaced type 2 odontoid fracture: A case report.

Background: Type 2 odontoid fractures with posterior displacement are rare. Most acute cases reported in the literature are readily reduced with traction alone. Here, we reviewed the management of a chronic, posteriorly displaced odontoid fracture that was managed with a unique posterior reduction maneuver.

Impairments in pulmonary functions in paediatric spinal tuberculosis: a cross-sectional study.

Purpose: This study aimed to investigate the impact of vertebral column destruction and kyphotic deformity due to spinal tuberculosis on pulmonary functions in paediatric patients.

Methods: A cross-sectional study was conducted, involving 30 patients diagnosed with healed spinal tuberculosis, aged 7-18 years. Detailed radiographic measurements, including the level of involvement, kyphosis angle, Spinal Deformity Index (SDI), and drug-resistance status, were compared with various pulmonary function parameters.

Efficacy of Periarticular Local Infiltrative Analgesic Injection on Postoperative Pain Control and Functional Outcome in Sequential Bilateral Total Knee Replacement: A Prospective Controlled Trial in 120 Consecutive Patients.

Background: One of the drawbacks of total knee replacements (TKR) is the early postoperative pain, which affects patient satisfaction and increases the duration of rehabilitation. The present study analyzes the potency of local infiltrative analgesia and its effect on rehabilitation in bilateral sequential TKRs.

Materials And Methods: The present prospective observational study was conducted on 120 patients undergoing bilateral sequential TKR performed by a single surgeon using an anterior midline incision with a standard medial parapatellar approach.

Management Dilemma of a Neuropathic Knee in a Known Case of Larsen Syndrome: A Case Report.

Introduction: Larsen syndrome (LS) is a rare genetic disorder affecting mainly the connective tissues. It is characterized by characteristic facial anomalies, cervical kyphosis, cardiorespiratory disorders, and multiple joint dislocations. We present a case of a 15-year-old male with unstable neuropathic knee joint instability in a known case of LS.

Outcome of Joint Aspiration in Acute Knee Haemarthrosis in a Haemophilic Joint: A Prospective Randomised Controlled Trial in 120 Patients in a Tertiary Haemophilia Care Centre.

Background: Bleeding into the joints cause major morbidity in haemophilia patients. The clinical hallmark of haemophilia is haemarthrosis especially in knee, ankle and elbow joint. Current literature suggests that aspiration of an acute haemarthrosis in haemophilia may lead to further bleeding and prevent tamponade effect.

The influence of joint line restoration on functional outcome after primary total knee arthroplasty: A prospective study.

Objective: Restoration of proper joint line position after primary total knee arthroplasty (TKA) is important for improved knee function and kinematics. We reviewed the magnitude of joint line alteration and the resulting effect on post-operative knee outcomes scores at one year follow-up.

Materials And Methods: 120 patients who underwent TKA for primary osteoarthritis knee were included.

Proximal Thoracic Kyphoscoliosis with Dorsal Myelopathy in a Case of Congenital Absence of Thoracic Pedicles: A Case Report.

Case: A 14-year-old boy with proximal thoracic kyphoscoliosis associated with the bilateral absence of thoracic pedicles presented with progressive deformity, paraparesis, and difficulty in ambulation. The case was managed by preoperative halo traction, single-stage 2-level vertebral column resection, decompression, and arthrodesis of thoracic vertebrae. Two years postoperatively, the patient showed neurological improvement, leading to unassisted ambulation and fusion at the corpectomy site.

Functional outcomes in the management of cervicothoracic junction tuberculosis.

Background: We analyzed the clinical and radiological parameters influencing functional outcomes and neurological recovery in patients with cervicothoracic junctional tuberculosis (TB).

Methods: This was a retrospective analysis of 16 cases of cervicothoracic junction (CTJ) spinal TB; 11 patients were managed operatively, while five were managed conservatively. Patients' outcomes were assessed at 1 month, 1 year, and yearly thereafter and included an analysis of multiple outcome scores, various radiographic parameters, and sensitivity or resistance to anti-tubercular therapy.

Clinicoradiological outcome of percutaneous intralesional polidocanol in Aneurysmal Bone Cysts: A prospective study of 43 patients in a single tertiary care centre.

Objective: The study reports the efficacy of sequential instillations of intralesional percutaneous polidocanol in the treatment of skeletal ABC. The study also analyses the pain relief, recurrence, radiological outcome and complications after percutaneous sclerotherapy.

Materials And Methods: A total of 43 patients with ABC were managed by fluoroscopy assisted percutaneous intralesional sclerotherapy with 3% Injection Polidocanol under suitable anaesthesia.

A case of cervical OPLL and DISH mimicking stroke.

Background: Ossification of the posterior longitudinal ligament (OPLL) is a progressive disorder that mostly involves the cervical spine. It is more prevalent in East Asian countries. Patients typically present with the gradual onset of myelopathy, while about 5% show rapid progression.

Isolated L5 nerve root injury without osseous disruption in a case of gunshot injury to the paediatric spine-A case report.

Introduction: There exists sparse literature on Gunshot injuries (GSI) to the pediatric spine, its natural course, management protocols and outcomes following surgical intervention. Here, we present a projectile injury to the paediatric lumbar spine without any osseous disruption in a 5-year-old child requiring surgical management.

Case Presentation: A 5-year-old child presented with a gunshot injury to the pediatric lumbar spine.

Short-Term Analysis of the Changes in the Bone Mineral Density of the Proximal Femur After Uncemented Total Hip Arthroplasty: A Prospective Study of 110 Patients.

Introduction Mechanical loading continuously exposes the bone to remodeling processes. Increased load leads to a gain in bone mass, and reduced load results in a loss. After inserting a prosthesis, the proximal femur is bypassed in loading as the bodyweight shifts distally.

Severe Kyphotic Deformity Involving Thoracolumbar Region -A Management Dilemma.

Introduction: Thoracolumbar kyphosis is common cause of sagittal spinal malalignment. Neglected tuberculous infection in childhood often presents as kyphotic deformity in adulthood, especially in India, where tuberculosis is endemic. Complete clinical and radiological evaluation is necessary to decide need for surgical intervention.

A Rare Case of Lateral Displacement of Median Nerve in a Dislocated Elbow and its Management.

Introduction: Elbow dislocation usually presents with a deformity and swelling, yet it can also present with neurological complication. Nerve injury with dislocation is common in the pediatric age group and is reported infrequently among adults. The most common nerve involved with dislocation is the ulnar nerve followed by the median nerve.

Evaluation of functional outcome and neurological recovery pattern in patients with retro-thecal tubercular epidural abscess managed at a tertiary center.

We performed a retrospective observational study to analyze the neurological recovery pattern in patients with a sub-laminar retro-thecal epidural abscess managed at our tertiary apex center from 2014 to 2020. We evaluated the Maximal Spinal Cord Compression (MSCC) ratio on Magnetic Resonance Imaging (MRI), the time interval between the appearance of neurological deficit and the initiation of management, spasticity as per Modified Ashworth Scale, presence of drug resistance, and the Lower Extremity Motor Score (LEMS). All patients were given anti-tubercular chemotherapy.

A rare case of an expansile spinopelvic aneurysmal bone cyst managed with embolization, excision, and fusion.

Background: Aneurysmal bone cysts (ABC) are benign osteolytic lesions of the metaphyseal regions of long bones that typically contribute to rapid bony expansion. Here, we present an ABC involving the spinopelvic region in a 15-year-old male that required embolization, surgical excision, and fusion.

Case Description: A 15-year-old male, presented with gradually progressive painful lower back swelling of 4 months' duration.

Is Bilateral Sequential Total Hip Replacement as Safe an Option as Staged Replacement? A Matched Pair Analysis of 108 Cases at a Tertiary Care Centre.

Background: Rationale for symptomatic severe bilateral arthritis of the hip is sequential bilateral THR completed under the same anaesthesia. The rarity of procedures and apprehension of complications preclude the widespread use.

Materials And Methods: Retrospective analysis of prospectively collected data from 108 patients (216 hips) with bilateral arthritis who underwent total hip arthroplasties was done: out of which 54 patients (108 hips) underwent a single-stage sequential procedure (sequential group) and a matched group of 54 patients (108 hips) underwent a two-stage procedure at different admissions (staged group).

Are we neglecting long-term effects of vertebral shortening on pulmonary function in spinal tuberculosis?

Purpose: In developing part of the world, it is common to see complete destruction of vertebral bodies in tuberculosis. Our study aims to assess the effect of spinal tuberculosis with vertebral shortening on pulmonary function.

Methods: Fifty cases of spinal TB (14 males, 36 females) managed both operatively and non-operatively, who presented to tertiary care institute between years 2011 and 2016 were assessed.

Degenerative Cervical Spondylosis: A Cause of Vertigo?

Study Design: Prospective observational study.

Objectives: Studying the effect of degenerative cervical spondylosis(CS) on blood flow velocity of vertebral artery (VA) during cervical spine rotation in different head positions and its association with vertigo.

Introduction: Vertigo is one of the most common complaints seen in an out-patient clinic.