scholarly journals Spinal Pedicle Morphometry using Multidetector CT—An experience from the Indian Subcontinent

2021 ◽  
Author(s):  
Samaresh Sahu ◽  
Ravinder Yadav ◽  
Manoharan D. Sudhan ◽  
Akhilesk Rao ◽  
Aneesh Mohimen
Keyword(s):  
Lumbar Spine ◽  
Indian Population ◽  
Multidetector Ct ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
Pedicle Screws ◽  
Lumbar Vertebra ◽  
Study Population ◽  
Screw Diameter ◽  
Pedicle Width

Abstract Introduction For safe pedicle screws placement, knowledge of pedicle morphometry is essential, because an inconsistency between pedicle width and the screw diameter may lead to severe complications like nerve, vessel or visceral injuries. Objectives To study the spinal pedicle width and height of lumbar spine, using multidetector CT (MDCT), among the Indian population.  To study the spinal pedicle angulation of lumbar spine, using MDCT, among the Indian population. Method The study was conducted at a tertiary care multispecialty hospital. In the present study, a total of 321 patients were included, who underwent MDCT scan without contrast at our institution, over a period of 2 years, from May 2017 to May 2019. The study population (n = 321) was divided into different subgroups on the basis of the age. The data was taken from the workstation. Comparison was made separately between each subgroup. Results In our subset of population, the 10 to 90 years age group, pedicle dimensions are as follow: The pedicle diameter from L1 to L5 is 4.46 to 11.92 mm. The pedicle height from L1 to L5 is 7.38 to 11.01 mm. The pedicle axial angulation from L1 to L5 is 22.27 to 36.08 degree. The pedicle lateral angulation from L1 to L5 is 16.12 to 22.47 degree. Conclusion Knowledge of the pedicle morphometry (pedicle width, height and angulation) of lumbar spine will help the neurosurgeons standardize the size of pedicle screws which is required for spinal fixation surgery at various lumbar vertebra levels.

Preliminary screening for orthorexia nervosa in undergraduate student population of north India using ORTO-15 questionnaire

2021 ◽  
Vol 7 (2) ◽  
pp. 79-83
Author(s):  
Mohita Singh ◽  
Jyoti Sethi ◽  
Meenakshi Garg ◽  
Parul Singh ◽  
Utkarsh Sethi
Keyword(s):  
Indian Population ◽  
Indian Subcontinent ◽  
Asian Population ◽  
Orthorexia Nervosa ◽  
North India ◽  
Preliminary Screening ◽  
Prevalence Studies ◽  
High Prevalence ◽  
Study Population ◽  
Young Students

Orthorexia is a term used for “obsession for healthy and proper nutrition”. ON is a recently identified disorder and prevalence studies are mainly limited to Eurasian and Scandanavian countries. There is a paucity of literature currently available for Asian population and more specifically for the Indian population. Therefore, the present study was designed to estimate the prevalence of Orthorexia Nervosa in Indian population. To estimate the prevalence of ON in young North Indian population and to highlight its characteristics. The study population consisted of 448 young students (males=173, females=275). The ORTO-15 questionnaire developed by Donini et al. was used to determine the prevalence. Subjects who scored below 40 were classified as having ON. : Mean score of the participants in the ORTO-15 was using a 40 point threshold. A total of three fourth of the young students in the study group exhibited orthorexic tendency. High prevalence of ON in young students necessitates that Orthorexia Nervosa trends in general population be assessed in Indian subcontinent for better understanding of eating disorders and its interplay with socio-cultural diversities.

Relationship of Height and Weight to Maximum Safe Pedicle Screw Diameter in the Lumbar Spine

2020 ◽  
Author(s):  
Jonathon Lentz ◽  
Joseph Albano ◽  
Robert Stockton ◽  
Maximillian Ganz ◽  
Larry Lutsky ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Pedicle Screw ◽  
Lumbar Vertebrae ◽  
Pedicle Screws ◽  
Significant Difference ◽  
Operative Planning ◽  
Screw Position ◽  
Screw Diameter ◽  
Intimate Knowledge ◽  
Relationship Of

Abstract Background Safely performing instrumented spinal fusion requires an intimate knowledge of anatomy and variations. Pedicle screw position and size have implications on intraoperative and post-operative complications. While pre-operative planning with Computed Tomography (CT) scan measurements may be the safest way to judge trajectory and maximal screw size, it is not standard practice for many spine surgeons. We investigated how height and weight correlated with PD. We hypothesized that these routinely obtained, non-invasive measurements would provide an easily referenced data point to aid in perioperative estimation of maximum safe pedicle screw diameter (MSPSD).Methods Coronal cuts of the lumbar spine were assessed to obtain transverse outer cortical PD as measured through the isthmus at lumbar vertebrae one through five. We assessed whether height, weight, and BMI significantly correlated with PD in our diverse population. Results Height and weight were found to significantly correlate with PD. Height explained roughly 10% of the variance in PD, weight explained only 3-4%, and BMI nearly 0%. There were significant differences in this theoretical safety profiles between the “Taller Height” and “Shorter Height” groups for the majority of pedicle screw sizes at L1 through L3. Significant differences between the populations at L4 and L5 were only seen for 8.0 mm screws at the L4 level. At L5, 100% of the “Taller Height” and “Shorter Height” subjects’ pedicles could safely accommodate pedicle screws up to 8.0 mm in diameter.Conclusions We previously reported on the significant difference in PD between different races. The results of this study provide yet another variable to be considered when making radiographic assessments of pedicle diameter.

Accuracy of Free-Hand Pedicle Screws in the Thoracic and Lumbar Spine: Analysis of 6816 Consecutive Screws

Neurosurgery ◽  
2011 ◽  
Vol 68 (1) ◽  
pp. 170-178 ◽  
Author(s):  
Scott L. Parker ◽  
Matthew J. McGirt ◽  
S Harrison. Farber ◽  
Anubhav G. Amin ◽  
Anne-Marie. Rick ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Radiation Exposure ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Intraoperative Fluoroscopy ◽  
Thoracic And Lumbar Spine ◽  
Institutional Experience ◽  
Screw Diameter

Abstract BACKGROUND: Pedicle screws are used to stabilize all 3 columns of the spine, but can be technically demanding to place. Although intraoperative fluoroscopy and stereotactic-guided techniques slightly increase placement accuracy, they are also associated with increased radiation exposure to patient and surgeon as well as increased operative time. OBJECTIVE: To describe and critically evaluate our 7-year institutional experience with placement of pedicle screws in the thoracic and lumbar spine using a free-hand technique. METHODS: We retrospectively reviewed records of all patients undergoing free-hand pedicle screw placement without fluoroscopy in the thoracic or lumbar spine between June 2002 and June 2009. Incidence and extent of cortical breach by misplaced pedicle screw was determined by review of postoperative computed tomography scans. We defined breach as more than 25% of the screw diameter residing outside of the pedicle or vertebral body cortex. RESULTS: A total of 964 patients received 6816 free-hand placed pedicle screws in the thoracic or lumbar spine. Indications for hardware placement were degenerative/deformity disease (51.2%), spondylolisthesis (23.7%), tumor (22.7%), trauma (11.3%), infection (7.6%), and congenital (0.9%). A total of 115 screws (1.7%) were identified as breaching the pedicle in 87 patients (9.0%). Breach occurred more frequently in the thoracic than the lumbar spine (2.5% and 0.9%, respectively; P < .0001) and was more often lateral (61.3%) than medial (32.8%) or superior (2.5%). T4 (4.1%) and T6 (4.0%) experienced the highest breach rate, whereas L5 and S1 had the lowest breach rate. Eight patients (0.8%) underwent revision surgery to correct malpositioned screws. CONCLUSION: Free-hand pedicle screw placement based on external anatomy alone can be performed with acceptable safety and accuracy and allows avoidance of radiation exposure encountered in fluoroscopic techniques. Image-guided assistance may be most valuable when placing screws between T4 and T6, where breach rates are highest.

scholarly journals Baseline titre of Widal amongst healthy blood donors at tertiary care hospital

2017 ◽  
Vol 5 (4) ◽  
pp. 1571
Author(s):  
Ranjana R. Khorgade ◽  
Pramod R. Bhise
Keyword(s):  
Typhoid Fever ◽  
Blood Donors ◽  
Indian Subcontinent ◽  
Tertiary Care ◽  
Care Hospital ◽  
Test Results ◽  
Widal Test ◽  
High Prevalence ◽  
Study Population ◽  
Th 1

Background: Indian subcontinent is a hotspot of Typhoid activity with high prevalence rates. The Widal test is one of the commonly used sero-diagnostic test for typhoid fever in developing countries. Lack of proper knowledge of baseline titre of Widal test can lead to over diagnosis of typhoid fever leading to mismanagement of patients. A single cut off value on average titre among healthy individuals needs to be determined. So, the purpose of the present study was to develop recommendations for the interpretation of Widal test results in the local region. The objectives were to determine the baseline Widal titre of study population and to propose titre-values of significance in the diagnosis of enteric fever.Methods: Sera of 242 apparently healthy blood donors from January 2016 to December 2016 in blood bank and Department of Microbiology, Dr. PDMMC, Amravati, Maharashtra, India were subjected to standard quantitative tube and semi-quantitative slide Widal test to know the titre.Results: Highest titre obtained by tube Widal test for TO was 1:320, for TH- 1:160, for AH- 1:80, and for BH- 1:80. Tube Widal titres of ≤1:160 for TO were seen in 238 (98.34%) and for TH titre of ≤1:80 were seen in 238 (98.34%), TO and TH titres of ≥1:160 were seen in 24 (9.91%) and 4 (1.65%) respectively. TO titre of 1:320 was seen in 4(1.65%) and TH titre of 1:160 was seen in 4 (1.64%). Highest titre obtained by semi-quantitative slide Widal for TO was 1:640, for TH, AH and BH was 1:160.Conclusions: We recommend that TO titre of ≥1:320 and TH titre ≥1:160 as diagnostic of typhoid fever and for AH and BH, titres of ≥1:80 should be considered diagnostic respectively in our region. Because of high expected false positivity rate of slide Widal test.

Trend of Hospital Admission and Outcome Study of Patients Admitted in a Neurology Unit at a Tertiary Care Neuroscience Hospital in Bangladesh

2018 ◽  
Vol 4 (2) ◽  
pp. 69-74
Author(s):  
Md Tauhidul Islam Chowdhury ◽  
Mohammad Shah Jahirul Hoque Choudhury ◽  
KM Ahasan Ahmed ◽  
Mohammad Sadekur Rahman Sarkar ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Total Death ◽  
Neurological Patients ◽  
Study Population ◽  
The Mean ◽  
Day By Day

Background: Neurological disorders is becoming a growing concern both for developed and developing countries. Magnitude of the problem is increasing day by day. Among all neurological disorders, stroke is the leading cause of morbidity and mortality globally.Objectives: The purpose of the study was to see the trend of admission of patients with neurological diseases and to study the outcome of patients at referral neurology hospital in Bangladesh.Methodology: This retrospective chart review was conducted in the blue unit of the Department of Neurology at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from 1st January to 31st December 2016 for a period of one (01) year. All the admitted patients with both sexes were selected as study population. The outcome was observed among the study population.Result: A total number of 1044 patients were admitted during the study period. Majority of the patients were in the age group of the 41 to 50 years which was 417(39.9%) cases. Both male and female were in highest number in the month of May which was 63 and 48 cases respectively. The total death of the study population was 146(14.0%) cases. The mean length of hospital stay was 8.4±2.31 days.Conclusion: Middle aged male is the main bulk of the neurological patients, admitted in a referral neurology hospital in Bangladesh. Highest admission and mortality was observed in stroke patients.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 69-74

A comparative study on screw loosening in osteoporotic lumbar spine fusion between expandable and conventional pedicle screws

2011 ◽  
Vol 132 (4) ◽  
pp. 471-476 ◽  
Author(s):  
Zi-xiang Wu ◽  
Fu-tai Gong ◽  
Li Liu ◽  
Zhen-sheng Ma ◽  
Yang Zhang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Comparative Study ◽  
Pedicle Screws ◽  
Spine Fusion ◽  
Screw Loosening ◽  
Lumbar Spine Fusion

Hypophosphataemia at a large academic hospital in South Africa

2008 ◽  
Vol 61 (10) ◽  
pp. 1104-1107 ◽  
Author(s):  
M Hoffmann ◽  
A E Zemlin ◽  
W P Meyer ◽  
R T Erasmus
Keyword(s):  
South Africa ◽  
Intensive Care ◽  
Tertiary Care ◽  
Neoplastic Disease ◽  
Western Cape ◽  
Tertiary Care Centre ◽  
Refeeding Syndrome ◽  
Common Causes ◽  
Study Population ◽  
Patient Groups

Aim:The aim of this study was to determine the most common causes of hypophosphataemia (⩽0.5 mmol/l) in a hospital population in order to identify patient groups at risk of developing the condition.Methods:The study was conducted at Tygerberg Hospital, a tertiary care centre in the Western Cape, South Africa. All patients identified with a phosphate level ⩽0.5 mmol/l during an 18-month period were included in the study. Medical records of these patients were reviewed.Results:Of all the requests received for serum phosphate determination by the laboratory, 2% (861 out of 45 394 requests) were ⩽0.5 mmol/l. Thirty per cent (30%; n = 189) of the patients in the study population died during their hospital stay. Most (45%; n = 278) of the patients with low phosphate levels occurred in an intensive care setting, whereas 10% (n = 63) were most likely due to refeeding, and 6% (n = 35) had neoplastic disease. Sepsis was implicated as a contributing factor in 26% (n = 162).Conclusion:Severe hypophosphataemia is associated with a very high mortality (30%, n = 189). Patients with a high risk of developing hypophosphataemia include those in an intensive care unit (ICU), patients suffering from neoplastic diseases, possible refeeding syndrome and septic patients. Regular phosphate determination is recommended in these patients to facilitate early diagnosis of hypophosphataemia.

scholarly journals Clinical analysis of gynecological diseases in postmenopausal women in tertiary care centre

2018 ◽  
Vol 7 (4) ◽  
pp. 1394
Author(s):  
Bharti Choudhary Parihar ◽  
Priyanka Tiwari
Keyword(s):  
Pelvic Organ Prolapse ◽  
Age Of Onset ◽  
Tertiary Care ◽  
Pelvic Organ ◽  
Clinical Analysis ◽  
Tertiary Care Centre ◽  
Indian Women ◽  
Urogenital Infections ◽  
Gynecological Diseases ◽  
Study Population

ABSTRACTBackground: Menopause is a natural step in ageing process represents the period end of menstruation after last menstrual period in previous 12 months. Gynaecological disorder in older women differs from those who are younger. Disorders peculiar to ageing are pelvic organ prolapse, urinary incontinence, genital infections and malignancies. Present study is contemplated with a view to assess the magnitude of postmenopausal gynaecological morbidity. The goal of this study was to assess the age of onset of menopause and the spectrum of different gynaecological diseases, their incidence, diagnosis and treatment modality in postmenopausal females.Methods: A Prospective observational study of postmenopausal females attending Gynecology OPD or admitted in Sultania Zanana Hospital, Bhopal was carried out between July 2014 to June 2015. Total 401 postmenopausal females were included. Age of menopause and detail of all gynecological problems were recorded using predesigned proforma.Results: The study population was drawn from both rural (41.4%) and urban (58.8%) areas. Mean age of onset of menopause was 48.01 years in study population. In all, 28.4% had pelvic organ prolapse, 26.6% had genital malignancies, 25.5% had urogenital infections and 17.7% had benign disorder like senile endometritis, fibroid uterus etc.Conclusions: Menopausal health has been one of the neglected area in our country and needs timely vital attention as they are at risk of developing various genital malignancies. This emphasises the need for a screening programme for Indian women in our scenario.

Hybrid dynamic stabilization: a biomechanical assessment of adjacent and supraadjacent levels of the lumbar spine

2012 ◽  
Vol 17 (3) ◽  
pp. 232-242 ◽  
Author(s):  
Prasath Mageswaran ◽  
Fernando Techy ◽  
Robb W. Colbrunn ◽  
Tara F. Bonner ◽  
Robert F. McLain
Keyword(s):  
Lumbar Spine ◽  
Lumbar Fusion ◽  
Industrial Robot ◽  
Pedicle Screws ◽  
Axial Rotation ◽  
Dynamic Stabilization ◽  
Follower Load ◽  
Lateral Bending ◽  
Intact Specimen ◽  
Flexion Extension

Object The object of this study was to evaluate the effect of hybrid dynamic stabilization on adjacent levels of the lumbar spine. Methods Seven human spine specimens from T-12 to the sacrum were used. The following conditions were implemented: 1) intact spine; 2) fusion of L4–5 with bilateral pedicle screws and titanium rods; and 3) supplementation of the L4–5 fusion with pedicle screw dynamic stabilization constructs at L3–4, with the purpose of protecting the L3–4 level from excessive range of motion (ROM) and to create a smoother motion transition to the rest of the lumbar spine. An industrial robot was used to apply continuous pure moment (± 2 Nm) in flexion-extension with and without a follower load, lateral bending, and axial rotation. Intersegmental rotations of the fused, dynamically stabilized, and adjacent levels were measured and compared. Results In flexion-extension only, the rigid instrumentation at L4–5 caused a 78% decrease in the segment's ROM when compared with the intact specimen. To compensate, it caused an increase in motion at adjacent levels L1–2 (45.6%) and L2–3 (23.2%) only. The placement of the dynamic construct at L3–4 decreased the operated level's ROM by 80.4% (similar stability as the fusion at L4–5), when compared with the intact specimen, and caused a significant increase in motion at all tested adjacent levels. In flexion-extension with a follower load, instrumentation at L4–5 affected only a subadjacent level, L5–sacrum (52.0%), while causing a reduction in motion at the operated level (L4–5, −76.4%). The dynamic construct caused a significant increase in motion at the adjacent levels T12–L1 (44.9%), L1–2 (57.3%), and L5–sacrum (83.9%), while motion at the operated level (L3–4) was reduced by 76.7%. In lateral bending, instrumentation at L4–5 increased motion at only T12–L1 (22.8%). The dynamic construct at L3–4 caused an increase in motion at T12–L1 (69.9%), L1–2 (59.4%), L2–3 (44.7%), and L5–sacrum (43.7%). In axial rotation, only the placement of the dynamic construct at L3–4 caused a significant increase in motion of the adjacent levels L2–3 (25.1%) and L5–sacrum (31.4%). Conclusions The dynamic stabilization system displayed stability characteristics similar to a solid, all-metal construct. Its addition of the supraadjacent level (L3–4) to the fusion (L4–5) did protect the adjacent level from excessive motion. However, it essentially transformed a 1-level lumbar fusion into a 2-level lumbar fusion, with exponential transfer of motion to the fewer remaining discs.

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