scholarly journals Non degenerative disease in MRI cervical spine of symptomatic patients

2016 ◽  
Vol 11 (4) ◽  
pp. 20-23
Author(s):  
Dan B Karki ◽  
Om Biju Panta ◽  
Ghanashyam Gurung
Keyword(s):  
Neck Pain ◽  
Degenerative Change ◽  
Degenerative Disease ◽  
Medical Sciences ◽  
Disc Disease ◽  
Signal Change ◽  
Neoplastic Lesions ◽  
Traumatic Lesions ◽  
Common Etiology ◽  
Operative Findings

Background & Objectives: The most common etiology of neck pain is degenerative disc disease, however non-degenerative disease can be important cause of neck pain. This study aims to study the non-degenerative findings in cervical MRI in symptomatic patients with neck and radicular pain.Materials & Methods: The study was a institutional record based retrospective study performed for the duration of 3 years. MRI performed for patients with neck pain and/ or radiculopathy were reviewed. Patients with post operative findings were excluded from the study. Statistical analysis was done using SPSS 21.0.Results: A total of 721 MRI were performed for neck pain and radiculopathy, among which 91 (12.13%) cases had non-degenerative changes. Most common non degenerative change was traumatic lesions followed by neoplastic lesions and syrinx. Traumatic lesions were more common in males as compared to females. Infection was more common in females as compared to males. C5 and C6 vertebrae were most common vertebra involved in trauma and infection. Some cases like signal change in spinal cord, and syrinx were also noted in our study.Conclusion: Non degenerative cause of neck pain were less common but important cause of neck pain. Traumatic lesions were the most common cause of non degenerative neck pain.Journal of College of Medical Sciences-Nepal, Vol.11(4) 2015: 20-23

scholarly journals Tuberculous Abdominal cocoon in childern– A Single Centre Study in remote area in northern India

2017 ◽  
Vol 90 (2) ◽  
pp. 179-184 ◽  
Author(s):  
Rikki Singal ◽  
Satyashree B ◽  
Amit Mittal ◽  
Bhanu Pratap Sharma ◽  
Samita Singal ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Medical Sciences ◽  
Abdominal Cocoon ◽  
Northern India ◽  
Single Centre Study ◽  
Encapsulating Peritonitis ◽  
Operative Findings ◽  
A Prospective Study ◽  
Tomography Scan

Background. Amongst the numerous causes of intestinal obstruction listed in the literature, sclerosing encapsulating peritonitis also called Abdominal Cocoon (AC) is one of the rarest entities. Its characteristic feature is a thick fibrotic membrane encasing varying lengths of the small and large gut in a cocoon. In India, there is an increasing incidence of tuberculosis, especially in the rural areas.Aims and objectives. The aim of this study was to investigate the clinical presentation and evaluate the operative findings of tuberculous AC. We also evaluated the outcomes and response to anti tuberculous treatment (ATT) in all the patients diagnosed with this condition.Material and methods. This study was carried out at M.M. Institute of Medical Sciences and Research, Mullana, Ambala, India between April 2013 – March 2016 in the Department of Pediatric Surgery. This is a prospective study. A total of 17 patients diagnosed with abdominal cocoon secondary to tuberculosis have been included in the study.Results. A total of 17 patients presented to the emergency ward with features of acute intestinal obstruction. The average age was 15.3 years (range 9 years to 16 years). There were 14 females and 3 males. All patients presented with abdominal pain, bilious vomiting, constipation and abdominal distention. The patients were operated in our hospital and relieved of their obstruction. Based on their operative findings and after histopathological confirmation, patients were given ATT. In the follow-up, all patients did well, without recurrence of tuberculosis or intestinal obstruction. Conclusion. Tuberculosis as a cause of childhood AC is rather common in developing countries and is potentially a fatal condition. A strong clinical suspicion, sonographic and computed tomography scan findings help establish a pre-operative diagnosis. Tuberculous AC has a strong prevalence in females.  Surgery is the mainstay of treatment followed by anti-tuberculous drugs.

Cervical pneumatocyst

2011 ◽  
Vol 15 (3) ◽  
pp. 332-335 ◽  
Author(s):  
Jason M. Hoover ◽  
Doris E. Wenger ◽  
Laurence J. Eckel ◽  
William E. Krauss
Keyword(s):  
Cervical Spine ◽  
Carpal Tunnel Syndrome ◽  
Neck Pain ◽  
Carpal Tunnel ◽  
Chronic Neck Pain ◽  
Cervical Radiculopathy ◽  
Disc Disease ◽  
Left Hand ◽  
Tunnel Syndrome ◽  
Multilevel Fusion

The authors present the case of a 56-year-old right hand–dominant woman who was referred for chronic neck pain and a second opinion regarding a cervical lesion. The patient's pain was localized to the subaxial spine in the midline. She reported a subjective sense of intermittent left arm weakness manifesting as difficulty manipulating small objects with her hands and fingers. She also reported paresthesias and numbness in the left hand. Physical and neurological examinations demonstrated no abnormal findings except for a positive Tinel sign over the left median nerve at the wrist. Electromyography demonstrated bilateral carpal tunnel syndrome with no cervical radiculopathy. Cervical spine imaging demonstrated multilevel degenerative disc disease and a pneumatocyst of the C-5 vertebral body. The alignment of the cervical spine was normal. A review of the patient's cervical imaging studies obtained in 1995, 2007, 2008, and 2010 demonstrated that the pneumatocyst was not present in 1995 but was present in 2007. The lesion had not changed in appearance since 2007. At an outside institution, multilevel fusion of the cervical spine was recommended to treat the pneumatocyst prior to evaluation at the authors' institution. The authors, however, did not think that the pneumatocyst was the cause of the patient's neck pain, and cervical pneumatocysts typically have a benign course. As such, the authors recommended conservative management and repeated MR imaging in 6 months. Splinting was used to treat the patient's carpal tunnel syndrome.

scholarly journals Total laparoscopic hysterectomy: a retrospective study of 5 years

2019 ◽  
Vol 8 (12) ◽  
pp. 5008
Author(s):  
Suma S. Moni ◽  
Suchith Hoblidar ◽  
Rathnamala M. Desai ◽  
Sunil Kumar K. S.
Keyword(s):  
Retrospective Study ◽  
Demographic Data ◽  
Operating Time ◽  
Laparoscopic Hysterectomy ◽  
Bladder Injury ◽  
Medical Sciences ◽  
Operative Specimen ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Operative Findings

Background: Hysterectomy is one of the most common gynecological surgeries performed around the world. This study was done to review the data of all patients who underwent TLH. With this study a uniform method of performing TLH by a single surgeon was assessed.Methods: A 5 years retrospective study was performed at Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital Dharwad, Karnataka India. Demographic data, pre-operative findings, indication for surgery, intra-operative and post-operative complications, duration of surgery were recorded and analyzed.Results: A total of 118 women were included in the study. Mean age of the patients wasMost common indication for the surgery was leiomyoma. Mean operating time was 162.18 minutes. Mean weight of the post-operative specimen was 208.45 grams. Intra-operative urinary bladder injury was seen in 1 patient. Conversion to laparotomy was needed in 2 patients.Conclusions: With improving experience TLH can be performed safely without complications. As number of surgeries done increases duration of TLH reduces. TLH can be effectively used to avoid laparotomy.

scholarly journals The Clinical Correlations between Diabetes, Cigarette Smoking and Obesity on Intervertebral Degenerative Disc Disease of the Lumbar Spine

2017 ◽  
Vol 11 (3) ◽  
pp. 337-347 ◽  
Author(s):  
Ande M. Jakoi ◽  
Gurpal Pannu ◽  
Anthony D'Oro ◽  
Zorica Buser ◽  
Martin H. Pham ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Retrospective Analysis ◽  
Degenerative Disc Disease ◽  
Lumbar Disc ◽  
Degenerative Disease ◽  
Disc Disease ◽  
Lumbar Degenerative Disc Disease ◽  
Degenerative Disc ◽  
Number Of Patients ◽  
Insurance Database

<sec><title>Study Design</title><p>Retrospective analysis of a nationwide private insurance database. Chi-square analysis and linear regression models were utilized for outcome measures.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to investigate any relationship between lumbar degenerative disc disease, diabetes, obesity and smoking tobacco.</p></sec><sec><title>Overview of Literature</title><p>Diabetes, obesity, and smoking tobacco are comorbid conditions known to individually have effect on degenerative disc disease. Most studies have only been on a small populous scale. No study has yet to investigate the combination of these conditions within a large patient cohort nor have they reviewed the combination of these conditions on degenerative disc disease.</p></sec><sec><title>Methods</title><p>A retrospective analysis of insurance billing codes within the nationwide Humana insurance database was performed, using PearlDiver software (PearlDiver, Inc., Fort Wayne, IN, USA), to identify trends among patients diagnosed with lumbar disc degenerative disease with and without the associated comorbidities of obesity, diabetes, and/or smoking tobacco. Patients billed for a comorbidity diagnosis on the same patient record as the lumbar disc degenerative disease diagnosis were compared over time to patients billed for lumbar disc degenerative disease without a comorbidity. There were no sources of funding for this manuscript and no conflicts of interest.</p></sec><sec><title>Results</title><p>The total number and prevalence of patients (per 10,000) within the database diagnosed with lumbar disc degenerative disease increased by 241.4% and 130.3%, respectively. The subsets of patients within this population who were concurrently diagnosed with either obesity, diabetes, tobacco use, or a combination thereof, was significantly higher than patients diagnosed with lumbar disc degenerative disease alone (<italic>p</italic> &lt;0.05 for all). The number of patients diagnosed with lumbar disc degenerative disease and smoking rose significantly more than patients diagnosed with lumbar disc degenerative disease and either diabetes or obesity (<italic>p</italic> &lt;0.05). The number of patients diagnosed with lumbar disc degenerative disease, smoking and obesity rose significantly more than the number of patients diagnosed with lumbar disc degenerative disease and any other comorbidity alone or combination of comorbidities (<italic>p</italic> &lt;0.05).</p></sec><sec><title>Conclusions</title><p>Diabetes, obesity and cigarette smoking each are significantly associated with an increased diagnosis of lumbar degenerative disc disease. The combination of smoking and obesity had a synergistic effect on increased rates of lumbar degenerative disc disease. Patient education and preventative care is a vital goal in prevention of degenerative disc disease within the general population.</p></sec>

scholarly journals Two-level cervical arthroplasty using a “no-distraction” technique

2017 ◽  
Vol 42 (videosuppl1) ◽  
pp. V1
Author(s):  
Deshpande Rajakumar ◽  
Ankit Sharma ◽  
Akshay Hari ◽  
Subhas Konar ◽  
Murali Krishna
Keyword(s):  
Surgical Technique ◽  
Neck Pain ◽  
Vertebral Body ◽  
Degenerative Disease ◽  
Anterior Cervical Fusion ◽  
Cervical Fusion ◽  
Cervical Arthroplasty ◽  
Motion Preservation ◽  
Link Type

Cervical arthroplasty is being recognized as an emerging alternative to anterior cervical fusion with comparable or superior outcomes. The authors describe the surgical nuances of 2-level cervical arthroplasty in a case of 2-level degenerative disease. In this surgical technique, conventional vertebral body distraction has been avoided to prevent facet distraction, which can be a cause of persistent postoperative neck pain. Good motion preservation was observed at the 1-year follow-up examination.The video can be found here: https://youtu.be/YTpRVRXuZZk.

scholarly journals A study of etiological and clinical profile of patients with severe anemia in a tertiary care hospital

2018 ◽  
Vol 5 (6) ◽  
pp. 1422 ◽  
Author(s):  
Dasharatham P. ◽  
V. Samyuktha Reddy
Keyword(s):  
Heart Failure ◽  
Tertiary Care ◽  
Pathological Examination ◽  
Care Hospital ◽  
Severe Anemia ◽  
Medical Sciences ◽  
Nutritional Anemia ◽  
Patients With Heart Failure ◽  
Common Etiology ◽  
Early Detection And Prevention

Background: Though anemia due to iron deficiency is quite common in India there has been little wok done on the incidence of etiopathogenesis of severe anemia without apparent cause. Anemia is prevalent throughout the world. The objective of the present endeavour was to study the prevalence of severe anemia, to form an etiological categorization of anemia and to study the prevalence of heart failure in the study groupMethods: Total of 50 patients admitted to the medical ward of MediCiti Institute of Medical Sciences and meeting all the exclusion and inclusion criterion were studied. All the patients were subjected to a detailed history and physical examination. All cases were examined in detail according to proforma, investigations, pathological examination and other special tests were carried out.Results: Female preponderance in a ratio of 3:2 was seen. Nutritional anemia was the most common etiology and all cases were seen only in females. Fatigue and tiredness were reported by all patients, hepatomegaly was the most in 42% of the patients. 38 (76%) were found to have cardiac murmurs. As the hemoglobin increased the proportion of patients with heart failure reduced. But this trend was not found to be statistically significant. The association between Hb level and presence of hepatomegaly or splenomegaly was not found to be statistically significant. Thrombocytopenia was the most common cytopenia found in 34%. Only 16% of the patients with severe anemia were found to have normocytic normochromic picture.Conclusions: Severe anemia was found to be associated with morbidity. Hence early detection and prevention by vigorous treatment is important.

Cervical spinal disease

2019 ◽  
pp. 697-710
Author(s):  
Navin Furtado ◽  
Georgios Tsermoulas ◽  
Adikarige Haritha Dulanka Silva
Keyword(s):  
Cervical Spine ◽  
Natural History ◽  
Neck Pain ◽  
Diffuse Idiopathic Skeletal Hyperostosis ◽  
Posterior Longitudinal Ligament ◽  
Surgical Approaches ◽  
Systemic Diseases ◽  
Spinal Disease ◽  
Disc Disease ◽  
Degenerative Cervical Myelopathy

Degenerative cervical spinal disease refers to neck pain, myelopathy, and/or radiculopathy. It is a common problem with increased prevalence above the age of 55 years. Understanding the natural history and pathophysiology is crucial in selecting patients for surgery. The degenerative pathological processes that can occur in the cervical spine include degenerative disc disease, degenerative cervical myelopathy, ossification of the posterior longitudinal ligament (OPLL) and ossification of the ligamentum flavum (OLF). There are also systemic diseases affecting the cervical spine and these include rheumatoid disease, sero-negative spondyloarthropathies and diffuse idiopathic skeletal hyperostosis (DISH). This section describes the pathology of cervical spinal disease, the clinical management, surgical approaches, and controversies in the field.

scholarly journals SPECTRUM OF PERFORATION PERITONITIS IN WESTERN NEPAL

2018 ◽  
Vol 6 (1) ◽  
pp. 11-13
Author(s):  
Rajesh Poudel ◽  
Santosh Shah ◽  
Kailash Chandra ◽  
Saroj Pradhan ◽  
Pravin Joshi
Keyword(s):  
Indian Subcontinent ◽  
Care Center ◽  
Tertiary Care ◽  
Exploratory Laparotomy ◽  
Medical Sciences ◽  
Peptic Disease ◽  
Perforation Peritonitis ◽  
One Year ◽  
Operative Findings ◽  
Perforated Peritonitis

Introduction: Despite advances in surgical technique, antimicrobial therapy and perioperative care morbidity and mortality in perforated peritonitis is still high.   Aim of this study was to highlight the clinical presentation, intra operative findings and postoperative complications and mortality among patient who has undergone emergency surgery for perforated peritonitis in tertiary care center in western Nepal.Materials and Methods: This was a retrospective descriptive study carried out in Universal College of Medical Sciences, Bhairawha, Nepal. All patients who underwent emergency exploratory laparotomy for perforated peritonitis in one year period (from April 2014 to March 2015) were included in the study.Results: Total 90 cases met inclusion criteria and were analyzed. Most common presenting symptom was pain abdomen. Pneumoperitoneum was seen in 86 (95.6%) patients. Most common site of perforation was prepyloric perforation followed by duodenum. Most common cause of perforation was Acid peptic disease. Most common surgical procedure performed was Omentopexy. There were total of 11 (12.2%)mortality.Conclusion: The spectrum of perforation peritonitis in our study differs from western countries whereas it is similar to that of other research from Indian subcontinent. Majority of perforations are noticed in the duodenum and stomach due to acid-peptic disease and small bowel typhoid followed by trauma. Overall mortality was seen in 12.2%.Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 11-13

180 Long-Term Outcomes of Arthroplasty for Cervical Myelopathy Versus Radiculopathy, and Arthroplasty Versus Arthrodesis for Cervical Myelopathy

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 247-247
Author(s):  
Jeffrey McConnell ◽  
Matthew F Gornet ◽  
K Daniel Riew ◽  
Todd H Lanman ◽  
J Kenneth Burkus ◽  
...  
Keyword(s):  
Neck Pain ◽  
Cervical Myelopathy ◽  
Neurological Status ◽  
Cervical Disc ◽  
Cervical Disc Arthroplasty ◽  
Disc Disease ◽  
Arm Pain ◽  
Similar Improvement ◽  
Sf 36

Abstract INTRODUCTION Cervical disc arthroplasty (CDA) is an effective treatment for symptomatic cervical disc disease (SCDD). Concerns remain about the appropriateness of CDA to treat patients with myelopathy. This study compares long-term safety and effectiveness of CDA in patients with myelopathy versus radiculopathy. METHODS Retrospective analysis of prospective 84-month data from IDE clinical trial of CDA vs ACDF for SCDD at 2 adjacent levels: NDI, neck/arm pain, SF-36 PCS, neurological status, adverse events (AEs), secondary surgeries at index and adjacent levels. A total of 397 patients were enrolled: 287 radiculopathy alone and 110 myelopathy +/− radiculopathy. Two comparisons were performed: 1)CDA for myelopathy vs radiculopathy. 2)CDA vs ACDF for myelopathy. RESULTS >All groups significantly improved for NDI, neck/arm pain, and PCS at 84 months. Comparison#1: Myelopathy and radiculopathy groups showed similar improvement for NDI (37.8 vs 35.8, P = 0.352), neck pain (12.0 vs 12.1, P = 0.477), arm pain (11.6 vs 9.6, P = 0.480), and PCS (14.1 vs 13.7, P = 0.863). Both groups had similar maintenance or improvement in neurological status (87.2% vs 93.5%, P = 0.218), serious AEs (54.5% vs 57.5%, P = 0.291) secondary surgeries at index (3.7% vs 4.4%, P = 0.839) and adjacent levels (3.7% vs 7.6%, P = 0.367). Comparison#2: The CDA and ACDF groups showed similar improvement for NDI (37.8 vs 31.1, P = 0.147), neck pain (12.0 vs 10.4, P = 0.337), arm pain (11.6 vs 11.4, P = 0.791) and PCS (14.1 vs 11.2, P = 0.363). Both groups had similar maintenance or improvement in neurological status (87.2% vs 96.2%, P = 0.409) and similar rates of secondary surgeries at the index (3.7% vs 9.4%, P = 0.374) and lower rates of surgeries at adjacent levels (3.7% vs 15.4%, P = 0.088). Compared to ACDF, CDA group demonstrated lower rates of serious AEs (54.5% vs 65.9%, P = 0.019). CONCLUSION Long-term, CDA is safe and effective for the treatment of myelopathy. Myelopathy patients gain similar improvement from CDA to patients with radiculopathy only. Furthermore, myelopathy patients report similar levels of improvement from CDA compared with ACDF, but suffer fewer serious AEs

Non-Discal Lumbar Radiculopathy: Combined Diagnostic Approach by CT and MR

1997 ◽  
Vol 10 (2) ◽  
pp. 165-173 ◽  
Author(s):  
M. Muto ◽  
G. De Maria ◽  
R. Izzo ◽  
G. Fucci ◽  
I. Aprile
Keyword(s):  
Clinical Evaluation ◽  
Facet Joint ◽  
Lumbar Radiculopathy ◽  
Disc Disease ◽  
Vascular Abnormality ◽  
Degenerative Disk Disease ◽  
Canal Stenosis ◽  
Ct Findings ◽  
Neoplastic Lesions ◽  
Inflammatory Processes

The goal of this paper was to evaluate the different causes of non-discal radiculopathies and to determine the different sensitivity and specificity of CT and MR. We reviewed 450 patients with non-discal radiculopathy; CT was performed in all patients while MR was done only in 95 cases. MR was obtained only in case of polyradiculopathy, or if there was a discrepancy between clinical evaluation and CT findings or when sphincteral symptoms were present. The most frequent cause of non-discal radiculopathy was degenerative disk disease associated with facet joint abnormality and secondary central and lateral spinal canal stenosis. Other causes were neoplastic lesions, traumas, malformations, inflammatory processes and vascular abnormality. CT was more sensitive and specific in degenerative disc disease while MR was better at evaluating other pathology. CT still represents a satisfactory technique in evaluating patients with non-discal radiculopathy; MR must be also performed in case of discrepancy between clinical evaluation and CT findings. Directly MR examination should be reserved for patients presenting sphincteral symptoms.

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