1.Dorsal Herniation of Cauda Equina Due to Sequestrated Intradural Disc.
Pradeep K SINGH ; Sandeep SHRIVASTAVA ; Rajesh DULANI ; Pankaj BANODE ; Sharad GUPTA
Asian Spine Journal 2012;6(2):145-147
Intradural lumbar disc herniation (ILDH) is uncommon pathology. In present report, authors present a case of ILDH associated with dorsal herniation of the cauda equina rootlets in a 30-year-old male laborer who had chronic backache since last two years. To the best of our knowledge we are reporting this for first time. Report demonstrates the natural course of ILDH.
Adult
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Back Pain
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Cauda Equina
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Humans
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Male
2.Role of Decompression in Late Presentation of Cervical Spinal Cord Disorders.
Sandeep SHRIVASTAVA ; Harshal SAKALE ; Rajesh DULANI ; Pradeep K SINGH ; Manoj SANRAKHIA
Asian Spine Journal 2014;8(2):183-189
STUDY DESIGN: Prospective study conducted at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, India. PURPOSE: To show the efficacy of decompression in the late presentation of cervical spinal cord disorders. OVERVIEW OF LITERATURE: Studies by various authors have shown that early spinal decompression results in better neurological outcomes. METHODS: From January 2003 to January 2005, 11 of the 41 patients with cervical spinal cord compression, meeting the inclusion criteria, underwent anterior decompression; interbody graft placement and stabilization by anterior cervical locking plate. The neurologic and functional outcomes were recorded. RESULTS: Five patients had spinal cord injury and 6 patients had compressive cervical myelopathy. Complications included 1 death and 1 plate loosening. No patient lost their preoperative neurological status. One patient had no improvement, 2 patients showed full recovery. The mean follow-up is 28.3 month. At the of rehabilitation, 6 were able to walk without support), 2 could walk with support, and 1 needed a wheelchair. The average American Spinal Injury Association motor score on admission to the hospital, 32.8 (standard deviation [SD], 30.5); admission to rehabilitation, 38.6 (SD, 32.4); discharge from rehabilitation, 46.2 (SD, 33.7). The most recent follow-up was 64.0 (SD, 35.3). CONCLUSIONS: The anterior approach for cervical decompression allows for adequate decompression. This decompression is the best chance offered in even late reported cases, including posttraumatic cases where there is no evidence of cord transactions. The use of anterior cervical plates reduces the chances of graft loosening, extruding, or collapsing.
Cervical Vertebrae
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Decompression*
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Decompression, Surgical
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Female
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Follow-Up Studies
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Humans
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India
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Neglected Diseases
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Prospective Studies
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Quadriplegia
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Rehabilitation
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Spinal Cord Compression
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Spinal Cord Diseases*
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Spinal Cord Injuries
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Spinal Cord*
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Spinal Injuries
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Transplants
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Wheelchairs
3.Windswept deformity: A rare skeletal manifestation in an adolescent with primary hyperparathyroidism
Pankaj Ferwani ; Bhushan Jajoo ; Sandeep Shrivastava
Journal of the ASEAN Federation of Endocrine Societies 2024;39(2):86-91
Primary hyperparathyroidism (PHPT) in adolescents is rare and has severe manifestations as compared to adults. Skeletal involvement in primary hyperparathyroidism in the form of deformities like genu valgus, genu varus and cubitus varus is rare and limited to case reports and case series. There is only one case of genu varus with genu valgus on the contralateral extremity (windswept deformity) that has been reported to date in the literature. We report the case of a 19-year-old male who presented with isolated progressive bending of his legs at the knee (windswept deformity) for three years. He was found to have hypercalcemia, hypophosphatemia, high alkaline phosphatase, high intact parathyroid hormone (iPTH), normal 25-hydroxy vitamin D level and a normal kidney function test. A diagnosis of primary hyperparathyroidism was made. On imaging studies, a left inferior parathyroid adenoma was localized and was successfully removed surgically. Serum calcium and iPTH normalized post-operatively. The patient is being planned for corrective osteotomy after stabilization of alkaline phosphatase levels.
Hyperparathyroidism, Primary
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Genu Varus
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Genu Varum