Objective: This study compared the impact of minimally invasive surgery (MIS) and open spinal deformity corrections on the paraspinal musculature and soft tissues in adolescent idiopathic scoliosis (AIS) patients by analyzing early postoperative serum tissue injury markers and later radiographic evidence of muscle atrophy within the paraspinal musculature until 6-month and 2-year postoperative follow-ups. Methods: Prospective data were collected at a single tertiary care center from January 1, 2015 to November 30, 2020. Demographic, clinical, laboratory, and radiographic data, including postoperative magnetic resonance imaging, were collected at various intervals. Results: Forty-four patients met the inclusion criteria. The mean estimated blood loss and mean operative time differed significantly between the groups. On postoperative day 1, the Open group had significantly higher serum aldolase concentrations (18.2±7.6 mU/mL vs. 12.9±4.2 mU/mL) and creatine kinase (CK) values (3,003.1±60.1 IU/L vs. 1,649.4±40.6 IU/L) than the MIS patients. In the Open group, serum aldolase and CK levels remained higher through postoperative day 4. The normalized difference in the loss of paraspinal muscle mass was higher in the Open group than in the MIS group. Patient-reported outcomes improved in both groups, but there were no significant between-group differences. Both groups reported similar complication rates. Conclusion In patients with AIS, MIS was associated with lower tissue injury markers and muscle atrophy than open surgical correction in the early postoperative period. While this difference may be associated with decreased blood loss and shorter hospital stays seen in MIS, it did not result in a significant difference in clinical outcomes versus open surgery.

Background & Objective:Epilepsy may have an impact on bone health of the patients even before drug therapy is initiated, particularly in the developing countries. This is in view of long delay in diagnosis and lifestyle changes. Therefore, in this study, bone health markers like bone mineral density (BMD) and urinary hydroxyproline were assessed in newly diagnosed epilepsy patients. Methods: The BMD was assessed by DEXA scan, and 24 hour urine hydroxyproline was estimated colorimetrically in 25 newly diagnosed epilepsy patients. Other bone markers like calcium, phosphorus, vitamin D and alkaline phosphatase were also estimated. Results were compared with 25 age and sex matched healthy controls, and were analyzed statistically. Results: The BMD and vitamin D were found to be significantly decreased (p<0.05) while serum alkaline phosphatase and urine calcium and phosphorus were observed to be significantly increased p<0.05) in epilepsy patients as compared to healthy controls. The difference in urinary hydroxyproline and serum calcium/ phosphorus in the two groups was not found to be statistically significant (p>0.05). Conclusions: Bone health is found to be already compromised in epilepsy patients in this study from North India. BMD and urinary hydroxyproline may act as simple, non-invasive, convenient and inexpensive markers to assess bone health in these patients
Bone Density ; Epilepsy