24 research outputs found
Integrative management of anaplastic astrocytoma through a combination of Ayurveda and conventional care: A case report
No full textAnaplastic Astrocytoma (AA) is a relatively rare cancer, and is associated with a median life expectancy of 3 years after conventional therapy. Complete cure of the highly infiltrative AA is uncommon, and reports of positive outcome in cases of partial resection of AA are rare. Further, integrative approaches to the management of AA remain underexplored. This paper contributes to the limited literature in this domain by presenting a case that was successfully treated through integrative conventional and Ayurvedic interventions. A patient diagnosed with AA in the left parieto-occipital lobe underwent partial lesion resection followed by post-operative radiation and chemotherapy. The patient was given a conservative post-surgical life expectancy of two years, and was referred to an Ayurveda hospital for further treatment. The Ayurvedic intervention was focussed on redressal of radiation and chemotherapy side-effects, improvement of quality of life, and improving the patient’s strength and immunity. Following this novel integrative model of care, the patient was able to resume all personal and professional routines, and a contrast MRI revealed absence of residual lesion allowing the patient to outlive his initial prognosis by several years till date. We posit that the findings of this report merit further examination in the interest of potential improvements to existing models of care
Rare manifestation of common disease with an unique method of minimally invasive spine stabilization: Cervical 2–3 facet lesion
No full textCervical granulomatous infections of the posterior elements are very rare, it is often difficult to diagnose due to rarity and variable presentation of symptoms. Any cervical surgical procedure carries a certain morbid risk to the patient. We present a case of cervical 2–3 facet joint lesion which was managed by a minimally invasive technique with a favorable outcome
Decompressive surgery in malignant cerebral venous sinus thrombosis: what predicts its outcome?
No full textComplete Excision of Intradural-Extraforaminal Spinal Tumors Using a Minimally Invasive 2-Incision Technique With Fixed Tubular Retractors
No full textUnique paradoxical atlantoaxial dislocation with C1-C2 facet diastases and isolated ligamentous injury to the craniovertebral junction without neurological deficits: A case report
No full textStudy design: Retrospective review of the case file. Objective: The primary objective was to report this rare case and discuss the mechanism of dislocation and technique of manual closed reduction of C1-C2 vertebrae in such scenarios. Summary of background data: Posterior atlantoaxial dislocation (AAD) is extremely rare and a few cases have been reported in English literature. This young man sustained a high speed car accident and survived an extreme hyperextension injury to the craniovertebral junction (CVJ) without any neurological deficits. On evaluation for neck pain he was noted with a dislocated odontoid lying in front of Atlas. There was C1-C2 facet diastases. No bony injury was noted at CVJ. Transverse axial ligament (TAL) was intact. He underwent a successful awake reduction of the dislocation. The joint had to be manually distracted, realigned, and released under the guidance of fluoroscopy. This was followed by single stage C1-C2 Goel′s fusion with awake prone positioning. This patient was able to go back to work at the end of 3 months (GOS 5). Conclusions: This condition is extremely rare, can be carefully reduced manually under adequate neuromonitoring, and requires C1-C2 fusion in the same sitting
Minimally Invasive Iliac Screw Insertion: Clinical Case Series and Technical Note
Get PDFObjective To describe the technique of minimally invasive iliac screw insertion by freehand technique and using intraoperative navigation guidance. Methods Bilateral iliac screws were inserted in total of seven patients. Five patients under- went navigation guided iliac screw placement and freehand technique was performed in 2 patients. Results Total of 7 patients underwent minimally invasive iliac screw fixation in our series. The pathology in 4 of the cases was spondylodiscitis, among them 2 cases each at L5-S1 and L4-L5, one with the destruction of L5 vertebral body and the other with the destruction of both L4 and L5 vertebral bodies. Of the remaining cases, two cases , one case of sacral insufficiency fracture and the last case was implant failure after L2-L5 oblique lumbar fusion. None of the cases required conversion to open procedure or had wound or hardware related complications till the last follow-up. All patients had an uneventful post-operative period with improvement in pain scores and were mobilized on the 1st postoperative day. One 50-year-old female patient suffering from L5-S1 tubercular spondylodiscitis died due to underlying chronic kidney disease three months post-surgery. Conclusion Minimal invasive iliac screw placement with or without navigation offers the same biomechanical stability as the open approach but without the need for extensive soft tissue exposure needed for a conventional/open procedure; thereby reducing exposure-related complications , enhancing post-operative recovery and early mobilization. Incorporating intra-operative 3D navigation provides real-time multi-planar images which help in easy planning and safe screw placement whilst reducing radiation exposure
Minimally Invasive Augmented Fixation for Anatomical Reduction of Grade 2 and Grade 3 Listhesis in Patients with Osteoporosis
Get PDFStudy Design A retrospective study. Purpose To study the efficacy of augmented fixation for anatomical reduction of grade 2 and grade 3 listhesis in patients with osteoporosis. Overview of Literature Spondylolisthesis in osteoporotic patients requiring spinal fixation are associated with complications such as loss of surgical construct stability, screw pulling out, and screw loosening. Augmented fixation is a novel strategy to achieve necessary construct integrity. Methods Thirteen consecutive patients with grade 2 or grade 3 listhesis, with proven osteoporosis on dual energy X-ray absorptiometry (DEXA) scan, and who underwent augmented fixation for reduction of listhesis were retrospectively analyzed. In all patients, surgical access was achieved with a fixed 22 mm tubular retractor. A modified technique of bilateral, sequential, transforaminal decompression and discectomy, followed by reduction of listhesis using unilaterally placed augmented screws was employed in all the cases. Patients were followed up with plain X-rays at regular intervals to assess for implant stability and fusion status. All patients were started on medical treatment for osteoporosis. Results The mean age of the patients was 52.46 years, with 12 females and one male. The median T-score on DEXA scan was −3.0. Of the 13 patients, listhesis was at L4–L5 in five and at L5–S1 in eight. Nine patients had grade 2 listhesis, while four patients had grade 3 listhesis. Complete reduction was achieved in 10 patients. The median duration of follow-up was 18 months. Postoperative outcomes were satisfactory in all cases. Conclusions Augmented fixation is a useful technique for achieving anatomical reduction of listhesis in patients with osteoporosis
Dimensional Accuracy and Details of the Panoramic Cross-sectional Tomographic Images: An in vitro Study
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