Sponlyloptosis
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This document summarizes a retrospective study of 7 cases of cervical spondyloptosis, a rare type of traumatic cervical spine injury. The injuries occurred most commonly at the C6-7 and C7-T1 levels and involved facet locking or bone fracture. MRI findings included disc prolapse, spinal cord signal changes, or contusion. All patients underwent traction initially, with complete reduction in 3 cases and partial reduction in 3 cases. Surgical treatment involved anterior cervical discectomy and fusion with plates and screws in cases of complete or partial reduction, and additional facet drilling or lateral mass fixation in cases of no reduction. Outcomes were generally good, with improvement in neurological status and fusion of the cervical spine.
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Perthes disease, also known as Legg-Calve-Perthes disease, is a childhood condition affecting the hip. It results in the temporary loss of blood supply to the femoral head, causing it to collapse. It typically affects children between the ages of 4-10 years old. Treatment depends on the stage of the disease and the age of the patient. For younger children, rest and anti-inflammatory medications may be sufficient, while older children or more severe cases may require procedures like bracing, osteotomies or pelvic osteotomies to contain the femoral head within the acetabulum. The prognosis is generally good if treated early, but advanced cases can lead to long term stiffness, limping
Idiopathic scoliosis
This document discusses idiopathic scoliosis, including its definition, prevalence, genetics, etiology, presentation, evaluation, classification, treatment options including observation, bracing, and surgery, and potential complications. Idiopathic scoliosis is a lateral curvature of the spine without a clear cause, affecting 2-3% of individuals. Evaluation involves radiographs and MRI to assess curve magnitude and rule out underlying issues. Treatment depends on curve size, progression risk, and remaining growth potential, ranging from observation to bracing to surgery.
deformities of spine.pptx
This document discusses various spinal deformities including scoliosis, kyphosis, and lordosis. It describes the anatomy, causes, classifications, treatments, and natural histories of these conditions. Infantile, juvenile, and adolescent idiopathic scoliosis are addressed. Scheuermann's kyphosis and congenital kyphosis are also summarized. Lordosis is defined and clinical features and treatments are provided.
Adult Degenerative Scoliosis 2008
A presentation on adult degenerative scoliosis: presentation, diagnosis, and treatment options based on the best available evidence as of 2008.
Kienbocks 2008
This document discusses Kienbock's disease, a condition caused by avascular necrosis of the lunate bone in the wrist. It begins with an introduction to the disease and its challenging diagnosis and treatment. Subsequent sections cover the debated etiology, staging classifications, clinical presentation, natural history, and surgical treatment options. The literature review discusses studies comparing various treatment approaches. The document concludes with details on the author's experience with a scapholunate triquetrum fusion procedure for late-stage Kienbock's disease, finding it provides reliable pain relief while maintaining carpal height.
Perthes disease
Perthes disease is a childhood condition that affects the blood supply to the femoral head, causing bone death (avascular necrosis). It most commonly affects boys between ages 4-8. While the disease process is self-limiting, it can have permanent effects on the femoral head shape and hip function. Treatment aims to contain the femoral head within the acetabulum during healing to promote proper reshaping, through nonsurgical means like bracing or surgical options like osteotomies if needed. The long-term outcomes are evaluated using classifications like Stulberg or Mose, with the goal of achieving a spherical femoral head congruent with the acetabulum. Management approaches vary between centers based on each child's severity and prognosis
perthes.pptx
This document discusses Perthes disease, also known as idiopathic avascular necrosis of the femoral head. It presents in children between 5-8 years old with pain or limping, often unilaterally but sometimes bilaterally. There are four stages of the disease: devascularization, collapse and fragmentation, re-ossification, and remodeling. Early radiographic signs include a radiolucent subchondral fissure (crescent sign). As the disease progresses, the femoral head loses height and fragments with sclerosis. This can lead to a coxa magna deformity with lateral uncovering of the femoral head. MRI, ultrasound, and skeletal scintigraphy can aid in diagnosis, though
Congenital kyphosis
The document discusses congenital kyphosis, which is an abnormal curving of the spine present from birth that can progress with growth. It describes the types of congenital kyphosis, including failure of vertebral formation or segmentation. Surgery is usually recommended to prevent neurological complications from progression, with the procedure dependent on the deformity severity and age. Anterior release and fusion with posterior instrumentation is often used for more severe cases. Complications can include pseudarthrosis or further kyphosis without a combined approach.
Scoliosis
1) Scoliosis is a lateral curvature of the spine greater than 10 degrees with rotation of the vertebrae in the frontal and sagittal planes.
2) It affects 2% of children at some point in life, with 10% requiring corrective surgery. Girls are more commonly affected than boys.
3) Scoliosis can be structural, involving vertebral abnormalities, or non-structural due to factors like posture or leg length discrepancy. Treatment options include observation, bracing, and surgery depending on the severity and progression of the curvature.
Myelopathy management
This document discusses cervical myelopathy, including its causes, symptoms, tests, treatment options, and surgical procedures. It provides details on:
- Common causes of cervical myelopathy like spinal stenosis, disc protrusions, and osteophyte formation.
- Typical symptoms like clumsy hands, leg stiffness, and gait imbalance and signs like hyperreflexia on examination.
- MRI as the best test to identify cord compression and changes, and CT myelogram as also useful.
- Surgical treatment options include anterior discectomy and fusion or corpectomy for one to two levels, and corpectomy with possible posterior fixation for three or more levels. Posterior laminectomy, laminectomy with fusion
Cryptorchidism (Undescended Testes)
Columbia Urology Grand Rounds 11/11/15 - Cryptorchidism: Evaluation, consequences and contemporary management
ub-hsped-scoliosis-differential-dx-functional-and-structural-scoliosis.pdf
This document discusses the differential diagnosis and evaluation of scoliosis. It defines structural and functional scoliosis, describing how physical examination can determine the type. Classification of scoliosis as structural or nonstructural is discussed. Evaluation techniques like the Adams forward bend test, leg length measurements, and scoliometer are described. The scoliometer provides objective measurements of curve rotation. Adolescent idiopathic scoliosis is defined as the most common type, affecting 2-4% of children aged 10-16. Genetic factors are implicated in its development and progression. Traditional protocols for evaluation with serial x-rays and treatment with bracing or surgery based on curve magnitude are covered. A new genetic test called ScoliScore that predicts
Kienbocks 2006
This case series examines lunate excision with dorsal scaphotriquetral tenodesis for treating Stage 3b Kienbock's disease. The procedure aims to address avascular necrosis of the lunate and carpal instability through a single step. Six patients underwent lunate excision and attachment of the dorsal intercarpal ligament to the scapholunate ligament. Post-operatively, patients experienced decreased pain but also reduced range of motion. Preliminary results found no significant change in carpal height ratio or capitate migration. The authors conclude the procedure provides viable pain relief for failed Stage 3b Kienbock's cases through a simple and reliable technique.
Unifacet dislocation MRI
This document discusses treatment options for unilateral cervical facet fracture/dislocation. It presents 4 scenarios of a 55-year-old woman with this injury and discusses whether immediate closed reduction, MRI first, or surgery is most appropriate. The literature suggests that early decompression and reduction can improve outcomes with rare risk of neurological deterioration from closed reduction. MRI may not predict outcomes or guide treatment. The consensus is that MRI is only needed for late presentations, failed closed reductions, or if the patient's mental state prevents safe closed reduction. Otherwise, immediate closed reduction by experienced surgeons is recommended, especially for significant neurological deficits.
Congenital anomalies of upper and lower limb
Developmental dysplasia of the hip is a condition where the femoral head does not properly fit into the acetabulum. It can present as hip dislocation or dysplasia. Risk factors include family history and breech presentation. Examination involves tests like Ortolani and Barlow. Treatment depends on age and severity, and may include casting, bracing, or surgery. Other congenital anomalies of the lower limbs discussed include congenital dislocation of the knee, clubfoot, and proximal femoral focal deficiency.
Fracture Of Femoral Neck In Adults.pptx
Flexes, adducts and internally rotates the hip
Surgeon:
- Posterior approach:
- Identifies fracture site
- Reduces fracture under direct vision
- Fixation with cannulated screws or sliding hip screw
- Capsulotomy allows decompression and reduction
- Closed suction drain
- Post-op hip in flexion, adduction, internal rotation
- Weight bearing as tolerated
- Follow up x-rays at 6 weeks, 3 months, 6 months
- Non-union, AVN, implant failure are complications
Open Reduction allows direct visualization and anatomic reduction
Oncologic emergencies asim
Cancer patients are prone to develop different kinds of complications. In time intervention improves outcomes and quality of life.
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A 6-year-old girl presented with right middle cerebral artery infarct due to moyamoya disease. She underwent bilateral encephaloduroarteriosynangiosis surgeries. Post-operatively, she developed seizures and new onset right hemiplegia. Her condition rapidly deteriorated with symptoms of fever, tachycardia, hypertension, tachypnea, hyperhidrosis, and posturing. This constellation of autonomic symptoms was diagnosed as paroxysmal sympathetic hyperactivity (PSH). PSH has been reported after traumatic brain injury and stroke in adults, but rarely in children after stroke. The multiple strokes from moyamoya disease in this child likely caused diffuse brain damage leading to
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3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
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3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Sponlyloptosis
- 1. Cervical Spondyloptosis Dhaval Shukla Department of Neurosurgery NIMHANS, Bangalore.
- 2. Introduction • Traumatic spondyloptosis of cervical spine is rare • Allen’s classification • Compressive Extension Stage 5 (CES5) • Distractive Flexion Stage 4 (DFS4) • Retrospective study of cervical spondyloptosis • 7 cases (1 female) • Age: 24 to 64 years • Neurological status • No deficits 1 case • Incomplete spinal cord injury 6 cases
- 3. CT Scan Level C6-7 in 4 cases C7-D1 in 3 cases Posterior Elements Facet locking in 2 cases Fracture in 5 cases
- 4. MRI Disc Prolapse with Normal Cord in 2 Cord Signal Changes in 4 Cord Contusion in 1
- 5. TreatmentTraction All Cases Complete Reduction 3 Cases Anterior Cervical Discectomy and Fusion with Plates and Screws 3 Cases Partial Reduction 3 Cases Anterior Cervical Discectomy– Facet Drilling and Lateral Mass Fixation – Anterior Fixation with Plates and Screws 3 Cases No Reduction 1 Case Facet Drilling - Anterior Cervical Discectomy and Fusion with Plates and Screws – Lateral Mass Fixation 1 Case
- 6. Case Illustration Only Anterior Approach 50 / F ASIA Grade C MRI – Normal Spinal Cord Preoperative Complete Reduction on Traction Surgery: 1. Anterior cervical discectomy fusion with iliac crest graft and fixation with cervical plate and screws Postop Shoulder Abduction Weakness - Improved Follow-up 10 months • ASIA Grade E • Nurick Grade 1 • Good Bone Fusion
- 7. Case Illustration 540◦Approach 24/ M ASIA Grade D MRI - Signal change Partial reduction on traction Surgery: 1. Anterior cervical discectomy 2. Bilateral C6-7 facetectomy, C6 laminectomy bilateral C5 lateral mass and C7 pedicle screws and rod fixation 3. Anterior cervical fusion with iliac crest graft and fixation with cervical plates and screws Follow-up 6 months • ASIA Grade E • Nurick Grade 1 • Good Bone Fusion