OBJECTIVE: The objective of the study is to generate reference values of bone mineral density (BMD) in north Indian population using phantomless quantitative computed tomography (QCT). MATERIALS AND METHODS: Bone mineral densities were generated from the computed tomography (CT) scans of 691 patients (390 males and 301 females, ages 11–85 years) who underwent CT of the abdomen or thorax for indications unrelated to bone diseases. The individuals were divided according to age groups from 11–15 to 80–85 years. BMD was calculated by phantomless QCT software by assessing L1 and L2 vertebrae. RESULTS: For females, the maximum BMD was observed for the age group of 21–25 years (144.67 mg/cc). The overall bone loss per year from 26 to 85 years was 1.62 mg/cc. Greater bone loss was seen from ages of 36–55 years which was 2.18 mg/cc. With bone loss per year being 0.99 mg/cc in ages from 26 to 35 years and 1.41 mg/cc from 56 to 85 years. Regression analysis gave a better fit using third order polynomial of age than did a linear regression line. For males, the maximum BMD was observed for the age group of 21–25 years (147.67 mg/cc). The overall bone loss per year from 26 to 85 years was 1.2 mg/cc. Regression analysis gave the best fit using linear regression. CONCLUSION: In the study population, the males show a linear relationship between age and BMD with continuous bone loss after the age of 25 years while females demonstrate a more complex relationship between age and BMD with accelerated bone loss in perimenopausal age group.
{"title":"Calculation of the reference bone mineral density values in North Indian population using phantomless quantitative computed tomography","authors":"K. Mistry, R. Bhoil, D. Sood, P. Suthar","doi":"10.4103/JOAS.JOAS_12_18","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_12_18","url":null,"abstract":"OBJECTIVE: The objective of the study is to generate reference values of bone mineral density (BMD) in north Indian population using phantomless quantitative computed tomography (QCT). MATERIALS AND METHODS: Bone mineral densities were generated from the computed tomography (CT) scans of 691 patients (390 males and 301 females, ages 11–85 years) who underwent CT of the abdomen or thorax for indications unrelated to bone diseases. The individuals were divided according to age groups from 11–15 to 80–85 years. BMD was calculated by phantomless QCT software by assessing L1 and L2 vertebrae. RESULTS: For females, the maximum BMD was observed for the age group of 21–25 years (144.67 mg/cc). The overall bone loss per year from 26 to 85 years was 1.62 mg/cc. Greater bone loss was seen from ages of 36–55 years which was 2.18 mg/cc. With bone loss per year being 0.99 mg/cc in ages from 26 to 35 years and 1.41 mg/cc from 56 to 85 years. Regression analysis gave a better fit using third order polynomial of age than did a linear regression line. For males, the maximum BMD was observed for the age group of 21–25 years (147.67 mg/cc). The overall bone loss per year from 26 to 85 years was 1.2 mg/cc. Regression analysis gave the best fit using linear regression. CONCLUSION: In the study population, the males show a linear relationship between age and BMD with continuous bone loss after the age of 25 years while females demonstrate a more complex relationship between age and BMD with accelerated bone loss in perimenopausal age group.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45056923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Transforaminal endoscopic discectomy has become popular due to its advantages over open discectomy. However, transforaminal endoscopic surgery may be difficult to perform at L5-S1 level in some cases due to anatomic variations such as high iliac crest. Endoscopic transiliac approach is an option for patients with high iliac crest or narrow foramen. The aim of this retrospective study was to describe the technique, analyse the results and complications. MATERIALS AND METHODS: 10 patients with variety of L5-S1 disc pathology who were treated with endoscopic transiliac surgery under local anaesthesia from June 2015 to December 2016 were included in the study. Clinical follow up was done at one month, three months, six months, one year. Outcome was assessed using modified Macnab's criteria. RESULTS: All patients had immediate relief from symptoms. Excellent outcome was noted in eight patients, Good outcome in one patient, and fair result in one patient. No patient had any complications. No patient required conversion to open or alternative procedure. Mean hospital stay was 1 day. CONCLUSIONS: Endoscopic transiliac approach is safe and effective in lumbosacral disc pathologies. Transiliac approach removes the limitations of transforaminal approach for L5-S1 disc space. Transiliac approach is the only versatile minimally invasive approach to lumbosacral junction which can tackle variety of clinical conditions.
{"title":"Endoscopic transiliac approach to L5-S1 disc and foramen, technique and results","authors":"K. Mahesha","doi":"10.4103/JOAS.JOAS_59_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_59_17","url":null,"abstract":"BACKGROUND: Transforaminal endoscopic discectomy has become popular due to its advantages over open discectomy. However, transforaminal endoscopic surgery may be difficult to perform at L5-S1 level in some cases due to anatomic variations such as high iliac crest. Endoscopic transiliac approach is an option for patients with high iliac crest or narrow foramen. The aim of this retrospective study was to describe the technique, analyse the results and complications. MATERIALS AND METHODS: 10 patients with variety of L5-S1 disc pathology who were treated with endoscopic transiliac surgery under local anaesthesia from June 2015 to December 2016 were included in the study. Clinical follow up was done at one month, three months, six months, one year. Outcome was assessed using modified Macnab's criteria. RESULTS: All patients had immediate relief from symptoms. Excellent outcome was noted in eight patients, Good outcome in one patient, and fair result in one patient. No patient had any complications. No patient required conversion to open or alternative procedure. Mean hospital stay was 1 day. CONCLUSIONS: Endoscopic transiliac approach is safe and effective in lumbosacral disc pathologies. Transiliac approach removes the limitations of transforaminal approach for L5-S1 disc space. Transiliac approach is the only versatile minimally invasive approach to lumbosacral junction which can tackle variety of clinical conditions.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45403364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Mishra, Vinay Kumar Oddam, S. Mishra, A. Gohiya
Winging of scapula is comprehensively known for the serratus anterior palsy and its dynamic presentation. However, on the contrary, pseudo winging may occur due to nonneuromuscular cause like osteochondroma. It is a rare case of pseudo winging of scapula due to osteochondroma in a pubescent girl. This article is for knowledge to share the experience of static scapula alata due to osteochondroma. It was managed by excision and confirmed by histopathological study. Patient relieved completely from her complaints.
{"title":"Pseudo scapula alata in adolescent: Unwonted diagnosis","authors":"P. Mishra, Vinay Kumar Oddam, S. Mishra, A. Gohiya","doi":"10.4103/JOAS.JOAS_32_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_32_17","url":null,"abstract":"Winging of scapula is comprehensively known for the serratus anterior palsy and its dynamic presentation. However, on the contrary, pseudo winging may occur due to nonneuromuscular cause like osteochondroma. It is a rare case of pseudo winging of scapula due to osteochondroma in a pubescent girl. This article is for knowledge to share the experience of static scapula alata due to osteochondroma. It was managed by excision and confirmed by histopathological study. Patient relieved completely from her complaints.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44749149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Krishnan, Manish Barot, B. Dave, Paresh Bang, D. Devanand, Denish Patel, Amit Jain
Spondylodiscitis is on rise due to increasing elderly population and immunocompromised people and now gets early detected due to early imaging. Percutaneous Transforaminal Endoscopic Discectomy and Drainage (PTELDD), is simple procedure that yields high culture wihich helps in specific targeted antimicrobial bombardment. Dr. Satishchandra Gore has been pioneer in introducing transforaminal endoscopy in India way back in 1999. His persistent efforts has made inroads into traditional spine care treatments and endoscopy bandwagon is flying high and many surgeons are able to give results with the technique all over India. The available english literature of transforaminal endoscopy in spondylodiscitis is reviewed here with technical note of this simplistic procedure. The reported outcome in literature is excellent in majority of cases. Authors unpublished report of 16 cases is also comparable with literature. PTELDD is a simplistic most minimalist minimally invasive procedure that gives very positive outcome in early cases of spondylodiscitis.
{"title":"Percutaneous transforaminal endoscopic discectomy and drainage for spondylodiscitis: A technical note and review of literature","authors":"A. Krishnan, Manish Barot, B. Dave, Paresh Bang, D. Devanand, Denish Patel, Amit Jain","doi":"10.4103/JOAS.JOAS_57_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_57_17","url":null,"abstract":"Spondylodiscitis is on rise due to increasing elderly population and immunocompromised people and now gets early detected due to early imaging. Percutaneous Transforaminal Endoscopic Discectomy and Drainage (PTELDD), is simple procedure that yields high culture wihich helps in specific targeted antimicrobial bombardment. Dr. Satishchandra Gore has been pioneer in introducing transforaminal endoscopy in India way back in 1999. His persistent efforts has made inroads into traditional spine care treatments and endoscopy bandwagon is flying high and many surgeons are able to give results with the technique all over India. The available english literature of transforaminal endoscopy in spondylodiscitis is reviewed here with technical note of this simplistic procedure. The reported outcome in literature is excellent in majority of cases. Authors unpublished report of 16 cases is also comparable with literature. PTELDD is a simplistic most minimalist minimally invasive procedure that gives very positive outcome in early cases of spondylodiscitis.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42682093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vikram Shah, Sachin Upadhyay, B. Kapadiya, Jatin Sanandia
Ralstonia pickettii remains a rare cause of periprosthetic joint infections, may therefore elude diagnosis, and causes a delay in optimal management. We describe our experience with a case of R. pickettii prosthetic knee joint infection to highlight key features in clinical presentation, isolation, identification, and optimal management.
{"title":"Ralstonia pickettii infection in total knee arthroplasty: From isolation and identification to revision surgery","authors":"Vikram Shah, Sachin Upadhyay, B. Kapadiya, Jatin Sanandia","doi":"10.4103/joas.joas_49_17","DOIUrl":"https://doi.org/10.4103/joas.joas_49_17","url":null,"abstract":"Ralstonia pickettii remains a rare cause of periprosthetic joint infections, may therefore elude diagnosis, and causes a delay in optimal management. We describe our experience with a case of R. pickettii prosthetic knee joint infection to highlight key features in clinical presentation, isolation, identification, and optimal management.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48911253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Vitamin D deficiency has been implicated in the pathogenesis of autoimmune diseases. Reduced Vitamin D intake has been linked to increased susceptibility to the development of rheumatoid arthritis (RA). The objective was to evaluate 25-hydroxy (25-OH) Vitamin D status in patients with RA and to assess the relationship between Vitamin D level and RA disease activity. MATERIALS AND METHODS: The study consists of 50 RA patients as cases and 50 age- and body mass index matched healthy individuals as controls. All study participants (both controls and cases) underwent biochemical profile such as RA factor, serum uric acid (UA), calcium, phosphorous, alkaline phosphatase, and 25-OH Vitamin D levels. Disease activity was evaluated by calculating the 28-joint count as disease activity score. All the results were expressed as mean and standard deviation (SD). RESULTS: Mean and SD values of serum UA (mg/dl), calcium (mg/dl), and phosphorous levels (mg/dl) in RA cases are as follows 7.2 ± 1.3, 7.5 ± 0.5, and 6.9 ± 1.5, respectively. Serum UA, calcium, and phosphorous levels in RA cases were found to be elevated when compared to controls (P < 0.0001). Mean erythrocyte sedimentation rate was 58.4 ± 14.7 mm/h in the group of patients with RA. Levels of 25-OH Vitamin D were found to be negatively correlated to the DAS28, the correlation coefficient being r = −0.51 (P < 0.05). Levels of 25-OH Vitamin D were found to be positively correlated to serum calcium levels, the correlation coefficient being r = 0.82 (P < 0.01). CONCLUSION: RA patients had lower Vitamin D values than healthy controls. There was a negative correlation between serum Vitamin D and RA disease activity.
{"title":"Study of biochemical profile and 25-hydroxy Vitamin D association with disease activity in rheumatoid arthritis patients","authors":"Regupathy Annamalai, A. Kumar","doi":"10.4103/JOAS.JOAS_37_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_37_17","url":null,"abstract":"BACKGROUND: Vitamin D deficiency has been implicated in the pathogenesis of autoimmune diseases. Reduced Vitamin D intake has been linked to increased susceptibility to the development of rheumatoid arthritis (RA). The objective was to evaluate 25-hydroxy (25-OH) Vitamin D status in patients with RA and to assess the relationship between Vitamin D level and RA disease activity. MATERIALS AND METHODS: The study consists of 50 RA patients as cases and 50 age- and body mass index matched healthy individuals as controls. All study participants (both controls and cases) underwent biochemical profile such as RA factor, serum uric acid (UA), calcium, phosphorous, alkaline phosphatase, and 25-OH Vitamin D levels. Disease activity was evaluated by calculating the 28-joint count as disease activity score. All the results were expressed as mean and standard deviation (SD). RESULTS: Mean and SD values of serum UA (mg/dl), calcium (mg/dl), and phosphorous levels (mg/dl) in RA cases are as follows 7.2 ± 1.3, 7.5 ± 0.5, and 6.9 ± 1.5, respectively. Serum UA, calcium, and phosphorous levels in RA cases were found to be elevated when compared to controls (P < 0.0001). Mean erythrocyte sedimentation rate was 58.4 ± 14.7 mm/h in the group of patients with RA. Levels of 25-OH Vitamin D were found to be negatively correlated to the DAS28, the correlation coefficient being r = −0.51 (P < 0.05). Levels of 25-OH Vitamin D were found to be positively correlated to serum calcium levels, the correlation coefficient being r = 0.82 (P < 0.01). CONCLUSION: RA patients had lower Vitamin D values than healthy controls. There was a negative correlation between serum Vitamin D and RA disease activity.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49031948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Symptomatic lumbar facets manifest as low back pain located paraspinally of varying intensity. The pain may increase with extension and rotation and can be well localized or diffuse and associated with extension lag on prolonged sitting. This pain can be easily identified by facet or medial branch block and then treated by ablating under vision this medial branch. Results are gratifying and can delay need for fusion in patients.
{"title":"LUMBAR facet denervation for degenerative symptomatic functional spinal unit: Overview","authors":"S. Gore","doi":"10.4103/JOAS.JOAS_55_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_55_17","url":null,"abstract":"Symptomatic lumbar facets manifest as low back pain located paraspinally of varying intensity. The pain may increase with extension and rotation and can be well localized or diffuse and associated with extension lag on prolonged sitting. This pain can be easily identified by facet or medial branch block and then treated by ablating under vision this medial branch. Results are gratifying and can delay need for fusion in patients.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70812462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Krishnan, Manish Barot, B. Dave, Paresh Bang, D. Devanand, Denish Patel, Amit Jain
INTRODUCTION: In the quest for better alternatives for open transforaminal lumbar interbody fusion (TLIF), minimally invasive surgery-TLIF (MIS-TLIF) has evolved, and feasibility studies of transforaminal endoscopic fusion are also getting reported in western literature. However, the cost of instrumented expandable cage may make it non-feasible for Indian setup whenever it will be commercially available. METHODS: This is a retrospective study of 13 patients of single-level percutaneous transforaminal endoscopic decompression and cageless percutaneous bone graft TLIF with percutaneous pedicle screw fixation under combined local with epidural anesthesia. The results of all patients as measured by validated tools of visual analogue score-Back and Leg, Oswestry Disability Index, patient satisfaction index, and fusion. The operating time, Estimated Blood Loss, Length of hospital stay and tolerance of patient for procedure was also scored. RESULTS: All the outcome measures were significant (P < 0.05) and fusion achieved in all with a mean follow-up period was 39 ± 6.36 months. Operating room time was 250.23 ± 52.90 min (187–327). Postoperative LOH hospital stay was 29.92 ± 4.94 h (24–39). The tolerance score was 2.30 ± 0.85 (1–3). One superficial bone graft site infection resolved with antibiotics. CONCLUSION: It not appealing to be recommendable to general population inspite of it being low cost and with negligible complications. Further research and engineered tools are needed to reduce the operating time.
{"title":"Percutaneous transforaminal endoscopic decompression and cageless percutaneous bone graft transforaminal lumbar interbody fusion: A feasibility study","authors":"A. Krishnan, Manish Barot, B. Dave, Paresh Bang, D. Devanand, Denish Patel, Amit Jain","doi":"10.4103/JOAS.JOAS_62_17","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_62_17","url":null,"abstract":"INTRODUCTION: In the quest for better alternatives for open transforaminal lumbar interbody fusion (TLIF), minimally invasive surgery-TLIF (MIS-TLIF) has evolved, and feasibility studies of transforaminal endoscopic fusion are also getting reported in western literature. However, the cost of instrumented expandable cage may make it non-feasible for Indian setup whenever it will be commercially available. METHODS: This is a retrospective study of 13 patients of single-level percutaneous transforaminal endoscopic decompression and cageless percutaneous bone graft TLIF with percutaneous pedicle screw fixation under combined local with epidural anesthesia. The results of all patients as measured by validated tools of visual analogue score-Back and Leg, Oswestry Disability Index, patient satisfaction index, and fusion. The operating time, Estimated Blood Loss, Length of hospital stay and tolerance of patient for procedure was also scored. RESULTS: All the outcome measures were significant (P < 0.05) and fusion achieved in all with a mean follow-up period was 39 ± 6.36 months. Operating room time was 250.23 ± 52.90 min (187–327). Postoperative LOH hospital stay was 29.92 ± 4.94 h (24–39). The tolerance score was 2.30 ± 0.85 (1–3). One superficial bone graft site infection resolved with antibiotics. CONCLUSION: It not appealing to be recommendable to general population inspite of it being low cost and with negligible complications. Further research and engineered tools are needed to reduce the operating time.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42864394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transforaminal endoscopic lumbar spine surgery has evolved leaps and bounds in the last 10 years, and as such, it is now not limited to simple contained herniation. It can now be successfully done for central, extraforaminal, extruded, and migrated herniations, which were considered bad indications when the procedure was limited to central intradiscal nucleotomy or debulking. With better understanding of the foraminal anatomy, more bold approaches to intervertebral foramen are now being undertaken. Moreover, with further development in instruments, such as motorized burrs and lasers, we can now successfully treat the foraminal and lateral canal stenosis. With the advantages of Transforaminal endoscopic techniques, such as use of local anesthesia, minimal skin incision, no need for neuromuscular retraction, and no excessive bone removal, with minimal approach-related morbidity, allows it to be applied safely in extremes of age, with early return to normal life. The procedure of foraminoplasty is vital to achieve these extended targets in Transforaminal endoscopic surgeries. The term foraminoplasty is used among the spine endoscopists to broadly describe the expansion of the foraminal boundaries and it is reversibly used to describe foraminotomy. However, foraminotomy is performed for widening the foramen to reach far off and difficult targets, whereas foraminoplasty is performed for decompression of neural structures in the treatment of foraminal and lateral stenosis. In this article, we discuss both the procedures. To understand the principles and successfully employ the technique, let us first understand the foraminal anatomy.
{"title":"Foraminoplasty","authors":"A. Kavi","doi":"10.4103/joas.joas_58_17","DOIUrl":"https://doi.org/10.4103/joas.joas_58_17","url":null,"abstract":"Transforaminal endoscopic lumbar spine surgery has evolved leaps and bounds in the last 10 years, and as such, it is now not limited to simple contained herniation. It can now be successfully done for central, extraforaminal, extruded, and migrated herniations, which were considered bad indications when the procedure was limited to central intradiscal nucleotomy or debulking. With better understanding of the foraminal anatomy, more bold approaches to intervertebral foramen are now being undertaken. Moreover, with further development in instruments, such as motorized burrs and lasers, we can now successfully treat the foraminal and lateral canal stenosis. With the advantages of Transforaminal endoscopic techniques, such as use of local anesthesia, minimal skin incision, no need for neuromuscular retraction, and no excessive bone removal, with minimal approach-related morbidity, allows it to be applied safely in extremes of age, with early return to normal life. The procedure of foraminoplasty is vital to achieve these extended targets in Transforaminal endoscopic surgeries. The term foraminoplasty is used among the spine endoscopists to broadly describe the expansion of the foraminal boundaries and it is reversibly used to describe foraminotomy. However, foraminotomy is performed for widening the foramen to reach far off and difficult targets, whereas foraminoplasty is performed for decompression of neural structures in the treatment of foraminal and lateral stenosis. In this article, we discuss both the procedures. To understand the principles and successfully employ the technique, let us first understand the foraminal anatomy.","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49151563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oblique lumbar interbody fusion","authors":"John Y. S. Choi, P. Singh","doi":"10.4103/JOAS.JOAS_21_18","DOIUrl":"https://doi.org/10.4103/JOAS.JOAS_21_18","url":null,"abstract":"","PeriodicalId":31882,"journal":{"name":"Journal of Orthopaedics and Allied Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45130214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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