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Acute Paraparesis Secondary to Epidural Hematoma Caused by Spinal Anesthesia Given for Lower Segment Caesarean Section

Volume 8 | Issue 2 | Aug – Sep 2020 | Page: 46-48 | Uday Kumar Guled


Authors: Uday Kumar Guled [1]

[1] Department of Orthopaedics, S Nijalingappa Medical College ,Bagalkot, Karnataka, India.

Address of Correspondence
Dr. Udaykumar Guled
Assistant professor , S Nijalingappa Medical College ,Bagalkot, Karnataka, India.
E-mail: DRUDAYGULED@GMAIL.COM


Abstract

Spinal anesthesia is one of the most common anesthetic procedure performed in operative cases . Neurological deficit is an uncommon but catastrophic complication of spinal anesthesia. Epidural hematoma is the most common cause of such neurological deficit. Unidentified bleeding and clotting disorders increase the risk. On detection such complications need close monitoring. Though many cases can be managed conservatively, progressive deficit warrants quick decompression of spinal canal.
Keywords: Epidural hematoma, Paraparesis, Spinal anesthesia, Laminectomy.


References

1. Vandam. On the origins of intrathecal anaethesia. Int Anaesthesiol Clin 1989; 27: 2-7.
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How to Cite this article: Guled U K| Acute Paraparesis Secondary to Epidural Hematoma Caused by Spinal Anesthesia Given for Lower Segment Caesarean Section | Journal of Karnataka Orthopaedic Association | August-September 2020; 8(2): 46-48.

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A Study to Assess the Functional Outcome After Laminotomy and Microdiscectomy in Lower Lumbar Disc Prolapse

Volume 6 | Issue 2 | May-Aug 2018 | Page 12-15 | Deepak Hegde, Arjun Ballal, Hishanil Rasheed


Authors: Deepak Hegde [1], Arjun Ballal [2], Hishanil Rasheed [1].

[1] Department of Orthopaedics, K.S Hegde Medical Academy, Mangalore – 575 018, Karnataka, India,

[2] Department of Orthopaedics, Consultant Orthopaedic Surgeon, Ballal Healthcare, Udupi – 576 105, Karnataka, India.

Address of Correspondence
Dr. Deepak Hegde,

Department of Orthopaedics, K.S Hegde Charitable Hospital,

Medical sciences Complex, Deralkatte, Mangalore – 575 018, Karnataka, India.

E-mail: arjchess_lp@rediffmail.com


Abstract

Background: Advances in technology with better surgical techniques and instrumentation have proved time and again to reduce the incidence of complications and cosmetic morbidities caused by the traditional techniques in the management of intervertebral disc prolapse of the lumbar spine. By limiting the width of the surgical corridor the risk of muscle crush, exposure of soft tissues for infection and post-operative morbidity and complications can be minimized by great amounts.

Aims and Objectives: The aim of the study was to assess the functional outcome of the spine after laminotomy and microdiscectomy in cases of lower lumbar intervertebral disc prolapse.

Materials and Methods: A prospective study was conducted in the department of orthopedics of a teaching hospital in Southern India. A total of 28 diagnosed cases of intervertebral disc prolapse at L5-S1 levels were included in the study. The preoperative functional status was assessed as per the modified oswestry disability index (ODI) and visual analog scale (VAS). All of them underwent laminotomy of L5 vertebra and microdiscectomy at L5-S1 level. The patients were reviewed at postoperative weeks 6, 12, and 24 and the functional status of the spine was assessed and tabulated using the modified ODI and VAS. All results were tabulated and calculated with repeated measures ANOVA using SPSS software version 20.0.

Results: It was noted that the modified ODI scores preoperatively had a mean of 75 ± 11.85% which improved to 55 ± 9.18% at 6 weeks, 45 ± 9.37% at 12 weeks, and 36 ± 8.65% at 24 weeks. The VAS scores were noted to have a mean of 8 ± 0.93 mm preoperatively. It was noted to have improved to 6 ± 0.93 mm at 6 weeks, 5 ± 0.74 mm at 12 weeks, and then to 5 ± 0.73 mm at 24 weeks. This showed that there was an improvement in the back function after surgery in all the cases. No complications were noted in any of the cases.

Conclusion: Laminotomy and microdiscectomy level is an excellent technique of management of intervertebral disc prolapsed of L5-S1 with minimal complication rate.

Keywords:  Visual analogue scale, Oswestry Disability Index, lumbar spine, laminotomy, microdiscectomy.


References

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2. Aslam M, Khan FR, Huda N, Pant A, Julfiqar M, Goel A. Outcome of discectomy by fenestration technique in prolapsed lumbar intervertebral disc. Ann Int Med Den Res 2015;1:286-90.

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6. Porchet F, Bartanusz V, Kleinstueck FS, Lattig F, Jeszenszky D, Grob D, et al. Microdiscectomy compared with standard discectomy: An old problem revisited with new outcome measures within the framework of a spine surgical registry. Eur Spine J 2009;18 Suppl 3:360-6.

7. Mayer HM, Brock M. Percutaneous endoscopic discectomy: surgical technique and preliminary results compared to microsurgical discectomy. J Neurosurg1 1993;78:216-25.

8. Arts MP, Nieborg A, Brand R, Peul WC. Serum creatine phosphokinase as an indicator of muscle injury after various spinal and nonspinal surgical procedures. J Neurosurg Spine 2007;7:2826.

9. German JW, Adamo MA, Hoppenot RG, Blossom JH, Nagle HA. Perioperative results following lumbar discectomy: Comparison of minimally invasive discectomy and standard microdiscectomy. Neurosurg Focus 2008;25:E20.

10. Harrington JF, French P. Open versus minimally invasive lumbar microdiscectomy: Comparison of operative times, length of hospital stay, narcotic use and complications. Minim Invasive Neurosurg 2008;51:30-5.

11. Oppenheimer JH, DeCastro I, McDonnell DE. Minimally invasive spine technology and minimally invasive spine surgery: A historical review. Neurosurg Focus 2009;27:E9.

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13. Bhatia PS, Chhabra HS, Mohapatra B, Nanda A, Sangodimath G, Kaul R, et al. Microdiscectomy or tubular discectomy: Is any of them a better option for management of lumbar disc prolapse. J Craniovertebr Junction Spine 2016;7:146-52.

14. Dewing CB, Provencher MT, Riffenburgh RH, Kerr S, Manos RE. The outcomes of lumbar microdiscectomy in a young, active population: Correlation by herniation type and level. Spine (Phila Pa 1976) 2008;33:33-8.

15. Lønne G, Solberg TK, Sjaavik K, Nygaard ØP. Recovery of muscle strength after microdiscectomy for lumbar disc herniation: A prospective cohort study with 1-year follow-up. Eur Spine J 2012;21:655-9.


How to Cite this article: Kulkarni M S, Fahim S M, Naik M, Vijayan S, Shetty S, Rao S K. Outcome Analysis of Osteosynthesis of Complex Fractures of Both Bones of Forearm. J Kar Orth Assoc. MayAug 2018; 6(2):12-15.

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