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MEDICAL SCIENCES (2241 journals)            First | 1 2 3 4 5 6 7 8 | Last

Showing 601 - 800 of 3562 Journals sorted alphabetically
F&S Science : Official journal of the American Society for Reproductive Medicine     Open Access  
Facial Plastic Surgery & Aesthetic Medicine     Full-text available via subscription   (Followers: 3)
Facta Universitatis, Series : Medicine and Biology     Open Access  
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Practice     Hybrid Journal   (Followers: 17)
Family Practice & Palliative Care     Open Access   (Followers: 5)
Family Practice Management     Full-text available via subscription   (Followers: 4)
Faridpur Medical College Journal     Open Access  
FEM : Revista de la Fundación Educación Médica     Open Access  
Finlay : Revista de Enfermedades no Transmisibles     Open Access  
Fisioterapia     Full-text available via subscription   (Followers: 2)
Fisioterapia & Saúde Funcional     Open Access  
Flugmedizin · Tropenmedizin · Reisemedizin - FTR     Hybrid Journal  
FMC - Formación Médica Continuada en Atención Primaria     Full-text available via subscription  
Folia Medica     Open Access  
Folia Medica Indonesiana     Open Access  
Folia Morphologica     Full-text available via subscription  
Folia Phoniatrica et Logopaedica     Full-text available via subscription   (Followers: 1)
Fontanus     Open Access  
Food Hydrocolloids for Health     Open Access  
Foodborne Pathogens and Disease     Hybrid Journal   (Followers: 11)
Foot & Ankle Specialist     Hybrid Journal   (Followers: 4)
Foot and Ankle Clinics     Full-text available via subscription   (Followers: 12)
Foot and Ankle Online Journal     Full-text available via subscription   (Followers: 6)
Forensic Science International : Mind and Law     Open Access   (Followers: 4)
Forum Medycyny Rodzinnej     Hybrid Journal  
Forum Zaburzeń Metabolicznych     Hybrid Journal  
Frontières     Full-text available via subscription   (Followers: 3)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Medical Technology     Open Access  
Frontiers in Medicine     Open Access   (Followers: 2)
Frontiers in Network Physiology     Open Access   (Followers: 2)
Frontiers in Neuroprosthetics     Open Access   (Followers: 6)
Frontiers in Synaptic Neuroscience     Open Access   (Followers: 2)
Frontiers in Tropical Diseases     Open Access  
Frontiers of Medical and Biological Engineering     Hybrid Journal  
Frontiers of Medicine     Hybrid Journal   (Followers: 2)
Fuss & Sprunggelenk     Hybrid Journal  
Future Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Future Prescriber     Hybrid Journal  
Future Science OA     Open Access  
Gaceta Médica Boliviana     Open Access  
Gaceta Médica Espirituana     Open Access  
Galen Medical Journal     Open Access  
Galician Medical Journal     Open Access   (Followers: 1)
Galle Medical Journal     Open Access  
Gefäßmedizin Scan     Hybrid Journal  
Gender and the Genome     Open Access   (Followers: 1)
Gene Expression     Full-text available via subscription   (Followers: 1)
General Reanimatology     Open Access  
Genes     Open Access   (Followers: 2)
Genome Instability & Disease     Hybrid Journal  
Geoforum     Hybrid Journal   (Followers: 25)
Gestão e Desenvolvimento     Open Access  
Ghana Medical Journal     Open Access   (Followers: 1)
GigaScience     Open Access   (Followers: 4)
Gimbernat : Revista d’Història de la Medicina i de les Ciències de la Salut     Open Access  
Glia     Hybrid Journal   (Followers: 5)
Global Advances in Health and Medicine     Open Access  
Global Bioethics     Open Access   (Followers: 5)
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Journal     Open Access   (Followers: 2)
Global Journal of Integrated Chinese Medicine and Western Medicine     Open Access  
Global Journal of Cancer Therapy     Open Access  
Global Journal of Fertility and Research     Open Access  
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Infectious Diseases and Clinical Research     Open Access  
Global Journal of Medical and Clinical Case Reports     Open Access  
Global Journal of Obesity, Diabetes and Metabolic Syndrome     Open Access   (Followers: 1)
Global Journal of Perioperative Medicine     Open Access  
Global Journal of Rare Diseases     Open Access  
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Reproductive Health     Open Access  
Grande Medical Journal     Open Access  
Growth Factors     Hybrid Journal   (Followers: 2)
GSTF Journal of Advances in Medical Research     Open Access  
Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi     Open Access  
Hamdan Medical Journal     Open Access  
Hämostaseologie     Hybrid Journal   (Followers: 5)
Hämostaseologie     Open Access  
Hand     Hybrid Journal   (Followers: 4)
Hand Clinics     Full-text available via subscription   (Followers: 6)
Hand Therapy     Hybrid Journal   (Followers: 11)
Hard Tissue     Open Access  
Head & Face Medicine     Open Access   (Followers: 1)
Head and Neck Cancer Research     Open Access  
Head and Neck Tumors     Open Access  
Health Information : Jurnal Penelitian     Open Access  
Health Matrix : The Journal of Law-Medicine     Open Access  
Health Notions     Open Access  
Health Science Journal of Indonesia     Open Access  
Health Science Reports     Open Access   (Followers: 1)
Health Sciences and Disease     Open Access   (Followers: 1)
Health Sciences Review     Open Access  
Health Security     Hybrid Journal   (Followers: 1)
Healthcare Technology Letters     Open Access  
Hearing, Balance and Communication     Hybrid Journal   (Followers: 6)
Hearts     Open Access   (Followers: 1)
HEC Forum     Hybrid Journal   (Followers: 1)
Heighpubs Otolaryngology and Rhinology     Open Access  
Heilberufe     Hybrid Journal  
HeilberufeSCIENCE     Hybrid Journal  
Heilpflanzen     Hybrid Journal   (Followers: 4)
Helicobacter     Hybrid Journal  
HemaSphere     Open Access   (Followers: 2)
Hemoglobin     Hybrid Journal  
Hepatology, Medicine and Policy     Open Access  
HERALD of North-Western State Medical University named after I.I. Mechnikov     Open Access  
Herald of the Russian Academy of Sciences     Full-text available via subscription  
Herzschrittmachertherapie + Elektrophysiologie     Hybrid Journal  
Highland Medical Research Journal     Full-text available via subscription  
Hipertensión y Riesgo Vascular     Full-text available via subscription  
HIV Australia     Full-text available via subscription   (Followers: 3)
Homeopathy     Hybrid Journal   (Followers: 1)
Homoeopathic Links     Hybrid Journal  
Hong Kong Physiotherapy Journal     Open Access   (Followers: 14)
Horizonte Medico     Open Access  
Hormones : International Journal of Endocrinology and Metabolism     Hybrid Journal  
Hospital a Domicilio     Open Access  
Hospital Practices and Research     Open Access  
Hospital Topics     Hybrid Journal   (Followers: 1)
Hua Hin Sook Jai Klai Kangwon Journal     Open Access  
Huisarts en wetenschap     Hybrid Journal   (Followers: 4)
Human & Veterinary Medicine - International Journal of the Bioflux Society     Open Access   (Followers: 4)
Human Factors in Healthcare     Open Access  
Human Fertility     Hybrid Journal   (Followers: 4)
Humanidades Médicas     Open Access  
I.P. Pavlov Russian Medical Biological Herald     Open Access  
Iatreia     Open Access  
Ibnosina Journal of Medicine and Biomedical Sciences     Open Access  
IDCases     Open Access  
IEEE Journal of Biomedical and Health Informatics     Hybrid Journal   (Followers: 14)
IEEE Journal of Electromagnetics, RF and Microwaves in Medicine and Biology     Hybrid Journal  
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 5)
IEEE Open Journal of Engineering in Medicine and Biology     Open Access   (Followers: 1)
IEEE Transactions on Medical Robotics and Bionics     Hybrid Journal   (Followers: 3)
IEEE/ACM Transactions on Computational Biology and Bioinformatics     Hybrid Journal   (Followers: 18)
IJID Regions     Open Access   (Followers: 1)
IJS Global Health     Open Access  
IJU Case Reports     Open Access  
iLiver     Open Access   (Followers: 2)
Im OP     Hybrid Journal  
Image Analysis & Stereology     Open Access   (Followers: 1)
IMAGING     Full-text available via subscription   (Followers: 1)
Imaging in Medicine     Open Access  
Imaging Journal of Clinical and Medical Sciences     Open Access   (Followers: 1)
Imam Journal of Applied Sciences     Open Access  
Indian Journal of Ayurveda and lntegrative Medicine Klue     Open Access   (Followers: 3)
Indian Journal of Burns     Open Access   (Followers: 2)
Indian Journal of Clinical Medicine     Open Access  
Indian Journal of Community and Family Medicine     Open Access   (Followers: 2)
Indian Journal of Community Medicine     Open Access   (Followers: 1)
Indian Journal of Health Sciences and Biomedical Research KLEU     Open Access   (Followers: 2)
Indian Journal of Medical Microbiology     Open Access   (Followers: 1)
Indian Journal of Medical Research     Open Access   (Followers: 3)
Indian Journal of Medical Sciences     Open Access   (Followers: 2)
Indian Journal of Medical Specialities     Hybrid Journal  
Indian Journal of Otology     Open Access   (Followers: 1)
Indian Journal of Public Health     Open Access   (Followers: 1)
Indian Journal of Transplantation     Open Access  
Indian Spine Journal     Open Access  
Indo-Pacific Journal of Phenomenology     Open Access   (Followers: 1)
Indonesia Journal of Biomedical Science     Open Access   (Followers: 1)
Indonesian Biomedical Journal     Open Access  
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Medicine     Open Access  
Indonesian Journal of Tropical and Infectious Disease     Open Access  
Infant Observation: International Journal of Infant Observation and Its Applications     Hybrid Journal   (Followers: 1)
Inflammation     Hybrid Journal   (Followers: 3)
Inflammation Research     Hybrid Journal   (Followers: 4)
Info Diabetologie     Full-text available via subscription   (Followers: 1)
Infodir : Revista de Información científica para la Dirección en Salud     Open Access  
Informatics in Medicine Unlocked     Open Access  
Injury Prevention     Hybrid Journal   (Followers: 6)
InnovAiT     Hybrid Journal   (Followers: 1)
Innovare Journal of Health Science     Open Access  
Innovare Journal of Medical Science     Open Access  
Innovation in Aging     Open Access   (Followers: 1)
Inside Precision Medicine     Full-text available via subscription   (Followers: 4)
Insights in Biology and Medicine     Open Access  
Integrative and Complementary Therapies     Full-text available via subscription   (Followers: 3)
Integrative Medicine Insights     Open Access   (Followers: 1)
Integrative Medicine International     Open Access   (Followers: 1)
Integrative Medicine Research     Open Access   (Followers: 3)
Intellectual Disability Australasia     Full-text available via subscription   (Followers: 12)
Intelligence-Based Medicine     Open Access  
Intelligent Medicine     Open Access   (Followers: 1)
intensiv     Hybrid Journal   (Followers: 1)
interactive Journal of Medical Research     Open Access  
Interdisciplinary Perspectives on Infectious Diseases     Open Access  
Interdisciplinary Sciences : Computational Life Sciences     Hybrid Journal   (Followers: 2)
Internal Medicine     Open Access   (Followers: 1)
International Biomechanics     Open Access   (Followers: 1)
International Health     Hybrid Journal   (Followers: 5)
International Health Trends and Perspectives     Open Access  
International Journal for Numerical Methods in Biomedical Engineering     Hybrid Journal   (Followers: 2)
International Journal for Vitamin and Nutrition Research     Hybrid Journal   (Followers: 10)
International Journal of Academic Medicine     Open Access   (Followers: 1)
International Journal of Advance in Medical Science     Open Access  
International Journal of Advanced Medical and Health Research     Open Access  

  First | 1 2 3 4 5 6 7 8 | Last

Similar Journals
Journal Cover
Indian Spine Journal
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2589-5079 - ISSN (Online) 2589-5087
Published by Medknow Publishers Homepage  [448 journals]
  • Cervical spine injury: A historical perspective

    • Authors: Manish Chadha, Rajesh Arora, Anil K Jain
      Pages: 1 - 3
      Abstract: Manish Chadha, Rajesh Arora, Anil K Jain
      Indian Spine Journal 2022 5(1):1-3

      Citation: Indian Spine Journal 2022 5(1):1-3
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_111_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Innovations in cervical spine trauma: Developing the next generation upper
           cervical spine injury classification system

    • Authors: Brian A Karamian, Hannah A Levy, Paul D Minetos, Michael L Smith, Alexander R Vaccaro
      Pages: 4 - 9
      Abstract: Brian A Karamian, Hannah A Levy, Paul D Minetos, Michael L Smith, Alexander R Vaccaro
      Indian Spine Journal 2022 5(1):4-9
      The upper cervical spine not only consists of intricate bony and ligamentous anatomy affording unique flexibility but also has increased susceptibility to injuries. The upper cervical spine trauma can result in a wide spectrum of injuries that can be managed both operatively and nonoperatively. Several existing classification systems have been proposed to describe injuries of the upper cervical spine, many of which rely on anatomic descriptions of injury location. Prior fracture classifications are limited in scope, characterizing fractures restricted to a single region of the upper cervical spine, and fail to provide insight into injury management. The AO Spine Upper Cervical Injury Classification System (AO Spine UCCS) has recently been developed as a comprehensive, yet concise classification scheme to describe all injuries of the upper cervical spine. The AO Spine UCCS represents a significant development in the classification of upper cervical spine injuries, with the potential to serve as a decision-making instrument to aid in patient management.
      Citation: Indian Spine Journal 2022 5(1):4-9
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_28_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Approach to upper cervical trauma

    • Authors: Gomatam R Vijay Kumar
      Pages: 10 - 23
      Abstract: Gomatam R Vijay Kumar
      Indian Spine Journal 2022 5(1):10-23
      Upper cervical spine injuries are relatively common and are often the result of blunt trauma. These injuries can be neurologically devastating and can have a high mortality. Management of these injuries requires an in-depth understanding of the complex anatomy of this region, delineation of the injury morphology, and classification after appropriate imaging. The treatment, surgical or conservative, is based on the neurological injury and structural instability.Bony injuries of the upper cervical spine, such as the occipital condylar fractures, fractures of the atlas, majority of odontoid fractures, and traumatic spondylolisthesis of the axis, respond well to nonsurgical management by external immobilization. In contrast, ligamentous injuries of the atlanto-occipital joints or the transverse atlantal ligament (TAL) have a poorer prognosis for healing and often require surgical intervention.
      Citation: Indian Spine Journal 2022 5(1):10-23
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_31_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Approach and considerations for surgery in subaxial cervical spine injury:
           A narrative review

    • Authors: K S Sri Vijay Anand, Ajoy Prasad Shetty, S Rajasekaran
      Pages: 24 - 38
      Abstract: K S Sri Vijay Anand, Ajoy Prasad Shetty, S Rajasekaran
      Indian Spine Journal 2022 5(1):24-38
      Subaxial cervical spine injuries are common and encompass a spectrum of injuries ranging from a minor ligamentous sprain to fracture dislocation with spinal cord injury. These injuries are often missed in the initial evaluation, and a high index of suspicion is needed to evaluate and diagnose these injuries, which otherwise could lead to spinal cord injury. Computed tomography scans are the gold standard in the evaluation of fractures as plain radiographs have limited sensitivity. Magnetic resonance imaging (MRI) is necessary to identify injury to the disco-ligamentous complex and to assess cord injury. The principles of the treatment of cervical spine injuries include early immobilization to prevent secondary neurological injury, achieving alignment by reduction and stabilization of the unstable injured segment and decompression of the cord in the presence of cord injury. Owing to a broad spectrum of injuries, there is no unified approach, and the management plan depends on the morphology of injury, the extent of structures damaged, and the presence of neurological impairment. Various classifications grade and help assess the severity of the injury. Minor injuries are conservatively managed with cervical orthoses, and unstable injuries require stabilization either anterior, posterior, or combined approaches, depending on the injury morphology. Controversy exists over the safety of closed reduction in facetal subluxations, need for pre-reduction MRI, and the ideal approach for each injury. This review presents the current evidence and guidelines on the management of subaxial cervical spine injuries.
      Citation: Indian Spine Journal 2022 5(1):24-38
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_39_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Diagnosis and management of acute traumatic central cord syndrome: Present
           consensus and narrative review

    • Authors: Harvinder S Chhabra, Nirdesh H Jagadeesh, Kuldeep Bansal, Phani K Karthik Yelamarthy
      Pages: 39 - 46
      Abstract: Harvinder S Chhabra, Nirdesh H Jagadeesh, Kuldeep Bansal, Phani K Karthik Yelamarthy
      Indian Spine Journal 2022 5(1):39-46
      This is a narrative review to get an overview of the diagnosis and management of the acute traumatic cervical central cord syndrome (ATCCS) with an evidence-based approach. We considered articles that addressed the gray areas in the management of ATCCS, that is, the need for surgical intervention and its timing. The ATCCS is the most common form of incomplete spinal cord injury. The presence of instability and deteriorating neurology have been absolute indications for surgery. The opinion has been divided between early surgeries vis-à-vis monitoring for recovery and delayed surgery if neurological recovery plateaus. An extensive search revealed a low level of evidence. With the advent of modern anesthetic as well as surgical techniques and perioperative management, there may be better and faster neurological recovery with surgery. Considering the timing of surgery, even though many articles are propagating the need for early surgery the level of evidence remains low. This narrative review highlights the need for well-conducted prospective studies to resolve the controversy regarding early surgery versus conservative management and delayed surgery if recovery plateaus or on neurological deterioration. Since there is only a low level of evidence in favor of early surgery for ATCCS with no instability and deteriorating neurology, the decision of the surgery and its timing should be left to the surgeon’s judgment, with a plan tailored after assessing risks and benefits.
      Citation: Indian Spine Journal 2022 5(1):39-46
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_40_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Controversies in cervical spine trauma: The role of timing of surgical
           decompression and the use of methylprednisolone sodium succinate in spinal
           cord injury. A narrative and updated systematic review

    • Authors: Nader Hejrati, Brett Rocos, Michael G Fehlings
      Pages: 47 - 68
      Abstract: Nader Hejrati, Brett Rocos, Michael G Fehlings
      Indian Spine Journal 2022 5(1):47-68
      Traumatic spinal cord injuries (SCIs) have devastating physical, social, and financial consequences for both patients and their families. SCIs most frequently occur at the cervical spine level, and these injuries are particularly prone to causing debilitating functional impairments. Unfortunately, no effective neuroregenerative therapeutic approaches capable of reversing lost neurologic and functional impairments exist, resulting in a large number of patients living with the persistent disability caused by a chronic cervical SCI. Over the past decades, a multitude of nonpharmacologic and pharmacologic neuroprotective strategies have been intensely investigated, including the timing of surgical decompression and the role of methylprednisolone sodium succinate (MPSS) in patients with acute SCI. These strategies have been the source of vibrant debate surrounding their potential risks and benefits. Our aim in this combined narrative and updated systematic review is to provide an assessment on the timing of surgical decompression as well as the role of high-dose MPSS treatment in patients with traumatic SCIs, with a special emphasis on the cervically injured subpopulation. Based on the current literature, there is strong evidence to support early surgical decompression within 24 h of injury to promote enhanced neurologic recovery. Meanwhile, moderate evidence supports the early initiation of a 24-h high-dose MPSS treatment within 8 h of injury, particularly in patients with a cervical SCI.
      Citation: Indian Spine Journal 2022 5(1):47-68
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_26_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Predicting outcomes following cervical spine trauma

    • Authors: Giorgio Scivoletto
      Pages: 69 - 81
      Abstract: Giorgio Scivoletto
      Indian Spine Journal 2022 5(1):69-81
      Outcome prediction is fundamental for patients with spinal cord injury (SCI) to allow correct counselling of patients and their families and to determine resource allocation during and after rehabilitation immediately after the lesion. Furthermore, knowledge of the natural history of SCI is mandatory to project and assess the results of clinical trials.Thus, the aim of this narrative review was to provide a clear picture of the neurological and functional outcomes of subjects with cervical SCI.This review was based on MEDLINE, EMBASE, SCOPUS, Web of Science, and the Cochrane Central Register of Controlled Trials databases. The following search terms were used: prognosis prediction, SCI, tetraplegia/quadriplegia, neurologic recovery, and ambulation/gait/walking recovery. All article types of the manuscript were included with the exception of animal studies and studies in languages other than English.Both neurological and functional recovery could be prognosticated by the severity of the lesion as assessed by radiological findings and the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). The effect of other factors (such as age, gender and presence of specific syndromes) is also discussed in relation to neurologic and walking recovery.
      Citation: Indian Spine Journal 2022 5(1):69-81
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_29_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Traumatic cervical spine injury: Clinical scenarios

    • Authors: Ankur Nanda, Sudhir Kumar Srivastava, Ajoy Prasad Shetty, Bharat R Dave, Harvinder Singh Chhabra, Raymond Onders, Jitesh Manghwani, Nandan Amrit Marathe, R Karthik, Mohit Navinchand Muttha
      Pages: 82 - 98
      Abstract: Ankur Nanda, Sudhir Kumar Srivastava, Ajoy Prasad Shetty, Bharat R Dave, Harvinder Singh Chhabra, Raymond Onders, Jitesh Manghwani, Nandan Amrit Marathe, R Karthik, Mohit Navinchand Muttha
      Indian Spine Journal 2022 5(1):82-98
      This section of the symposium deals with different clinical situations related to the management of traumatic cervical spine cord injury (SCI) and its complications. These cases give an overview of the clinical dilemmas that test our decision-making abilities in dealing with patients with cervical SCI and its associated complications. The patients were managed in various centers across India with different infrastructures and facilities. They are managed by different experts in the field of spine surgery. This should help the reader in providing a wider perspective in the management of vertebral lesions of traumatic cervical SCI. This section also helps in understanding the newer advances in dealing with the dreaded complication of invasive long-term ventilation in a patient with cervical SCI. The spine clinic ends with comments by the authors on key takeaway points from each case scenario, and some literature supported recommendations for the management of traumatic cervical SCI.
      Citation: Indian Spine Journal 2022 5(1):82-98
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_105_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Tailbone: Is partial coccygectomy the way to go?

    • Authors: Subir Nipunbhai Jhaveri, Arth Patel, Sachin R Patel, Sharan Subir Jhaveri, Jignasu Yagnik
      Pages: 99 - 105
      Abstract: Subir Nipunbhai Jhaveri, Arth Patel, Sachin R Patel, Sharan Subir Jhaveri, Jignasu Yagnik
      Indian Spine Journal 2022 5(1):99-105
      Background: Complete coccygectomy has proved to be a successful operation, with a success ratio of 70%–85%. Wound infection and dehiscence following coccygectomy ranges between 15% and 30%. The purpose of this article was to present improved outcomes following partial coccygectomy and to suggest modifications to mitigate wound complications. Methods: Seventeen patients (13 women and 4 men) underwent partial coccygectomy using a curved paramedian incision after failing nonoperative care for minimum of 6 months over the last 8 years. Twelve of these were posttraumatic, whereas five were of idiopathic origin. Patients were barred from sitting or sleeping supine for 2 weeks following the surgery. The use of water for cleaning post-defecation was also prohibited. Visual analog scale (VAS), Oswestry Disability Index (ODI), along with a novel Coccyx Disability Questionnaire (CDQ) as well as a truncated ODI (Coccyx Disability Index – CDI) were administered preoperatively, at 6 months and then at last follow-up. Wilcoxon signed rank tests were used as variables were nonparametric. Results: Fifteen patients completed questionnaires at a mean follow-up period of 68 months. Fourteen (93.33%) patients had good-to-excellent outcomes. VAS sitting improved from 9.27 to 0.79 (P = 0.001) and ODI improved from 68.89 to 8.27 (P = 0.001) postoperatively. Novel CDQ scores improved from 7.33 to 1.12 (P = 0.001) and CDI scores improved from 84.56 to 6.44 (P = 0.001). We compared outcomes of our partial coccygectomy cohort with those of complete or partial coccygectomy in literature, and found equivalent or superior results. Three (20%) of our patients developed wound infections, with only one (6.67%) requiring revision surgery, while the other two recovered with dressings. Conclusion: Partial coccygectomy provides equivalent or superior outcomes, compared to complete coccygectomy. Postoperative modifications for 2 weeks help mitigate wound complications. The proposed novel CDQ can be used by surgeons across the globe, once validated.
      Citation: Indian Spine Journal 2022 5(1):99-105
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_34_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Learning curve of thoracic pedicle screw fixation by freehand technique

    • Authors: Zahir Abbas, Sanjeev Asati, Vishal G Kundnani, Sanyam Jain, Ankit Patel, Saijyot Raut
      Pages: 106 - 111
      Abstract: Zahir Abbas, Sanjeev Asati, Vishal G Kundnani, Sanyam Jain, Ankit Patel, Saijyot Raut
      Indian Spine Journal 2022 5(1):106-111
      Background: The freehand method of inserting thoracic pedicle screw has become one of the most popular techniques; however, data on its learning curve are scanty. The purpose of this study was to delineate the learning curve and to evaluate the safety of freehand technique of thoracic pedicle screw placement in nondeformed spine. Materials and Methods: A total of 92 consecutive patients who underwent thoracic posterior stabilization with pedicle screws using freehand technique between 2012 and 2017 in various pathologies of nondeformed spine from T1 to T10 at a single institution by a single surgeon were analyzed. Patients were divided into four quartiles (Q1, Q2, Q3, Q4, with 23 patients each) with each consecutive group serving as control for its prior. Demographics (age, sex, pathology involved) and complications were evaluated. Postoperative computed tomography (CT) scan was taken for evaluation of screws perforation including level, direction, grade, and severity of perforation. Results: Of total of 735 screws inserted in 92 patients, 72 screws were perforated with a perforation rate of 9.79%. Of the total perforations, more than half (63.88%) were of Grade 2 and maximum perforations were seen in the lateral direction (58.3%). Total three critical perforations were noted but none of them were symptomatic. The highest rate of perforation was evident at T4 vertebra (18.29%), whereas it was lowest at T9 (3.79%). The perforation rate showed a statistically significant (P < 0.05) decline in Q2 as compared to Q1 achieving asymptote in Q1 after approximately 80–100 screws. Conclusion: A steep learning curve is associated with the freehand technique of thoracic pedicle screws and asymptote can be achieved after approximately 80–100 screws. Novice surgeons can reduce the learning curve by doing practice on saw bone models and cadaveric dissection learning to avoid perforations and other complications with understanding the complex anatomy and variations encountered in the typical thoracic spine.
      Citation: Indian Spine Journal 2022 5(1):106-111
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_11_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • Cauda Equina Syndrome—retention type (CESR): Outcome after delayed
           discectomy and decompression for lumbar disc herniation

    • Authors: Ujjwal Kanti Debnath, Sishir Kumar, Rishi Thakral, Tarun Chabra, Gourab Chatterjee
      Pages: 112 - 119
      Abstract: Ujjwal Kanti Debnath, Sishir Kumar, Rishi Thakral, Tarun Chabra, Gourab Chatterjee
      Indian Spine Journal 2022 5(1):112-119
      Background: The objective of this study was to evaluate the functional outcome after lumbar discectomy in Cauda equina syndrome—retention type (CESR) patients with delayed presentation. Materials and Methods: Fourteen patients with CESR presenting after 48 h (i.e., 2–42 days) from the onset of symptoms were included in the study. Acute lumbar disc prolapse was the cause of CESR in all patients. A detailed history including age, sex, onset of back pain, bladder and bowel symptoms, neurological signs, level of lesion, timing of surgery, and neurologic recovery (resolution of pain, sensory and motor deficits, and urinary, rectal, and sexual dysfunction [SD]) were recorded and analyzed. Bladder dysfunction was assessed using the urinary symptom profile (USP) questionnaire. Bowel dysfunction was assessed using the neurogenic bowel dysfunction (NBD) questionnaire. SD in men was analyzed using the international index of erectile function (IIEF) questionnaire and Female SD was analyzed using the female sexual function index (FSFI) questionnaire. Physical and mental health was assessed by short-form 12 (SF-12). Results: 9M:5F with a mean age of 35 years (range 26–45 years) presented with back and leg pain, parasthesia in the limbs, and retention of urine. Nine patients had acute backache and five had chronic back pain. All patients were catheterized on admission. The disc herniation levels were L4/L5 (seven patients), L5/S1 (six patients), and one had L3/4. The mean time of onset of symptoms to presentation at the hospital was 9.7 days (range 2–42 days). Preoperative mean Oswestry disability index (ODI) was 67.4 (range 58–80), mean visual analog score (VAS) for back pain was 2.8 (range 0–7) and mean VAS for leg pain was 6.5 (range 5–9). Preoperatively, motor power was affected in 12 patients. At presentation, perianal sensation (PAS) was labeled as “decreased,” in 12 patients (85.7%), and “absent” in two patients (14.3%). Voluntary anal contraction (VAC) was reported as “weak” in 10 patients (71.5%) and “absent” in 4 patients (28.5%).At a mean follow-up of 30 months, five patients had complete and five patients had partial recovery of motor and sensory deficit. Complete restoration of bladder status was experienced in eight patients after a mean duration of 6 months following surgery (ranging from 3 to 10 months). Three patients had partial recovery of bladder function (stress or nocturnal incontinence or signs of post-voiding residual urine) after a mean duration of 10 months following surgery (range 7–15 months). The return of bowel functions was determined as “complete” in seven (50%), “partial” in five (35.7%) and “no recovery” in two patients (14.3%). All patients had varying grades of SD. The mean SD scores in the nine male patients were 36.1 ± 20.4. In the five female patients, the mean SD scores were 22.9 ± 6.2. The mean physical component summary (PCS) and mental component summary (MCS) scores were 44.7 ± 8.8 and 40.1 ± 10.7, respectively. The group mean was significantly lower (P < 0.0001) as compared to the population norm for age groups 25–45 years. Conclusion: Late presentations of patients with CESR had variable long-term outcomes following lumbar discectomy. The recovery of the bladder and sexual function probably is the worst affected after late decompression. Validated questionnaires provide the clinicians a guide to prognosticate.
      Citation: Indian Spine Journal 2022 5(1):112-119
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_89_20
      Issue No: Vol. 5, No. 1 (2022)
       
  • Presacral epidermoid: A rare case and meningocele mimick

    • Authors: Sunit Mediratta
      Pages: 120 - 124
      Abstract: Sunit Mediratta
      Indian Spine Journal 2022 5(1):120-124
      Epidermoid cysts of the presacral space are a rare congenital entity. They have mostly been reported among women. We report a case of a 28-year-old male presenting with chronic constipation wherein magnetic resonance imaging (MRI) was suggestive of an anterior sacral meningocele associated with an epidermoid. This patient underwent a laparotomy and total excision of the mass. The lesion turned out to be an epidermoid cyst without any intradural communication or associated meningocele. This report highlights the limitations of imaging while it accentuates the need to perform diffusion-weighted MRI sequences for all cystic tumors in this region and to choose the correct operative approach based on its exact location in the presacral space.
      Citation: Indian Spine Journal 2022 5(1):120-124
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_76_20
      Issue No: Vol. 5, No. 1 (2022)
       
  • Acute postoperative cauda equina syndrome following an elective
           gynecological procedure

    • Authors: Conor B Garry, Woojin Cho, Alan V Job, Alok D Sharan
      Pages: 125 - 128
      Abstract: Conor B Garry, Woojin Cho, Alan V Job, Alok D Sharan
      Indian Spine Journal 2022 5(1):125-128
      We report a patient with cauda equina syndrome who presented immediately following hysterectomy. Intraoperative cauda equina syndrome is very rare, and to our knowledge, this is the first case reported following a gynecological procedure, which was unequivocally caused by a herniated intervertebral disc. A 72-year-old woman with a history of chronic low back pain and degenerative disc disease was referred to the orthopedic service after developing urinary retention, decreased rectal tone, and diminished bilateral lower extremity sensory and motor function following hysterectomy for the management of endometrial carcinoma. Magnetic resonance imaging revealed a large central disc herniation at L2/3. Due to a delay in recognition of the progressive neurological deterioration that began immediately postoperatively, decompressive surgery was performed between 48 and 72 hours after the onset of symptoms. Emergent surgical decompression including laminectomy and microdiscectomy resulted in improved bowel and urinary function but no improvement in lower extremity strength or sensation. Cauda equina syndrome is a rare but devastating condition whose recognition and management requires vigilance, communication, and early surgical involvement. This case presents novel information that cauda equina syndrome can occur immediately postoperatively from disc prolapse during unrelated procedures.
      Citation: Indian Spine Journal 2022 5(1):125-128
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_94_20
      Issue No: Vol. 5, No. 1 (2022)
       
  • Rare sudden hearing loss after lumbar spine decompression surgery: A case
           report and review of the literature

    • Authors: Shankar Acharya, Varun Khanna, Nitin Adsul, Rupinder Singh Chahal
      Pages: 129 - 132
      Abstract: Shankar Acharya, Varun Khanna, Nitin Adsul, Rupinder Singh Chahal
      Indian Spine Journal 2022 5(1):129-132
      Sensorineural hearing loss (SNHL) is a known but rare complication of non-otological surgeries. SNHL after spinal decompression also remains a rare occurrence with a handful of reports in the literature. The exact mechanism is not clearly understood. Cerebrospinal fluid leak, barotrauma, microemboli, hypoperfusion, vasospasm, traumatic event, and anesthetic agents are some of the proposed etiologies. Early diagnosis and prompt intervention have shown benefits though management lacks consensus. We report a case of profound SNHL post-lumbar decompression and fixation surgery, who showed significant recovery at 4-week follow-up, and we review the literature for hearing loss after spine surgeries.
      Citation: Indian Spine Journal 2022 5(1):129-132
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_36_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • A rare case of voriconazole-induced vertebral periostitis in a patient
           with invasive aspergillus spondylodiscitis

    • Authors: Alok Jain, Aaditya Kashikar, Premik B Nagad, Shekhar Y Bhojraj
      Pages: 133 - 136
      Abstract: Alok Jain, Aaditya Kashikar, Premik B Nagad, Shekhar Y Bhojraj
      Indian Spine Journal 2022 5(1):133-136
      The author illustrates the first ever reported case of voriconazole-induced periostitis of vertebral body. A 66-year-old immunocompetent male patient was diagnosed with multilevel invasive aspergillus spondylodiscitis of dorsal spine and was put on long-term voriconazole therapy for the same. Initially, the patient showed a good response to treatment but later on paradoxically the patient started to deteriorate symptomatically as well as radiologically. Differential diagnosis of misdiagnosis or co-in­fection with an another mold, inadequate voriconazole blood levels, voriconazole-induced periostitis were thought. After a detailed radiological and serological investigation, the patient was diagnosed with voriconazole-induced vertebral periostitis. Based on thorough literature review, discontinuation of voriconazole therapy was opted as treatment. Clinically, the patient started improving within four weeks of cessation of therapy and was symptom-free by the end of four months. Hence, to conclude, clinicians and spine surgeons should be aware of the fact that long-term voriconazole treatment of invasive aspergillosis can be complicated by skeletal fluorosis and painful periostitis. Once the symptoms of periostitis develop, investigations such as skeletal imaging and measurement of serum fluoride levels should be performed and if periostitis deformans is confirmed, reducing the dose or ceasing voriconazole should be considered.
      Citation: Indian Spine Journal 2022 5(1):133-136
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_8_21
      Issue No: Vol. 5, No. 1 (2022)
       
  • C2 intraspinal osteochondroma causing spinal cord compression in a patient
           with multiple hereditary exostoses

    • Authors: Janardhana P Aithala
      Pages: 137 - 141
      Abstract: Janardhana P Aithala
      Indian Spine Journal 2022 5(1):137-141
      Intraspinal osteochondroma causing neurological manifestations is a rare condition and can present as either solitary osteochondroma or more commonly as a part of multiple hereditary exostoses. We report a case of osteochondroma arising from lamina of C2 in a 21-year-old patient with multiple hereditary exostoses causing spinal cord compression and cervical myelopathy. The patient presented with worsening neurological deficit and an inability to walk. Immediate laminectomy and surgical decompression were done after accurately localizing the lesion through computed tomography and magnetic resonance images. Following excision of the lesion, the patient recovered completely. The case report is followed by a review of literature highlighting the incidence of spinal osteochondroma, location preferences, clinical presentation, diagnosis, and results of decompression.
      Citation: Indian Spine Journal 2022 5(1):137-141
      PubDate: Wed,2 Feb 2022
      DOI: 10.4103/ISJ.ISJ_55_20
      Issue No: Vol. 5, No. 1 (2022)
       
 
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