Incidence of spinal cord injury (SCI) is on the rise affecting the young strata of the society leading to permanent disability in majority of cases with limited treatment to offer. Treatment of sci has many challenges due to the complex blood spinal cord barrier (BSCB). Nanotechnology presents a substantial solution in neuroprotective treatment by enabling targeted delivery of drugs to the site of injury by overcoming BSCB. Nanofiber scaffolds which are built of biodegradable nanofibers forms structural support for injured spinal cord, guiding and supporting cell growth thereby favoring neural regeneration. Common concerns with nanotechnology include the health hazards due to the difficult degradation and immunomodulation. The lack of proper clinical trials and the lack of centralized monitoring agency are the serious ethical concerns regarding nanotechnology. Nanotechnology is still a developing field and it is unclear exactly what effects it will have on the body or the environment. This fact leads to the greater regulation imposed on nanotechnology, making the process of drug development even more expensive and time consuming. Application of nanotechnology in stem cell research and nanorobotics are promising future research that can revolutionize the treatment strategies in SCI.

[ABSTRACT]   Full text not available  [PDF]

Background: Over the past decades, significant progress has been made in our understanding of the basics and techniques of surgical treatment for intradural tumors. However, the management which is most ideal for these lesions has remained a controversial topic. Objectives: To review previous work on the available operative options for intradural tumors with focus on both the advantages and disadvantages in each case, the outcomes and also highlight on the current trends in this aspect of spine surgery. Materials and methods: A systematic literature review of previous publications on the various techniques employed in the surgical treatment of intradural tumors. We discuss their presentation, basic concepts and practical aspects of their management with emphasis on the techniques of operative treatment. Results: Different outcomes following the application of various techniques in the surgical management of intradural spinal tumors have been well-documented in the literature. However, there are currently no algorithms to guide the surgeon on surgical care for intradural spinal tumors. The choice of which surgery to do in each case is a function of each surgeon's philosophy, knowledge and cummulative experience as well as a clear understanding of the anatomy of the lesion in each patient, the available facilities and equipment.

[ABSTRACT]   Full text not available  [PDF]

Decompressive surgery remains the gold standard for lumbar canal stenosis. The overall patient satisfaction is reduced due to factors, such as adjacent segment disease, recurrent stenosis and instability that develop several years after the decompressive procedure. Fusion procedures themselves are not devoid of complications. In the recent times, we have been using functionally posterior dynamic stabilization (PDS) with interlaminar device Coflex following decompression with micro internal decompression for spinal stenosis (IDSS). We encountered three patients with spondylolisthesis whom we treated with PDS with satisfactory reduction and good clinical outcome. The follow-up period is short, but excellent patient satisfaction makes us feel this could be excellent surgical strategy to treat degenerative spondylolisthesis.

[ABSTRACT]   Full text not available  [PDF]

Cervical spine fractures are devastating spinal injuries, which typically occur following settings involving high velocity trauma situations, especially in polytrauma patients. The current article describes a patient, who had a significant, grade IIIB open injury to the arm, accompanying cervical spine injury. The case report describes a 27 years old gentleman, who had suffered from quadriparesis following cervical spine injury with open humerus fracture (grade IIIB). The intricacies of managing such devastating polytrauma, damage control protocol and guidelines, which may be followed during the management of such unique situations have been elaborated and discussed. The ideal protocols and guidelines of damage control philosophy in combined spine injuries with neurological deficit and open extremity fractures are still in the process of evolution and the management steps which may be followed, need to be tapered in accordance with the individual circumstances. The present case may provide a good platform for understanding these issues and explicate the vitality of appropriate, timely management.

[ABSTRACT]   Full text not available  [PDF]

Sublaminar wires are used as a modality for posterior spinal stabilization is described for selective indications. However, its use has been declined mainly because of high chances of neurological complication, ambiguity on long-term effect of wires on the spinal cord and recent advances in posterior instrumentation of spine. Improper wiring techniques are the most common cause of dural complications. We report a case of 60 years old gentleman presented with symptoms of lumbar canal stenosis to our spine department with a loop of wire at stenotic level. He had spine surgery done 20 years back using sublaminar wires. Intraoperatively, we found that the wire was looping through the dura. We performed revision decompression with posterior stabilization using pedicle screw/rod construct and removed the wire. Thus, our case highlights the consequences of subdural location of stainless steel wire, revision technique and highlights correct technique of insertion of sublaminar wires.

[ABSTRACT]   Full text not available  [PDF]

Objective: To study the clinical profile of patients with spinal dysraphisms and the outcome of surgical interventions in these patients. Methodology: A total of 39 patients with spinal dysraphism were studied in a tertiary care setting during the period of June 2012 to January 2015. Among the selected patients the clinical profile, radiological profile and the surgical interventions undertaken were studied and the outcome were noted. All patients were followed for a period 3 months postoperatively for presence of complications. Appropriate descriptive statistics were used to analyze the findings and to draw the inferences. Results: Median age of the patients was 6 months, ranging from 12 days to 7 years. Majority of the cases were diagnosed to have myelomeningocele (82.1%) and other conditions of spinal dysraphism included lipomyelomeningocele (2 cases), Diastematomyelia (2 cases and dermal sinus 1 case). Lumbosacral region (79.5%) was the commonest location. In four cases hypotonia and paraparesis were the presenting symptoms and nearly half of the patients had cerebrospinal fluid (CSF) leak (46.2%) and one-third of the patients had associated hydrocephalus (33.3%). All cases underwent operative procedure, anatomical repair using standard techniques. Postoperatively, all the patients were followed for upto 3 months where in CSF leak (10.3%), wound infection (10.3%) and paraparesis (10.3%) were the common postoperative complications in our study. Mortality was witnessed in two patients. Conclusion: Among the spinal dysraphisms, myelomeningocele is the most common birth defect. Management of patients with spinal dysraphisms should be individualized involving timely diagnosis and selective surgical intervention.

[ABSTRACT]   Full text not available  [PDF]

Full text not available  [PDF]

Full text not available  [PDF]

Full text not available  [PDF]

Full text not available  [PDF]

Full text not available  [PDF]