Adjacent segment degeneration following lumbar spine fusion and lumbar discectomy remains a widely known problem, but due to insufficient knowledge regarding the factors that contribute to its occurrence it is difficult to diagnose considering the fact that it has variable presentation in terms of the symptoms it produces, the time frame for its occurance and radiological changes. Our study shows that both in single level discectomy and post instrumented fusion and is marginally more in post single level discectomy without fusion. In both groups cephalic segment is more affected as compared to the caudad segment. There is a significant relationship between radiological degeneration and the clinical adjacent segment degeneration. It has been seen that there is a significant relation between degeneration and chronic smokers both radiologically and clinically. Since there is only marginally difference, we hold on to our hypothesis that the role of natural degeneration is more compared to the role of instrumented fusion causing adjacent segment degeneration. Thus we have to rule out natural and post surgical causes of adjacent segment degeneration leading to different clinical complaints of the patient and manage it accordingly.
Intraarticular injections are considered as minor day care/opd procedures around the world. Intra-articular injections for shoulder are used frequently in our region by both Orthopaedic surgeons as well as general practitioners. These injections are not without complications and require training regarding its indication and technique. We are reporting a case of a 52 year old male who presented with abscess of the posterior aspect of left shoulder region post attempted intraarticular injection, that was managed surgically by incision and drainage. This case study should help us understand the inherent complications of such injections and gives insight about the current practice of intra-articular injections.
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