Background:The number and quality of scientific publications reflects the standards of scientific research in a country. However, the contribution of Indian spine surgeons toward global publications is unknown. The goal is to study the publications of Indian spine surgeons between 2000 and 2013.Materials and Methods:A literature search of the publications by Indian spine surgeons was performed using MEDLINE. The search terms used were India and several spine-related terminologies. The main information of the selected papers including the year of publication, scientific journal, type of pathology studied, Neurosurgical or Orthopedic Department where the study was done, type of study, and the type of article was analyzed.Results:A total of 4459 articles were identified using MEDLINE and after exclusion, 507 articles were analyzed. A growth of 440% in the number of publications was observed in the period between 2009 and 2013, during which 60.15% of the articles were published. Clinical studies (n = 492; 97.04) were the most common types of articles, followed by experimental studies and other types. The Neurosurgery department published the majority of the articles (58.2%). The three most common pathologies studied were spinal tumors (17.35%), surgical technique (15.4%), and spinal infection (15.2%).Conclusion:The current study shows that publications in the field of spine surgery have been increasing in the last few years, although it is less. Further efforts such as research training of spine surgeons, inducing collaborations and formulation of multicenter projects and periodically allocating adequate funds are key factors to improve the scientific publications from India.
Introduction Patients with symptomatic lumbar degenerative disease can have one or more intervertebral disc involved according to several factors, such as age, smoking, weight, and profession. The objective of this study was to evaluate the outcome of patients with degenerative disease submitted to lumbar spinal fusion considering the number of levels fused. Patients and Methods Prospective comparative study in patients that were submitted to fusion of one (G1), two (G2), or three or more (G3) levels with a 6-month follow-up. The patients were evaluated preoperatively, at 30 days and 6 months postoperatively with the following validated instruments: NRS, ODI, HAD, and IDB. Comparisons among the groups were done with ANOVA and chi-square tests. The post hoc analyses were conducted with Bonferroni test. Results A total of 65 patients (G1 = 21; G2 = 25; and G3 = 19) were studied. The mean age was greater in G1 and lower in G3 ( p = 0.024). There was no difference among the groups regarding gender, previous surgery, evolution of the symptoms, and work compensation. The duration of surgery was longer, there was more bleeding and a greater incidence of postoperative complications ( p = 0.022) in G3 group ( p < 0.05). The intensity of pain was higher in G3 in the postoperative evaluation at 30 days, but that difference disappears postoperatively, within 6 months. There was no difference concerning hospital stay, transoperative complications, disability (ODI), depression and anxiety (HADS), and satisfaction among the groups ( p = 0.140). Conclusion There was no difference in relation to the pain, disability, depression and anxiety, and postoperative satisfaction among the groups. The patients with three or more fused levels were older and had higher rates of postoperative complications.
Introduction Germ cell tumors originate in the primary stem cell located either inside or outside the gonadal system. Teratomas are the major group, with the sacrococcygeal location being the most common extragonadal site, independent of their being benign or malignant. We describe five cases of sacrococcygeal teratoma and emphasize aspects of diagnosis, surgical techniques, and complementary approaches. Patients and Methods A total of five cases of sacrococcygeal teratoma were reported and a literature review was performed using an online database, Pubmed.gov. The authors emphasize aspects of diagnosis, classification, prognosis, and the therapeutic options. Results The five cases were females and the age range from 38 weeks intrauterine (ultrasonography diagnosis) to 1.5 years. The clinical presentation usually was a sacral mass or fecal constipation. The Altman classification was type 1 in three cases and type 4 in two cases. The serum levels of α-fetoprotein was normal in three cases. Preoperative high serum α-fetoprotein levels returned to normal levels 10 days after surgery. The radical surgical resection of the tumor and the coccyx was done in all cases through a posterior sacral approach and midline incision. The surgery did not compromise the neurological function. No tumor recurrence was seen in by radiologic and α-fetoprotein examinations after a medium follow-up of 15.3 years. Conclusion The sacrococcygeal region is the most frequent site of teratomas in children. Complete tumor resection and removal of the coccyx are the main objective in curative treatment of the teratoma. Diagnosis and treatment as early as possible is essential to prevent it from becoming malignant.
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