Fallopian tube prolapse through a ruptured vagina is a rare, but well-documented, gynaecological condition. The majority of cases reported in the literature complicated vaginal hysterectomy and presented with vaginal bleeding and pelvic pain. We report a case after abdominal hysterectomy, which presented with urinary symptoms, an unreported presentation, and was managed successfully via the vaginal route. An update on the cases reported in the literature is also presented.
Objective: To compare the operative time and post-operative pain with PEEK cage method versus autologous iliac crest bone graft in anterior cervical discectomy and fusion in the cervical spine.
Material & Methods: This randomized control trial study (RCT). 90 patients with cervical disc disease, cervical stenosis with or without myelopathy and cervical trauma (fractures or facet jumps with disrupted disc) were included in the study from the Department of Neurosurgery, LGH, PINS, Lahore. Patients were evaluated with plain X-rays and MRI scans of the cervical spine. All patients underwent anterior cervical decompression and fusion. In 45 patients (group A), cervical fusion was achieved with PEEK cage method and in other 45 patients (group B), autologous Iliac Crest Bone graft was used.
Results: Mean age in group A was 57.1 years and in group B, it was 54.7 years. In group A, 31.1% patients were of cervical disc disease, 28.8% of cervical degenerative stenosis and 40% were of cervical trauma. In group B, 15 patients 33.3% were of cervical disc disease, 24.4% of cervical degenerative stenosis and 42.2% were of cervical trauma. The mean Postoperative Visual Analogue Scale (VAS) score for pain was 2.8 in group A and 5.4 in group B patients.
Conclusion: The patients of group A (PEEK cage method) could be easily mobilized within bed and out of bed depending upon their neurological status. Decreased operative time and less post-operative pain makes PEEK cage method superior to autologous iliac crest bone graft in anterior cervical decompression and fusion.
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