Introduction: surgical approach for thoracolumbar pott spine has been controversial. Traditionally, earlier anterior decompression and fixation had been long considered as the gold standard for treatment of tb of spine. Recently, the posterior approach has gained popularity based on the principle of adequate debridement, decompression and stable fixation with much lower complication rates, the present study aims to evaluate the results (functional, neurological, and radiological) of the posterior only approach in patients operated for thoracic and lumbar tuberculosis. Methods: all patients (n=40) who were included in the study had thoracolumbar tuberculosis of spine with or without neurological deficit and with or without deformity, were managed by only posterior decompression and fixation. Preoperative and postoperative visual analog scale, frankel neurological grading, radiologic fusion by bridwell criteria were compared and functional assessment was done by oswestry disability questionnaire. Results: Statistical significant improvement seen in Oswestry disability functional questionnaire and VAS scores (p < 0.05), the clinical outcomes were satisfactory at the end of final follow-up.no worsening of neurological deficit. Solid fusion was achieved in 85% patients after surgery. Two patient developed superficial wound infection which healed by Conservative methods and extended antibiotic therapy. Conclusion:Posterior decompression and fixation is safe and effective approach for management of patients with thoracolumbar pott spine, provides rapid relief of pain, neurological recovery by adequate decompression and prevents progression of deformity with posterior stabilization with fewer complications.
Background: Displaced femoral neck fractures are common in the elderly patient, it is predicted that, the number of hip fractures would triple by 2050, and these patients are subjected to an increased disability, morbidity, and mortality. The optimal treatment for displaced fracture neck of femur with best clinical outcome is still inconclusive and determined by the mobility and functional demands of the patient. Materials and Methods: Thirty cases of fracture neck of femur in elderly patients above the age of 60 years treated by hemiarthroplasty using bipolar prosthesis between November 2018 to May 2020 were selected according to inclusion and exclusion criteria. Cases were followed up for 6 months and the short term functional results were analysed by using modified Harris hip score. Results: out of 30 patients, most of the patients were in the age group of 60 to 70 years with mean average age of 68.9 years. Females were predominant, there were 36% excellent results and 43% good results. Conclusion:Modular Bipolar hemiarthroplasty for fractures neck femur provides better range of movement, freedom from pain and more rapid return to unassisted activity with an acceptable complication rate. The end functional results depend on the age of the patient, associated co-morbidity and optimum post-operative rehabilitation. Early functional results are satisfactory.
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