Publications by authors named "Jeevan Kumar Sharma"

8 Publications

  • Page 1 of 1

Mid Thoracic intra-spinal facet cyst with lumbar canal stenosis: A rare "double crush".

Int J Neurosci 2021 Jun 1:1-6. Epub 2021 Jun 1.

Department of Spine Services, Indian Spinal Injuries Centre, Vasant kunj, Sector C, 110070 New Delhi.

Introduction: Intraspinal synovial cysts occurrence causing spinal canal occlusion are mostly seen in mobile segments of the spine (lumbar and cervical). An appearance of the cyst in thoracic spine is a relatively rare occurrence. We present an interesting case of "double crush" caused by Lumbar canal stenosis with a mid-dorsal Facet cyst.

Case Presentation: A 67-year-old woman presented with complaints of back pain with neurogenic claudication with significant loss of touch sensation and motor power of MRC grade 3/5 in lower extremities bilaterally. However, patient was hyperreflexic with Babinski sign positive. She was unable to perform tandem walking test and complained of instability. MRI of lumbar spine revealed lumbar canal stenosis. However, in view of the UMN signs, an MRI of the dorsal spine was done. It revealed an extradural, well-delineated lesion along the dorsal aspect of spine at T6-7 level. Thus the patient had a "double crush" due to the FC along with lumbar canal stenosis.Clinical findings correlated with the imaging. Two teams simultaneously operated the 2 pathologies and T6-7 laminectomy along with left sided TLIF at L4-5 level was performed. Presently she is asymptomatic for back pain, claudication distance has improved to 800m.

Conclusion: Our case reiterates the importance of thorough clinical examination to avoid missing a diagnosis. Our case is the first in literature to report a "double crush" due to a proximal dorsal FC and distal LCS. Both the pathologies were tackled in a single setting by two operating teams with a good functional outcome.
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http://dx.doi.org/10.1080/00207454.2021.1938034DOI Listing
June 2021

Radiological changes in sagittal parameters after C1-C2 arthrodesis and their clinical correlation: Is there a difference between traumatic and non-traumatic causes?

Int J Neurosci 2021 May 12:1-10. Epub 2021 May 12.

Department of Spine Service, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, India.

: Compensatory changes in cervical sagittal alignment after C1-C2 arthrodesis have been reported in a few studies. No studies have explored the differences in these compensatory changes between traumatic and non-traumatic pathologies. Conflicting reports exist on the correlation between cervical sagittal parameters and neck pain or function.: Medical records of 81 consecutive patients [Jan 2010 - Dec 2018] who underwent Harms arthrodesis were retrospectively reviewed. 53 patients were included in the final analysis. Radiological parameters [C0-C1, C1-C2, C2-C7 angles and T1 slope] and clinical parameters [VAS (Visual analogue scale) and NDI (Neck disability index)] were compared between the two groups, Group A (traumatic) and Group B (non-traumatic).: The 53 patients [Group A ( = 24,) and Group B ( = 29)] had a mean age of 49.98 ± 21.82 years (42 males, 11 females). Mean follow up duration was 48.9 months. Δ C1-C2 angle is significantly correlated with ΔC2-C7 angle (Group A,  = 0.004; Group B,  = 0.015) but not with ΔC0-C1 angle (Group A,  = 0.315; Group B,  = 0.938). Though significant improvement in the clinical parameters (VAS/NDI) has been noted in both groups, Group A showed a greater improvement in VAS scores [Group A, ( < 0.001); Group B, ( < 0.023)]. The sub-axial sagittal profile was strongly correlated with the ΔC1-C2 angle in both groups. Group B showed greater changes in sagittal parameters after Harms fixation and Group A showed greater improvement in long-term functional outcomes. The final functional outcomes were not related to the initial or final radiological sagittal profile in both groups.
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http://dx.doi.org/10.1080/00207454.2021.1929213DOI Listing
May 2021

Hydatid Cyst of the Spine: A Rare Case Report and Review of Literature.

J Orthop Case Rep 2020 May-Jun;10(3):57-59

Department of Spine Services, Indian Spinal Injuries Centre, Delhi, India.

Introduction: Hydatid disease is caused by the parasite Echinococcus granulosus which is also known as the dog tapeworm. This disease is a relatively uncommon cause of spinal cord and dural compression.

Case Report: We came across a peculiar case in a 41-year-old male patient who presented to us with pus discharge from a surgical wound over lower back for 10 days. The patient was a diagnosed as a case of lumbar canal stenosis with recurrent hydatid cyst. The patient had neurological involvement in the form of left-sided foot drop. The patient gave a history of lumbar canal stenosis secondary to hydatid cyst, for which decompression and cyst excision were done 3 years prior. The patient was re-operated in the form of wound debridement with removal of hydatid cyst.

Conclusion: Meticulous surgery avoiding spillage of cyst material, appropriate medication as advised by the infectious disease specialist, will avoid recurrence of the disease.
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http://dx.doi.org/10.13107/jocr.2020.v10.i03.1748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051559PMC
May 2021

Clinico-Radiological Outcome of Single-Level and Hybrid Total Disc Replacement with Spineart Baguera®-C for Cervical Myeloradiculopathy: Minimum 2-Year Follow-Up Study in Indian Population.

Asian J Neurosurg 2020 Oct-Dec;15(4):856-862. Epub 2020 Dec 21.

Indian Spinal Injuries Center, New Delhi, India.

Context: Cervical radiculopathy and myelopathy is one of the most frequent ailments encountered by spine surgeon. Motion-preserving surgeries in cervical spine is a standard of care due to its certain advantages such as biomechanical anatomical conformity, reduced chances of adjacent segment degeneration, and revision surgeries. While there is abundant data from some centers, data from developing countries are still limited.

Aims: The aim was to study the clinico-radiological outcome of single-level and hybrid total disc replacement (TDR) with Spineart Baguera-C cervical prosthesis for cervical myeloradiculopathy.

Settings And Design: Retrospective study.

Materials And Methods: Retrospective analysis of the 29 consecutive patient undergoing single level TDR and hybrid fixation (i.e., TDR with anterior cervical discectomy and fusion) with Spineart Baguera-C cervical prosthesis for myeloradiculopathy from January 1, 2014 to December 31, 2017, was done. Radiological features and outcome were studied from data collected on Insta-picture archiving and communication system.

Statistical Analysis Used: SAS 9.4 was used for all computations. Results on continuous measurements were presented as mean and standard deviation (min-max) and results on categorical measurements were presented as numbers (n) and percentages.

Results: Twenty-nine patients were included in the study. The mean age was 43.31 ± 9.04 years with 14 males and 15 females. The most common level of TDR was C5-C6 (72.41%). The mean follow-up duration was 3.14 years ± 1.13 years (2-5 years). The mean hospital stay was 4.93 ± 2.12 days. The mean neck disability index (NDI) at admission was 27.24 ± 7.66 which decreased to 6.41 ± 4.29 at final follow-up.

Conclusions: Two-year data on treatment with Spineart Baguera-C cervical prosthesis shows significantly improved NDI, visual analog scale (arm) with maintenance of movement of the prosthesis.
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http://dx.doi.org/10.4103/ajns.AJNS_288_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869274PMC
December 2020

Incidence and Risk Factors for Neurological Deterioration in Posterior Corrective Surgeries for Severe Angular Kyphotic Deformities: A 10-Year Institutional Retrospective Study.

Global Spine J 2020 Dec 30:2192568220979122. Epub 2020 Dec 30.

Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India.

Study Design: Retrospective case-control study.

Objective: Neurological deficit is one of the dreaded complications of kyphotic deformity correction procedures. There is inconsistency in the reports of neurological outcomes following such procedures and only a few studies have analyzed the risk factors for neurological deficits. We aimed to analyze the factors associated with neurological deterioration in severe kyphotic deformity correction surgeries.

Methods: We performed a retrospective study of 121 consecutive surgically treated severe kyphotic deformity cases (49 males, 56 females) at a single institute (May 1st 2008 to May 31st 2018) and analyzed the risk factors for neurological deterioration. The demographic, surgical and clinical details of the patients were obtained by reviewing the medical records.

Results: 105 included patients were divided into 2 groups: Group A (without neurological deficit) with 92 patients (42 males, 50 females) and Group B (with neurological deficit) with 13 patients (7 males, 6 females) (12.4%). Statistically significant difference between the 2 groups was observed in the preoperative sagittal Cobbs angle (p < 0.0001), operative time (p = 0.003) and the presence of myelopathic signs on neurological examination (p = 0.048) and location of the apex of deformity (p = 0.010) but not in other factors.

Conclusions: Preoperative Sagittal Cobbs angle, presence of signs of myelopathy, operative time and location of apex in the distal thoracic region were significantly higher in patients with neurological deterioration as compared to those without neurological deterioration during kyphotic deformity correction surgery. Distal thoracic curve was found to have 4 times more risk of neurological deterioration compared to others.
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http://dx.doi.org/10.1177/2192568220979122DOI Listing
December 2020

Robotic spine surgery: a review of the present status.

J Med Eng Technol 2020 4;44(7):431-437. Epub 2020 Sep 4.

Department of Spine Service, Indian Spinal Injuries Centre, New Delhi, India.

With technological advancements being introduced and dominating many fields, spine surgery is no exception. In view of the patient safety and surgeon's comfort, robotics has been introduced in spine surgery. Due to small corridors for work, little room for inaccuracy, lengthy and tedious procedures, spine surgery is an ideal scenario for robotics to establish as the standard of care. Spine robotics received their first FDA clearance in 2004. New generation of spine robotics with integrated navigation systems has become available now. The primary role of spine robotics, at present, is to aid pedicle screw fixation. High quality studies have been performed to establish its role in increasing the accuracy of pedicle fixation. Studies have also reported decreased radiation and decreased operative time with spine robotics. However, few studies have reported otherwise. It is still in its nascent stage in both industrial view and surgeon familiarity. Continued research to overcome the challenges such as high cost and steep learning curve is crucial for its widespread use. Also, expanding the scope of spine robotics beyond pedicle screw fixation such as osteotomies and dural procedures would be an area for potential research. This review is intended to provide an overview of various studies in the field of robotic spine surgery and its present status.
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http://dx.doi.org/10.1080/03091902.2020.1799098DOI Listing
September 2020

Letter to the Editor concerning "Handgrip strength correlates with walking in lumbar spinal stenosis" by Inoue H. et al. [Eur Spine J (2020): DOI 10.1007/s00586-020-06525-1].

Eur Spine J 2020 11 2;29(11):2845. Epub 2020 Sep 2.

Department of Spine Service, Indian Spinal Injuries Centre, Vasant Kunj, New Delhi, India, 110070.

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http://dx.doi.org/10.1007/s00586-020-06582-6DOI Listing
November 2020

Clinicoradiological outcomes of Goel and Harms fixation for atlantoaxial instability: An institutional experience.

Surg Neurol Int 2020 11;11:189. Epub 2020 Jul 11.

Department of Spine Service, Indian Spinal Injuries Center, New Delhi, India.

Background: Few studies have reported on the long-term outcomes of Goel and Harms C1-C2 fusions in the Asian population.

Methods: This was a retrospective analysis of 53 patients undergoing Goel and Harms fixation (2010 -2018). Clinical outcomes were assessed utilizing the neck disability index (NDI), Japanese Orthopedic Association (JOA) score, and visual analog scale (VAS). Outcomes were then correlated with fusion rates (using dynamic X-rays), atlanto-dens interval (ADI), and space available for cord (SAC) data.

Results: The study's 53 patients averaged 49.98 years of age and included 42 males and 11 females. The mean preoperative versus postoperative scores on multiple outcome measures showed NDI 31.62 ± 11.05 versus decreased to 8.68 ± 3.76 post, mean JOA score (e.g., in 41 patients with myelopathy) improved from 13.20 ± 3.96 to 15.2 ± 2.17, and the mean VAS decreased from 4.85 ± 1.03 to 1.02 ± 0.87 and showed restoration of the ADI (1.96 ± 0.35 mm) and SAC (20.42 ± 0.35 mm). A 98.13% rate of C1-C2 fusion was achieved at 12 postoperative months.

Conclusion: Goel and Harms technique for C1-C2 fusion resulted in both good clinical and radiological outcomes.
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http://dx.doi.org/10.25259/SNI_350_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395524PMC
July 2020