Publications by authors named "Prasad Patgaonkar"

4 Publications

  • Page 1 of 1

Extramedullary myeloid sarcoma mimicking tuberculosis of spine: A case report and literature review.

Surg Neurol Int 2021 19;12:178. Epub 2021 Apr 19.

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

Background: A definitive diagnosis of spinal tuberculosis (TB) remains challenging. The "gold standard" is to obtain histopathological confirmation of the lesion. This analysis highlights how to avoid missing the diagnosis of an extramedullary myeloid sarcoma (EMS) versus TB.

Case Description: A 25-year-old male presented with paraparesis. Although this was first attributed to TB spondylodiscitis, a PET-CT and reevaluation of the biopsy specimen both confirmed the diagnosis of an EMS.

Conclusion: Nontubercular spinal disease should be suspected when a patient deteriorates despite the institution of antitubercular therapy for a reasonable duration. Further, microbiological and/or pathological confirmation is warranted to direct appropriate treatment and differentiate spinal TB from other entities as, in this case, an EMS.
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http://dx.doi.org/10.25259/SNI_855_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8168697PMC
April 2021

Adolescent Lumbar Disc Herniation with a Peculiar Gait Pattern Managed by Transforaminal Endoscopic Spine Surgery.

J Orthop Case Rep 2020 Nov;10(8):93-96

Department of Spine, Indore Spine Centre, Indore, Madhya Pradesh, India.

Introduction: Lumbar disc herniation (LDH) is common manifestation of a degenerative disease involving tensile failure of the annulus to contain the gel like nuclear portion of the disc. Lumbar herniated discs can often cause muscle weakness, reduced motor function, and change in walking capacity and gait pattern.

Case Presentation: We present the case of an 18-year-old obese hypertensive male, with multiple level lumbar disc herniation, with a neurological deficit and failed conservative treatment. The patient was successfully operated by minimal invasive endoscopy approach and had a marked improvement in the neurological status post-surgery. Post-surgery, his neck regained normal posture, with no back or leg pain. At present, he is walking with a normal gait pattern after a 2-year follow-up.

Conclusion: Here, we describe a unique gait abnormality in a patient with adolescent LDH. Transforaminal endoscopic spine surgery had good functional outcomes with minimal morbidity.
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http://dx.doi.org/10.13107/jocr.2020.v10.i08.1876DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933625PMC
November 2020

Rosai Dorfman disease of the spine causing lumbosacral radiculopathy: A case report.

J Clin Orthop Trauma 2020 Sep-Oct;11(5):947-951. Epub 2020 Jan 24.

Indore Spine Centre and Global SNG Hospital, Indore, India.

Rosai Dorfman disease (RDD) also known as sinus histiocytosis with massive lymphadenopathy (SHML) is a rare non-malignant proliferative disorder of unknown etiology. Here we present a case of Rosai Dorfman disease of the spine causing lumbo-sacral radiculopathy. CT and MRI revealed lytic expansile lesion in the left half of L4 vertebra mainly involving posterior aspect involving left pedicle and transverse process. Patient underwent surgery at L3-4 level by left fenestration. Histological examination confirmed the diagnosis of Rosai Dorfman disease. Skeletal involvement is a very rare presentation seen in 2% case with involvement of long bones including tibia, femur, humerus, clavicle and bones of hand. RDD affecting the spine has been rarely reported in literature. A team approach involving the radiologist, spine surgeon, pathologist and oncologist will lead to the early diagnosis and appropriate management of this rare clinical entity.
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http://dx.doi.org/10.1016/j.jcot.2020.01.010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452285PMC
January 2020

Suprailiac versus transiliac approach in transforaminal endoscopic discectomy at L5-S1: a new surgical classification of L5-iliac crest relationship and guidelines for approach.

J Spine Surg 2020 Jan;6(Suppl 1):S145-S154

Orthopaedic Surgeon, Indore Spine Centre, Global SNG Hospital, Indore, Madhya Pradesh, India.

Background: Approach to the L5-S1 level with transforaminal access can be challenging. Some surgeons employ the interlaminar or paraspinal endoscopic approach as an alternative apart from the other minimally invasive posterior surgical options. To precisely target and safely access disc herniations at L5-S1, the authors attempted to stratify patients into trans and supra iliac approach groups and propose a simple surgical classification based on the radiographic findings.

Methods: A prospective study was performed on a cohort of 90 patients with L5-S1 disc herniation who underwent transforaminal endoscopic discectomy through suprailiac or transiliac approach depending on the best trajectory to access the herniated disc. Preoperative radiological assessment was done on anteroposterior and lateral radiographs of the lumbosacral spine by two independent observers. The proposed classification and approach guidelines were used to stratify patients for the preferred access route. The outcome was measured as mean VAS and ODI scores pre-operative and at 6 months post-operative and compared using the null hypothesis (P value) and the paired -test. The interrater reliability was calculated as the percentage agreement between different observers.

Results: The L5-S1 disc herniation was treated with the transforaminal approach in 46 patients via the suprailiac and in the remaining 44 patients via the transiliac approach. There were statistically significant VAS and ODI reductions in patients of both groups (P<0.05). Interrater reliability of 92.5% using percent agreement shows strong level of agreement.

Conclusions: This surgical approach classification based on radiographs aids in the preoperative planning for selection of patients to either suprailiac or transiliac approach for transforaminal endoscopic surgery at L5-S1 level.
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http://dx.doi.org/10.21037/jss.2019.09.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063327PMC
January 2020