Role of Decompression in Late Presentation of Cervical Spinal Cord Disorders

Study DesignProspective study conducted at Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, India.PurposeTo show the efficacy of decompression in the late presentation of cervical spinal cord disorders.Overview of LiteratureStudies by various authors have shown that early spinal decompression results in better neurological outcomes.MethodsFrom January 2003 to January 2005, 11 of the 41 patients with cervical spinal cord compression, meeting the inclusion criteria, underwent anterior decompression; interbody graft placement and stabilization by anterior cervical locking plate. The neurologic and functional outcomes were recorded.ResultsFive patients had spinal cord injury and 6 patients had compressive cervical myelopathy. Complications included 1 death and 1 plate loosening. No patient lost their preoperative neurological status. One patient had no improvement, 2 patients showed full recovery. The mean follow-up is 28.3 month. At the of rehabilitation, 6 were able to walk without support), 2 could walk with support, and 1 needed a wheelchair. The average American Spinal Injury Association motor score on admission to the hospital, 32.8 (standard deviation [SD], 30.5); admission to rehabilitation, 38.6 (SD, 32.4); discharge from rehabilitation, 46.2 (SD, 33.7). The most recent follow-up was 64.0 (SD, 35.3).ConclusionsThe anterior approach for cervical decompression allows for adequate decompression. This decompression is the best chance offered in even late reported cases, including posttraumatic cases where there is no evidence of cord transactions. The use of anterior cervical plates reduces the chances of graft loosening, extruding, or collapsing

Foot morphology and its relationship to arch height index in asymptomatic adults versus adults presenting with foot pain (nontraumatic)

Background: The uniqueness of the human foot, in performing various functions, is intricately associated with different morphological parameters, and arch height index (AHI) is an important parameter for the same. The measurement of AHI has putative clinical implications in correcting the underlying causative factors, which contribute to foot pain. This study was an attempt to investigate these parameters as a correlation among asymptomatic versus patients complaining of foot pain (due to nontraumatic causes). Methodology: One hundred asymptomatic and 50 symptomatic adults were engaged in the study after taking prior consent. Various measurements (such as foot length, truncated foot length, foot breadth, arch height – [AH], and AHI) were taken in a standing position. In this study values of foot length, truncated foot length, foot breadth, AH and AHI were compared amongst the two groups . Comparison was done with earlier studies. Results: The difference in AH and AHI (P < 0.05) among the asymptomatic versus the foot pain patients, was significant. There was a considerable difference in body weight and Body Mass Index (BMI) affecting AH and AHI. AHI in the case of the symptomatic foot pain adults was 0.18 in both feet, with a standard deviation (SD) of 0.07. Conclusion: The AHI has been considered an essential parameter in defining and identifying the potential structural factors that predispose an individual to injuries of the foot. Our results indicate that the mean AHI in the case of foot pain adults (nontraumatic) was 0.18 in both feet, with an SD of 0.07. This is lower as compared to other studies. This can be attributed to the fact that earlier studies have been done on asymptomatic patients only. The present study was done to correlate between normal asymptomatic versus foot pain patients. There was a significant difference in the AH and AHI between our two study groups