Magnetically-driven growing rods

This is a lecture given by Dr. N.S. Harshavardhana, who is a spine surgeon from the United Kingdom and has worked closely with one of the developers of the magnetic growing rods. This was part of the SICOT INDIA sponsored CME conducted at Sir HN Reliance Foundation Hospital in 2017.

The talk details the development of the magnetically-driven growing rods through three generations of modifications. At present, these rods are recommended for early-onset scoliosis (age less than 10 years) as a means to control the curve until definite fusion is performed. The MAGEC rods, as they are known, do not require multiple planned surgeries for distraction, thus avoiding repetitive anesthesia​ in children.

Although the current evidence of its effectiveness over traditional​ growing rod is limited, this technology definitely has a tremendous potential to benefit our patients for the better.

For more details, please view the above video.

Vertebral artery injury in CVJ surgery

This is a talk on vertebral artery injury and how to tackle it if it happens during craniovertebral surgery.

In brief, the vertebral artery can be injured in two locations:

  1. Extraosseous injury (open space injury): The vertebral artery (VA) is vulnerable to injury above the C1 posterior arch and lateral to the atlantoaxial joints. Sometimes, there is an anomalous course of VA than can get injured. The bleeding tends to be torrential. The quickest way to stop bleeding is by using tamponade for about 20-30 minutes. Endovascular intervention may be required if the bleeding cannot be controlled. Ligation or repair of the VA in this region is technically quite challenging.
  2. Intraosseous injury (in the screw hole): The VA is vulnerable to injury in the C2 pars especially if it has an anomalous course (high riding VA). The bleeding can be controlled by using bone wax and by inserting the screw. The opposite side has to be abandoned to prevent bilateral VA injury. Postoperative angiography may be needed to assess the damage or to detect ongoing bleeding.

 

 

 

Spinal tuberculosis – an update

Please read our recently published review on spinal tuberculosis in Journal of Clinical Orthopaedics – an initiative of the Bombay Orthopaedic Society.

Chaudhary K, Dhawale A, Chaddha R, Laheri V. Spinal Tuberculosis – an Update. Journal of Clinical Orthopaedics Jan – June 2017; 2(1):31-42.

The focus of this article is on nonoperative treatment of spinal tuberculosis with details about diagnostic protocols and antibiotic therapy.

Following is the abstract:

“Musculoskeletal tuberculosis, especially spinal tuberculosis is a challenging scenario. The disease presentation varies and profile of the organism is changing rapidly with the rise of antibiotic resistance. The management protocols need to be revisited in light of new information and current review is aimed at achieving this goal. This review article is a summary of the symposium conducted by Bombay Orthopaedic Society at KEM Hospital in November 2016. The focus of this discussion was primarily on nonoperative management of spinal tuberculosis including a focus on diagnostic protocol and medical management controversies. Surgical aspect of the disease is also covered with recent advances in the spine surgical protocols mentioned in brief.”