Biomedical subjects

L H S Sekhon

Publications and source records attributed to L H S Sekhon.

3 recordsLinked to original sources

PubMed2006

Timing of decompression and fixation after spinal cord injury--when is surgery optimal?

Spinal cord injury affects a large number of young individuals with a significant cost to affected persons, families and societies both in terms of economic and non-economic costs. To date, our interventions have been limited to prevention, good initial resuscitation, modest pharmacotherapy and nursing care. This review examines the role of surgery in spinal cord injury. The pathophysiology of spinal cord injury is reviewed. The compelling animal data for early decompression is discussed as well as evidence for improved neurological outcome with early decompression in humans. Finally, the impact of early surgery on non-neurological outcome and overall complication rates is examined with the concept of "damage control" discussed with relevance to spinal cord injury. It appears that favourable outcomes are achieved with early surgery, with reduced morbidity/mortality, but definitive data is still pending.

Animals↗

PubMed2005

Artificial cervical disc replacement: principles, types and techniques.

Cervical arthroplasty after anterior decompression with insertion of a prosthetic total disc replacement has been suggested as an alternate to anterior cervical fusion. Currently there are four cervical arthroplasty devices available on the market whose results in clinical use have been reported. Each device varies in terms of materials, range of motion, insertion technique and constraint. It is not known which device is ideal. Early studies suggest that in the short term, the complication rate and efficacy is no worse than fusion surgery. Long-term results have not yet been reported. This review examines the current prostheses available on the market as well as discussing issues regarding indications and technique. Pitfalls are discussed and early experiences reviewed. In time, it is hoped that a refinement of cervical arthroplasty occurs in terms of both materials and design as well as in terms of indications and clinical outcomes as spinal surgeons enter a new era of the management of cervical spine disease.

Biomechanical Phenomena↗

PubMed2004

Surgical management of spinal epidural abscess: selection of approach based on MRI appearance.

Spinal epidural abscess (SEA) is associated with considerable morbidity and mortality despite its infrequent occurrence. The evolution of magnetic resonance imaging has allowed for easier diagnosis of this potentially devastating condition. It is also possible to predict the intraoperative appearance of each individual case of SEA prior to the procedure, based on the MR findings. Surgical treatment of SEA usually involves extensive decompressive laminectomy, predisposing the patient to the development of spinal instability and deformity. Recent advances in surgical approach to SEA have seen the institution of less invasive techniques to manage this condition, including washout of the epidural space with catheters introduced via laminotomy. Our three cases illustrate the ability to predict the intraoperative findings in patients with SEA, and accordingly adjust the surgical approach to minimize the extensiveness of potentially destabilizing procedures, without impinging on the effectiveness of treatment.

Adolescent↗