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Biomedical subjects

P S Ramani

Publications and source records attributed to P S Ramani.

At least 19 recordsLinked to original sources

A radiological evaluation of allografts (ethylene oxide sterilized cadaver bone) and autografts in anterior cervical fusion.

Serial roentgenograms of 40 patients who had 70 cervical intervertebral spaces grafted with ethylene oxide sterilized cadaver bone and 28 patients who received 44 iliac crest auto grafts for anterior cervical spine fusion, were studied. The radiological evaluation was made on the basis of settlement of intervertebral spaces, fusion rate, delayed union, non-union, graft collapse and extrusion of the graft. Indigenous methodologies were designed for the assessment of settlement of grafted intervertebral spaces in percentage. Disc space settlement was more common in autografts (93% cases) than in allografts (80% cases). The average percentage of settlement of intervertebral disc space (S%) was 22 in autografts and 28 in allografts during the first four months. By the end of eight months, allograft disc spaces settle more. No significant difference was noted in fusion rate at the end of one year viz. allografts (90% cases) and autografts (93% cases). Autograft and allograft (ethylene oxide sterilized cadaver bone) are equally useful in anterior cervical spine fusions.

Bone Transplantation↗

Combined anterior and posterior decompression and short segment fixation for unstable burst fractures in the dorso lumbar region.

The dorso lumbar segment of spine (D10 to L2) is an unstable zone between fixed dorsal and mobile lumbar spine. A combined anterior and posterior approach with short segment stabilization was found most appropriate. Thirty cases were treated over a period of 4 years and 6 months. There were 26 male and 4 female patients with mean age of 32.6 years. L1 vertebra was fractured in 17 cases, D1 in 8 cases, D11 in 4 cases and D10 in one case. 14 cases had total neurological deficit, 9 cases had partial and 7 had no neurological deficit. We have used three column classification of Denis to assess the cases. Seven patients returned to regular physical work, 5 had restricted physical work, 5 remained in full time light job and 9 patients were unable to return to original job but did some work. Most had flaccid paraplegia but 4 patients were completely disabled due to spastic paraplegia. Neurological recovery occurred in all the patients with partial paralysis, and appeared to be dependent on initial kyphosis. The overall recovery rate varied from 50% to 90%. There is no correlation between canal compromise and severity of injury. Neurological injury occured at the time of trauma, rather than as a result of pressure of fragment in the canal. No strong conclusion could be drawn to say that the results of surgery were superior to non-operative treatment.

Adolescent↗

Treatment of severe double spinal cord injuries.

This is a case report describing an injury--sustained by a 25-year-old man during a car accident, and characterized by fracture dislocation of the spine at the level of C7 and T4 accompanied by pulmonary contusion. He had an incomplete spinal cord lesion at the level of C7 and a complete lesion at the level of T4 (T4 ASIA A). Imaging of the spine showed three column fractures with ventral spinal cord compression at both levels. Discussants of this case comment on the concept of acute treatment of severe double spinal cord injuries, and present their chosen way of management in this particular case.

Accidents, Traffic↗

Variations in size of the bony lumbar canal in patients with prolapse of lumbar intervertebral discs.

Prolapse of the lumbar intervertebral disc is one of the commonly accepted causes of low back pain. Most patients respond well to conservative treatment, but some may not respond at all. Though the reason for this variation is not clearly understood, it is felt that a developmentally narrow spinal canal might have some relation to the persistence of backache and sciatica. The canal was therefore measured at each of the lumbar vertebral level by a method described by Jones and Thomson (1969) in 100 consecutive patients operated upon for prolapsed lumbar intervertebral discs, in 100 normal patients for comparison. This method does not give direct measurements of the bony spinal canal but provides a ratio of the size of the canal to the adjacent vertebral body. We found a trend towards the presence of a narrower than normal lumbar canal in patients with prolapsed lumbar intervertebral discs. It is concluded that in patients with prolapsed lumbar intervertebral discs necessitating operation, the canal tends to be narrower than normal, and such narrowing enhances the effect of any disc protrusion leading to severe symptoms of backache and sciatica.

Adolescent↗

Electrocardiographic abnormalities associated with raised intracranial pressure.

Serial electrocardiographic (E.C.G.) recordings were taken in seven patients suffering from intracranial conditions, for which their intracranial pressure was directly and continuously monitored with a Konigsberg extradural transducer. The E.C.G. changes observed in patients with raised intracranial pressure were prominent U waves, ST-T segment changes, notched T waves, and shortening and prolongation of Q-T intervals. Two patients with normal intracranial pressure showed no E.C.G. abnormalities but also establish a relationship between E.C.G. abnormalities and changing intracranial pressure.

Adult↗

Cervical spinal interbody fusion with Kiel bone.

Experience with the use of the Kiel bone graft in anterior cervical interbody fusion in cervical spondylosis is reported. The survey reviews the results of operations on 73 disc spaces in 65 consecutive patients, from 2 to 5 years after the operation. We have failed to confirm that any bony fusion in the true sense occurs with Kiel bone in anterior cervical interbody fusion. However, the aims of the operations are achieved, namely removal of the disc and osteophyte, fixation of the spine to prevent compression of the neural tissues, distraction of the adjacent vertebral bodies providing increased room in the intervertebral foramina and stability of the spine.

Aged↗

Nodular fasciitis causing unilateral proptosis.

A case report of an unusual case of nodular fasciitis in the orbit presenting with unilateral proptosis is described, and the radiological features are outlined. The histological features are discussed and the benign nature of the lesion stressed. Nodular fasciitis arising in the orbit and presenting as unilateral proptosis has not previously been reported in the literature.

Adult↗

Role of ligamentum flavum in the symptomatology of prolapsed lumbar intervertebral discs.

Hypertrophy of the ligamentum flavum has been reported to occur in the prolapsed intervertebral disc syndrome. The ligaments from 28 patients were compared with a necropsy control group (18). Only minor histological anomalies were noted in two patients and the ligament was not thickened in cases of disc prolapse. In addition, there was no evidence to suggest previous trauma to the ligaments associated with disc protrusion or that the elastic fibres in the ligament degenerate with age, although some degeneration of the collagen fibres had apparently occurred in the two oldest control cases.

Adolescent↗