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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 16, Issue 1, Aug 2015 pp 159-162
Risk of caserean delivery following induction of labor in term nulliparous women
Mukesh Phalak1, Saumil Patel2, Deepak Joshi3, A B Goregaonkar4
1Assistant Professor, Department of Orthopedics, Dr D Y Patil Hospital, Pune, Maharashtra, INDIA.
2Sr. Resident, 3Assistant Professor, 4Professor and Head, Department of Orthopedics, Lokmanya Tilak Municipal Medical College and Hospital, Sion, Mumbai, Maharashtra, INDIA.
Introduction: Adjacent segment degeneration is a highly challenging entity faced by every spine surgeon. It is difficult to diagnose considering the fact that it has variable presentation in term of symptom it produces, its time frame and radiological changes. Also of challenge is to distinguish it from age-related degenerative process. Aims and objective: To study the adjacent segment degeneration following spinal fixation and determine if it significantly contribute to patient morbidity in follow up patients. Materials and Method: In the present study total 31 patients who had undergone spinal surgery either at cervical or lumbar level were included. Postoperative x ray and MRI were taken and studied for changes. Preoperative x ray and MRI were studied wherever available. However many a time preoperative X ray and MRI were not available. Clinical outcome were decided based on questionnaire given to the patients. This clinical outcome was matched with radiological outcome. X ray and MRI were reported by single person to avoid inter observer variation. The changes found were matched with clinical criteria to measure significance of the same. MRI criteria by Beattie et al were utilized. Results: It was observed that majority of the patients in the study were between the age group of 31to 50 years and majority of them were male. Out of the total cases, lumbar spine was involved in 80.65% cases whereas cervical spine was involved in 19.35% cases. Instrumentation was done in 45.16% cases. Multiple vertebras were involved in 38.71% cases. Fusion was done in 74.19% cases. It was seen that 4 out of 31 patient had x ray change in form of adjacent osteophyte. 11 out of 31 patients showed MRI changes of grade 1 disc prolapsed Conclusion: We conclude that adjacent segment degeneration is highly complex entity, which is difficult to predict. Multiple segment fusion is needed to treat degenerative spinal deformity; more care should be taken in deciding the extent of fusion and correction of the sagital balance to prevent possible ASD.