The Journal of Spinal Surgery

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1 October-December 2017 Volume 4 Number 4 eissn Editor-in-Chief JKBC Parthiban Founder and Former Editor-in-Chief PS Ramani Associate Editors Sushil Patkar Vedantam Rajashekhar Shashank Kale Komal Prasad Assistants to Editor Shradha Maheswari S Shanthanam Vinu V Gopal Balamurali Sumeet Pawar The Journal of Spinal Surgery (A Journal Dedicated to Propagation of Knowledge in Spine) The Official Journal of Neuro Spinal Surgeons Association, India

2 The Journal of Spinal Surgery 1. Aims and Scope The Journal of Spinal Surgery (JOSS) is the official journal of Neuro Spinal Surgeons Association (NSSA), India. Journal of Spinal Surgery is dedicated to propagation and sharing of knowledge in spinal surgery and spinal dis or ders among neurosurgeons, spinal surgeons and other allied medical fraternities. Younger generation authors from India and abroad are particularly encouraged to publish their scientific articles in research, innovations, challenges in spinal surgery. This, apart from original articles, case reports, review articles, operative techniques and letter-to-editors on various issues, notes on spinal instruments, views and counter views, reflections from experts, will provide an excellent platform for expanding the knowledge for the readers. Journal of Spinal Surgery is unique in bringing out a CD on surgical techniques and eloquent lectures along with it. Since its inception in July 2009, the journal is peer-reviewed and has been guided by excellent team of members in editorial board from India and abroad. Journal of Spinal Surgery is poised to take the Indian contribution in spinal surgery to the world. Spinal surgery in India has grown well now and its time the contributions are known to the world. Journal of Spinal Surgery is just aiming to spread the contributions made by Indians around the world. The parent body NSSA is one of the leading organization in India, spreading the values of spinal surgery. Learning is never ending for intellects and its not different for spinal surgeons. 2. Ethical Considerations Manuscripts submitted for publication must comply with the following ethical considerations: Informed Consent Informed consent of the patients must be taken before they are considered for participation in the study. Patient identifying information, such as names, initials, hospital numbers, or photo graphs should not be included in the written descriptions. Patient consent should be obtained in written and archived with the authors. Protection of Human Subjects and Animals in Research When conducting experiments on human subjects, appropriate approval must have been obtained by the relevant ethics committees. All the procedures must be performed in accor dance with the ethical standards of the respon sible ethics committee both (institutional and national) on human experimentation and the Helsinki Declaration of 1964 (as revised in 2008). When reporting experiments on animals, authors must follow the institutional and national guidelines for the care and use of laboratory animals. 3. Copyright Following guidelines must be followed before submission of the manuscript: The articles must represent original research material, should not have been published before, and should not be under consideration of publication else where. This however does not include previous publication in form of an abstract or as part of published literature (review or thesis). It is the duty of the author to obtain the necessary permissions for extensive quotations, tables, illus trations, or any other copyrighted material they are using in the paper before a paper can be considered for publication. Copyright of the article gets transferred to Jaypee Brothers Medical Publishers (P) Ltd., once the article has been accepted for publication. The author would be asked to sign the Copyright Transfer Form before his/her article is considered for publication. Once the Copyright Transfer statement has been signed by the corres ponding author, no change in authorship or in the order of the authors listed on the article would be accepted by Jaypee Brothers Medical Publishers (P) Ltd. Also by signing the above-mentioned form, the author reassigns the rights of copublishing, or translation if considered necessary in future to the publisher. In the advent of occurrence of any dispute, the matter would be resolved within the jurisdiction of New Delhi court. While all care has been taken to provide accurate and correct information in accordance with the date of publication, neither the authors/ editors nor the publisher takes any legal responsibility for any unintentional omission or error. The publisher makes no expressed or implied warranty with respect to the information contained herein. The published material cannot be photocopied for the following purposes: general distribution, promotion, new works or resale. If this is required, specific written permission requires to be obtained from the publisher. Exclusive rights to reproduce and distribute the articles in this journal have been protected by copyright. This also covers the rights to reproduce or distribute the article as well as the translation rights. No material published in this journal can be reproduced in digital format or stored in form of electronic databases, video disks, etc. Both the conflict of interests and financial disclosure need to be handled well while conducting the research study. Disclosure of such relationships is also important in connection with all articles submitted for publication. Both of these have also been included in the copyright transfer form. Authors should give due acknowledgement to the individuals who provide writing or other assistance while conducting the research study and also disclose the funding source for the research study. 4. Subscription Information ISSN eissn Subscription rates For information on subscription rates and the other journal-related enquiries, please contact: subscriptions@jaypeejournals.com Orders Journals Department Jaypee Brothers Medical Publishers (P) Ltd. 4838/24, Ansari Road, Daryaganj New Delhi , India Phone: Fax: subscriptions@jaypeejournals.com 5. Electronic Media An electronic edition of this journal is available at Manuscripts can be submitted online at 6. Advertisement For advertisement queries, please contact: Journals Department Jaypee Brothers Medical Publishers (P) Ltd. advertisements@jaypeejournals.com For any queries regarding online submission, please us at: help-desk@jaypeejournals.com For editorial queries, please contact: chetna.malhotra@jaypeebrothers.com The journal is printed on acid free paper. Copyright Jaypee Brothers Medical Publishers (P) Ltd. ii

3 JOSS October-December 2017 Vol. 4 No. 4 Editor-in-Chief JKBC Parthiban Founder and Former Editor-in-Chief PS Ramani Associate Editors Sushil Patkar Vedantam Rajashekhar Shashank Kale Komal Prasad Assistants to Editor Shradha Maheswari S Shanthanam Vinu V Gopal Balamurali Sumeet Pawar Publishing Center Publisher Jitendar P Vij Associate Director Chetna Malhotra Vohra Managing Editor Kiran Gupta Editorial and Production Office PS Ghuman Journals Department Jaypee Brothers Medical Publishers (P) Ltd. 4838/24, Ansari Road, Daryaganj New Delhi , India Phone: , , Fax: journals@jaypeebrothers.com ps.ghuman@jaypeebrothers.com Advertisements/ Subscriptions/ Reprints Ashwani Shukla Phone: advertisements@jaypeejournals.com subscriptions@jaypeejournals.com ashwani.shukla@jaypeebrothers.com For Website Queries Phone: contact@jaypeejournals.com The Journal of Spinal Surgery Honorary Advisory Board George Dohrman, USA Jain VK, India Mehmet Zileli, Turkey Mohamad Maziad, Egypt Motoi Shoda, Japan Singh AK, India Yuri Shulev, Russia Editorial Board Members International Abdul Hafid Bajamal, Indonesia David Sun, Hong Kong Enrique Osorio-Fonseca, Colombia Giancarlo Guizzardi, Italy Patrick Fransen, Belgium PD Kulkarni, England Pragnesh Bhatt, England Samuel JK Abraham, Japan Se-Hoon Kim, South Korea Bong-Soo Kim Junichi Mizuana Marcus Eif, Germany Salman Sharif, Pakistan Devkota U.P Nikolay A Peev Khairun Nabi Khan Krishna Sharma National Anil Pande, Chennai Anil Peethambaram, Thiruvananthapuram Balaji Pai S, Bengaluru Deepu Banerji, Mumbai Deopujari CE, Mumbai Harjinder Singh Bhatoe, Pune Krishnaprabhu, Vellore Manas Panigrahi, Hyderabad Muthukumar N, Madurai Prakash Modha, Rajkot Ravi RR, Coimbatore Sajesh K Menon, Kochi Sandeep Chatterjee, Kolkata Sarat Chandra, New Delhi Satish Rudrapa, Bengaluru Shridhar K, Chennai Shrikant Rege, Indore Yashbir Dewan, Haryana Sumit Sinha, Delhi Dhandapani, Chandigarh Pravin Salunke, Chandigarh Siddhartha S Sahoo, Odisha Gomatam Vijayakumar, West Bengal Deshpande Rajkumar, Bengaluru Alok Ranjan, Hyderabad Vivek Joseph, Tamil Nadu iii

4 Neurospinal Day 2017 Dr PS Ramani held a camp at Gomantak Seva Sangh, Vile Parle on Sunday, the 26th November Mr & Mrs Kishore Kulkarni, Chairman, NKGSB Bank was the Chief Guest and trustees of Kavale Math, Walkeshwar were the Guest of Honor. The patients waiting in the hall were kept entertained by continuous DVD projections and all of them were served tea and snacks. Neurospinal Day 2017 at Rajkot We had the privilege of celebrating Neurospinal Day 2017 at Gokul Hospital, Rajkot, India. Dr Prakash Modha and Dr Sumeet Pawar held various academic and patient-related activities in honour of Dr PS Ramani on his birthday which was celebrated as Neurospinal Day all over the world. A free medical camp was organised where more than 30 spine patients were given medical consultation and advice to remain pain free. This was followed by a lecture on how to avoid back pain in day-to-day life for patients and their relatives. iv

5 Neurospinal Day 2017 In the evening, a CME was organized in association with Rajkot Orthopedic Club at Hotel Silver Palace where Neurospinal Day was introduced to them and lecture on Lumbar Canal Stenosis was delivered by Dr Prakash Modha. More than 35 doctors attended this event. Sumeet Pawar Consultant Neurosurgeon Gokul Hospital, Rajkot, Gujarat, India Spine Clinic on Dr PS Ramani s Birthday remembrance day. PD Kulkarni President, NSSA, India Spinal Neurosurgeon Kings College Hospital, London, UK v

6 Sanjeev Kumar The media coverage of the Neurospinal Day celebrations at two places (South and East Delhi ) and a very brief video clip ( vi Sanjeev Kumar Advanced Training Mount Sinai School of Medicine New York, USA St. Anna Hospital Herne, Germany Senior Consultant Neurosurgeon Batra Hospital and Medical Research Center Institute of Brain and Spine, New Delhi, India

7 Neurospinal Day celebration, Nagercoil on December 8, 2017 Neurospinal Day 2017 We conducted an awareness programme for nursing students and medical representatives about spine, caring of spine and spine trauma initial management. We had an interaction session also. It went out very well and was well appreciated by all. We initially gave an introduction about NSSA and its various activities. The 80th birthday of our founder president was highlighted and the novel idea of celebrating it as Neurospinal day was enlightened. The programme was coorganised by my wife Dr Uma Selvan. Rajendran Selvan Senior Assistant Professor, Department of Neurosurgery, Kanyakumari Goverment Medical College, Nagercoil, Tamil Nadu, India vii

8 Shraddha Maheshwari viii Shradha Maheshwari Brain and Spine Surgeon Assistant Professor Department of Neurosurgery LTMG Hospital and LTM Medical College, Sion Department Incharge HBT Medical College and Dr R N Cooper Hospital, Mumbai, Maharashtra, India

9 The Journal of Spinal Surgery October-December 2017 Volume 4 Number 4 Contents EDITORIAL Launch Pad God s Own Country: Special Note on Development of Spinal Surgery JKBC Parthiban ORIGINAL ARTICLES Morphometric Factors affecting Functional Outcome in Symptomatic Chiari I Malformation and Syrinx Anil Kumar, Nupur Pruthi, B Indira Devi, Arun K Gupta Cauda Equina Syndrome Assessment, Diagnosis, and Management: Results from a Neurosurgical Unit from 1-year Retrospective Series Is Our Referral System Effective? Giulio Anichini, Gaurav Gulsin, Mazhar Iqbal, Caroline MacIntosh, Mahmoud Kamel, Pragnesh Bhatt Subaxial Cervical Pedicle Morphometric Assessment in Normal South Indian Subjects using Computed Tomography Scan Images Penkulinti Murahari, Himanshu Bhargav, Amuru LMV Kumar, K Vinayak Santosh, L Jayaprakash Reddy, Rajkiran R Banala, Goli PV Subbaiah Respiratory Dysfunction in Craniovertebral Junction Pathology: A Pulmonary Function Test Correlation Alok M Uppar, George C Vilanilam, B Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla, Hardik Siroya, Talakkad N Sathyaprabha Operations for Symptomatic Herniated Intervertebral Disk: A Study of 45,048 Patients George J Dohrmann, Joseph C Hsieh, Nassir Mansour Incidence of Cervical Spine Injury observed in Polytrauma Patients at Autopsy Jitendra Tadghare, Shrikant V Rege, Manish Nigam TECHNICAL NOTE Single Reference Point for Lumbar Pedicle Screw Insertion in Degenerative Spine: A Technique and Case Series Analysis Sreedharan PE Namboothiri, Krishnakumar Rangasamy, Venkatesh Kasi CASE REPORTS Acute Spontaneous Spinal Epidural Hematoma Secondary to Aspirin Edwin Pathrose, Manoj Sharma, Sunil Kutty, Sanjith Saseedharan, Yatin Gadgil Use of Posterior Dynamic Stabilization in Multilevel Degeneration of Lumbar Spine Sumeet G Pawar, Apurva Prasad, Premanand S Ramani Multilevel Intramedullary Spinal Epidermoid Cyst Shrikant V Rege, Gourav Jatav Multifocal Skeletal Tuberculosis involving the Calvarium and Posterior Spinal Elements in an Immunocompetent Patient Sarang Gotecha, Ashish Chugh, Gaurav Amle, Prashant Punia, Aditya Ashok, Megha Kotecha ix

10 SUBSCRIPTION INFORMATION Annual Subscription: Individual: ` (National) $ (International) Institutional: ` (National) $ (International) Subscription can be sent to M/s Jaypee Brothers Medical Publishers (P) Ltd. Journals Department Jaypee Brothers Medical Publishers (P) Ltd. 4838/24 Ansari Road, Daryaganj New Delhi , India Phone: Fax: subscriptions@jaypeejournals.com This journal is published quaterly in a year, i.e. January, April, July and October. Dollar rates apply to subscribers in all the countries except India where INR price is applicable. All subscriptions are payable in advance and all the rates include postage. Journals are sent by air to all the countries except Indian subcontinent. Subscriptions are on an annual basis, i.e. from January to December. Payment will be made by dollar, cheque, credit card or directly through our bank account at the following address: 1. Our Banker s Name: Canara Bank, Netaji Subhash Marg Darya Ganj, New Delhi Telephone No: , Fax No: Telex No: Our Current A/c No: Amount to be transferred JAYPEE BROTHERS MEDICAL in the Name of: PUBLISHERS (P) LTD., NEW DELHI 7. Swift Code No: CNRB IN BB DFM For further queries, please do not hesitate to contact at subscriptions@jaypeejournals.com ADVERTISEMENT RATES (For the Print Issues) Page Single Issue Back cover color ` 50,000 $ Inside front cover color ` 40,000 $ Inside back cover color ` 35,000 $ Inside full page color ` 30,000 $ Special position: Price on request Technical Details Paper size Text size Digital file format EPS on CD (at 300 dpi resolution) Printed on art paper using offset printing. Schedule Issues are published in the months of January, April, July and October. Advertisement material along with purchase order and payment should reach us at least four weeks prior to the scheduled print date. Payment Details Payment should be in favor of Jaypee Brothers Medical Publishers (P) Ltd., and should be payable at New Delhi, India. Payment to be done at the time of submitting the advertisement material/booking the advertisement. Please send your advertisement request, payment and advertisement material to the address given above. Editorial board reserves the right to accept or decline the advertisement. For further queries, please contact advertisements@jaypeejournals.com

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