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Bone & Joint Research
Vol. 5, Issue 7 | Pages 301 - 306
1 Jul 2016
Madhuri V Santhanam M Rajagopal K Sugumar LK Balaji V

Objectives

To determine the pattern of mutations of the WISP3 gene in clinically identified progressive pseudorheumatoid dysplasia (PPD) in an Indian population.

Patients and Methods

A total of 15 patients with clinical features of PPD were enrolled in this study. Genomic DNA was isolated and polymerase chain reaction performed to amplify the WISP3 gene. Screening for mutations was done by conformation-sensitive gel electrophoresis, beginning with the fifth exon and subsequently proceeding to the remaining exons. Sanger sequencing was performed for both forward and reverse strands to confirm the mutations.


Bone & Joint Research
Vol. 5, Issue 4 | Pages 145 - 152
1 Apr 2016
Bodalia PN Balaji V Kaila R Wilson L

Objectives

We performed a systematic review of the literature to determine the safety and efficacy of bone morphogenetic protein (BMP) compared with bone graft when used specifically for revision spinal fusion surgery secondary to pseudarthrosis.

Methods

The MEDLINE, EMBASE and Cochrane Library databases were searched using defined search terms. The primary outcome measure was spinal fusion, assessed as success or failure in accordance with radiograph, MRI or CT scan review at 24-month follow-up. The secondary outcome measure was time to fusion.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_15 | Pages 30 - 30
1 Oct 2014
Molloy S Aftab S Patel A Butler J Balaji V Wilson L Lee R
Full Access

To assess screw malposition rates and complications associated with pedicle screw insertion using 3D navigation technology.

A retrospective study was undertaken for all cases where O-arm® and StealthStation® systems were used over a 2-year period. The primary outcome measure was return to theatre rates for pedicle screw malposition.

A total of 938 screws were inserted (934 thoracolumbar and 4 cervical), and 103 patients underwent spinal fixation using O-arm® and StealthStation® navigation. 64 were revision cases and 39 primary cases. Average number of levels was 4.6. There were a total of 10 complications: 3 infections, 1 DVT, 1 PE, 1 fast atrial fibrillation (AF), 1 screw malposition, 1 non-union, 1 undisplaced vertebral body fracture and 1 nerve root compression following osteotomy. The percentage return to theatre for screw malposition using 3D navigation was 1% of patients and 0.1% of pedicle screws. No patients developed permanent neurological compromise.

These systems provide accuracy that is comparable to traditional 2D fluoroscopic techniques. We advocate their use in the safe insertion of pedicle screws in complex revision deformity cases where original anatomical landmarks are absent or obscured. We also believe that radiation exposure is considerably less with navigation especially in these complex and revision cases.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_6 | Pages 2 - 2
1 Apr 2014
Balaji V Chin K Samir F Kouklinos A Tucker S Shaw M
Full Access

Aim:

Vitamin D deficiency is a common problem in the UK. It is more prevalent in patients with orthopaedic conditions. Previous studies in the literature have shown that vitamin D deficiency is associated with low patient-related outcome scores. To date, no studies have been performed in spinal patients. The aim of this study was to investigate whether there is a relationship between vitamin D status and pre-operative outcome scores in patients with AIS.

Methods:

AIS patients undergoing scoliosis correction between July 2012 and May 2013 at the Royal National Orthopaedic Hospital were investigated. Serum 25-hydroxyvitamin D levels were measured and SRS-22r questionnaires were completed as part of their pre-admission work up.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_III | Pages 458 - 458
1 Oct 2006
Fagan A Fraser R McKenzie I Balaji V Ryan W
Full Access

Introduction This is a Prospective Comparative cohort study to determine the change in the Low Back Outcomes Score (LBOS) after intensive non-operative, multi-disciplinary treatment for low back pain and to compare this with data collected from earlier cohorts undergoing surgical fusion. Recently published Randomised Controlled Trials have been inconclusive regarding the benefits of surgery compared with rehabilitation for low back pain. We examine this question using the Low Back Outcome Score (LBOS) as an outcome measure.

Methods The LBOS was acquired prior to and two years following treatment in cohorts undergoing fusion or rehabilitation for low back pain. Follow up was 70% and 90% respectively. The surgical group had a lower starting LBOS ( 18 v 27) but the rehabilitation group had a higher proportion of cases involved in compensation, litigation, and who were not working.

Results A significantly greater improvement in LBOS was seen in the surgically treated group than was seen in the rehabilitation group (18 v 10)

Discussion Although we do not propose surgery before non-operative treatments are exhausted, these results suggest that surgical treatment can have significant benefits for selected patients who have not improved despite a state of the art rehabilitation programme.