Rakesh B Singh

Abstract

Background: Most of the lumbosacral radiculopathies are caused by irritation of spinal nerve roots associated with lower back and leg pain. Most common causes for spinal root irritation are intervertebral disc herniation and spinal canal stenosis, other causes include spondylolisthesis, spondylosis, thickening of ligamentum flavum, scoliosis etc. Lumbar radiculopathy frequently treated by epidural corticosteroid injections. Common route for administering epidural steroid injections are interlaminar, transforaminal and caudal. But there are concerns due to rare major neurologic complications after this treatment. Therefore this literature focuses on caudal route of epidural steroid injections. Objective: To know the benefits of caudal epidural steroid injection in lumbar radiculopathy and low backache by analyzing clinical and functional outcome. Results: Out of 35 patients, in 28 patients (80%) low backache and radiating pain subsided after 3 days. But 7 patients (20%) get partial relief or having persistent complaints after 3 days, administered 2epidural steroid injection after a month. After one month 32 patients (91%) do not complain of pain but 3 patients (9%) tend to have some back pain which eventually improved on two to three months of regular physiotherapy and postural correction exercises. Conclusion: Caudal epidural steroid injections are safe, quick and effective. It can be performed on OPD basis, has considerably fewer side effects than surgery. Therefore injections can help to increase function while avoiding surgery and long term use of analgesics.   Keywords: Epidural injection, Caudal route, Steroids, Low backache.

View Article

Abstract

Authors in group collected the data for fracture of the shaft of radius and ulna in 80 adult patients. Study Period: 1st October 2014-1st October 2017 The aim of the study was to determine relationship of the subjective, objective and radiographic method of treatment. The type of fractures, both open and closed, grade of communition and other injuries were assessed in patients in term of degree of pain, rotation of forearm and return to the same work following injury and the patients treated with ORIF and plate fixation were having better result in all aspect assessed than closed reduction and plaster cast. Factor most often associated with return to same work after injury are better with ORIF (Open reduction and internal fixation). Longer time for union and higher rate of infection were the only disadvantages of ORIF over closed reduction, otherwise outcomes were same for both the methods. Presence of other injuries often compromise the end result because of more pain , greater forearm rotation loss and decline in return to same work. The satisfaction and work status in assessment of outcome, concept of functional malunion, interpretation of radiographic finding should help in counselling the patient as to economic and functional impact of these injuries. Keywords: Fracture radius-ulna open reduction with plate fixation, Closed reduction with nailing.

View Article