The literature shows consensus over high rates of pedicle screw misplacement, but low clinical complications, in the hands of the best of spine surgeons. The concept of acceptable screw placements and the outcome classification makes the pedicle screw assessment results correlate better with the clinical outcome.

Background:The key to the safe and effective use of thoracic pedicle screws in the deformed spine is to thoroughly understand pedicle anatomy. There are a few studies related to pedicle anatomy in the Indian population and no pedicle morphometric studies in scoliosis patients. The present study aims to highlight the differential features of pedicle morphometry, including pedicle width, transverse pedicle angle and the depth to anterior cortex on the concave and convex side, in a group of Indian patients with adolescent idiopathic scoliosis and compare this to that of a western population.Materials and Methods:This is a prospective study of 24 patients with adolescent idiopathic scoliosis. The average age is 14.6 years (12.3-18.3 years) of which 14 were females and 10 were males. All the patients underwent CT scan using Siemens 4th generation scanner. The scans were analyzed by measuring the transverse pedicle width, transverse pedicle angle and the chord length; all the measurements being made both on the convex as well as the concave pedicle. Statistical analysis was performed with unpaired ‘t’ test.Results:A total of 1295 measurements were performed from 24 patients and an average of 215 pedicles were assessed for each set of the measurements made. The transverse pedicle width was consistently found to be smaller on concave side in comparison with the convex side at all levels except at T1. The transverse pedicle angle was greater on the concave side at all levels as compared to the convex side, though there was wide individual variation. The depth to anterior cortex was lesser on convex side in comparison to the concave side except at T1.Conclusions:The concave pedicle is much thinner and directed more medially than the convex side, especially at the apical region of the scoliotic curve. The pedicle anatomy in scoliosis patients shows very high individual variations and a careful study of pre-operative CT scans is essential for planning proper pedicle screw placement. Slightly longer screws can be accommodated on the concave side as compared to the convex side, though the difference in the chord length is not statistically significant at most levels.

Objective: To do detailed comparative study on the functional outcome of bone patellar tendon bone graft and the hamstring tendon graft for reconstruction of ACL and evaluation of results. This was a prospective study com Methods: prising 88 patients who presented with knee instability and/or pain at SMSMC & H,Jaipur from November 2020 to July 2022. They were diagnosed clinically and conrmed by MRI to have ACL tear. Outcome evaluation was done using Lysholm knee score and IKDC. The patients were followed up at 4,8,12 weeks, 6 months and 1 year. Results: Mean post-operative Lysholm score in bone patellar tendon bone group was 88.9 with scores ranging from 81 to 95. Mean post-operative Lysholm score in Hamstring graft group was 88.6 with range from 79 to 95. Arthroscopic ACL Conclusions: reconstruction by either quadrupled STG graft or bone patellar tendon graft gives satisfactory results in short term follow up in terms of activities of daily living, patient satisfaction, and return to near normal daily activity. However, a larger scale study with longer follow up is required to evaluate the long term results.