This paper reviews the pathophysiology of cervical spondylotic myelopathy (CSM) and several surgical approaches for the treatment of CSM. CSM is a degenerative disease with severe morbidity. The pathophysiology of CSM involves static, dynamic, and ischemic factors. The management of mild CSM typically involves conservative treatments and medication; whereas, moderate and severe CSM are better treated surgically. Surgical treatments for CSM are basically classified into anterior and posterior surgeries. The common techniques are anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), laminectomy, and laminoplasty. Each technique has its own advantages and disadvantages. In this paper, we review the research papers from PubMed database to elaborate the advantages and disadvantages of each technique.

Background: Spinal Injury is a devastating injury with life-long impact on an individual’s health and quality of life. Sport­ing activities, such as water sport, is also known contributed to the spinal injury.  This study aims to evaluate the water sport-related spine injury (WS-RSI) which is occurred in Bali during 2017 as a preliminary study at BROS Hospital.Methods: A cross-sectional study was conducted retrospectively among 55 patients who got an injury during water-sport activity in 2017 and admitted to BROS Hospital, Denpasar, Bali by medical records. There was 28 patient-related spine injury. Demographic status regarding age, sex, length of stays, hemoglobin (Hb), random blood glucose, nationality, country origin, treatment, patient’s status, history of alcohol intake, type of water sport, and the location of spine injury were recorded. Data were analyzed using SPSS version 25 for Windows in mean±SD, percentage, and odds ratio (OR) as well as statistically significant if P-value less than 0.05.Results: Indonesian travelers were predominant in WS-RSI (53.6%), followed by China and Australia (17.9%), India, Japan, and European countries (3.6%, respectively). The average age of patients was higher in spine injury (47.89±15.98 years; P=0.047). Both sexes were equal (50%). There was no significant difference in Hemoglobin (Hb) (11.08±1.30 g/dL) and random blood glucose (100.65±21.37 mg/dL) (P>0.05) levels. However, there was a significant difference among nationality, type of treatment, patient’s status, and type of WS-RSI compared with non-spine injury (P<0.05). Based on variables, banana boat, foreign travelers, conservative treatment, and outpatient status were having a higher risk in WS-RSI (OR= 4.275; 5.143; 5.014; 7.389; P<0.05, respectively)Conclusion: As a preliminary study, recent findings at BROS Hospital, Denpasar, Bali suggest that several factors are having a higher risk towards water sport-related spine injuries such as older age, banana boat, foreign travelers, conservative treatment, and outpatient status

BACKGROUND: Charcot neuroarthropathy (CN) of the foot and ankle, which is complicated with infection, is debilitating disease and presents challenges until now. External fixation with half-pins is useful as provisional treatment. AIM: The purpose of this retrospective case series is to summarize the patient characteristic, type of surgical intervention, outcome, and complication of infected CN treated in our hospital. MATERIALS AND METHODS: This case series studied retrospectively patients with CN of the foot and ankle due to diabetes mellitus type II, complicated by infection, who required surgical treatment in a single institution, from 2018 to 2019. Diagnosis was based on chronic deformity (fracture or dislocation) as proven on X-ray and recently developed infection as shown through clinical, laboratory, and radiological evaluation. RESULTS: We studied seven patients with CN classified as Eichenholtz Stage 3 (100%) and Brodsky type 3A alone (n = 3) (Figure 1), and type 3A with other types (n = 4). The mean age is 44.6 years old (range, 35–60) and mean body mass index was 24.08 kg/m2 (range, 21.45–25.39). Signs of infection include leukocytosis (n = 6), soft-tissue swelling (n = 4), ulcer (n = 4), and osteomyelitis (n = 1) at presentation. Operative treatment consisted of debridement, followed by external fixation only (n = 4), combined external fixation and pinning (n = 2), and intramedullary pinning only (n = 1). The mean hospital length of stay was 4.5 days (range, 3–7). We performed short-term follow-up after a mean of 4.12 months (range, 1.3–5.3) and long-term after a mean of 15.02 months (range, 11.27–16.8), the limb salvage rate was 100% in both. One patient had revision of external fixation. As for functional outcome, at the time of long-term follow-up mean visual analogue scale was 0.75 (range, 0–2) and American Orthopaedic Foot and Ankle Score was 66.25 (range, 57–77). CONCLUSION: In this study, mostly external fixation with half-pins and methyl metacrylate was used based on the bone condition and patient’s compliance. Despite of its limitation, this method is effective when it is combined with strict blood glucose level and infection control.

Among musculoskeletal injuries, the incidence of ankle sprains is between 15% and 20% of sports injuries. The ankle is supported laterally by the anterior talofibular ligament, calcaneofibular ligament and posterior talofibular ligament, whilst the medial aspect is supported by the deltoid ligament. Ankle sprains can be either acute sprains, which can be further classified into three grades depending on the severity of the injury, or chronic instability. Acute ankle sprain is usually managed conservatively and functional rehabilitation failure by conservative treatment leads to development of chronic ankle instability, which most often requires surgical intervention. Successful treatment of acute ankle sprain can be achieved with individualized, aggressive and non-operative measures. Surgery should always be indicated on an individual basis

Osteoarthritis (OA) is the most common form of arthritis that affects cartilage joints and leads to disability. OA becomes the major public health problem, as it is the most leading cause of disability and morbidity worldwide. Treatment choices for OA can be classified into several categories such as non-pharmacologic, pharmacologic, surgical therapy, and cell-based therapy. There is no curative treatment for OA, while conventional treatments that are commonly used focus on alleviating the pain as the main symptom of the disease. Mesenchymal stem cells (MSCs) that can be found in several tissues of human body offer a new strategy for OA treatment owing to their ability to differentiate into chondrocytes. This article provides an overview about the basic concept of osteoarthritis as well as an insight about the MSCs therapy, including their basic characteristics, source, and transplantation strategies in the OA area.