Anterior cervical discectomy/corpectomy and fusion is performed in degenerative, traumatic and neoplastic etiologies of the cervical spine. This procedure is highly successful and associated with fewer complications. The rates of early and late postoperative infection have been reported to be between 0.1% and 1.6%, the late infections are being very rare. We report a rare case of a 30-year-old HIV negative, non-diabetic male who developed a late prevertebral cervical abscess with discharging sinus over posterior triangle of neck 3 years after an anterior cervical C6 corpectomy with fibular grafting and buttress screw fixation performed elsewhere for traumatic fracture C6 vertebra. The abscess was drained using radical neck dissection approach with complete excision of sinus track and removal of the infected implant. On culture, the organism was found to be beta-hemolytic streptococci, for which appropriate antibiotics were administered postoperatively. The sinus tract completely healed in 3 months time. Late infection as a complication of anterior cervical spine surgeries is rare and is associated with esophageal perforation, implant migration, seeding of the deep prevertebral space with oropharyngeal flora, or from surgical site/bacteremia or with Zenker's diverticulum. Few cases have been reported till date, but none have presented with a sinus tract. We present a case of delayed prevertebral abscess after cervical spine instrumentation that followed abnormal path causing sinus track to be developed in the site (the posterior triangle of the neck) other than previous incision site. Exploring both triangles of the neck using radical neck dissection approach was essential for complete excision of sinus track, removal of screw and debridement.

Background: There are four anatomic parts of the proximal humerus namely, head, greater tuberosity, lesser tuberosity, and surgical neck. 140 ͦ is the approx angle that is formed by the neck-shaft of the humeral. With prevalence rate of 5-6% among the elderly its incidence increase with the advancement in the age.  There are various factors affecting this advancement of the elderly patients towards the proximal humerus including increasing age, osteoporosis, age, sex and other similar factors. Aim: To study the efficacy of Hemiarthroplasty for Humeral Four-part Fractures in Elderly Patients Methods: It was an observational study. 30 patients were taken up for the study, who were diagnosed with humeral fracture. All the patients were included in the study after getting written consent from them. Radiography was done for all the patients from an AP view, a lateral shoulder view in the scapular plane, and of the axilla according to the Neer’s classification. Results: The above table shows that the number of patients was 10 and that of the female patients was 20. The mean age for the patients was 75.45±10.69 years. The VAS score before treatment was found to be ranged from 50-90 and the VAS score after treatment was found to be ranged from 75-95. The above table shows that the VAS pain was 20 in 3 months follow up time that increased to 25 in 1 year follow up time. The VAS disability score within 3 months follow up was 53 that reduced to 47 in 1 year follow-up period. The CMS activity score was in 3 months follow-up was 10.5 and that in 1 year follow up was 15. The CMS mobility after 3 months follow-up was 13 that increased to 22 in 1 year follow-up period. Conclusion: In the light of above results and discussion it is evident that the Hemiarthroplasty is a more viable option for reducing pain and increasing mobility in elderly patients suffering from four-part humeral fracture as compared to any other operative technique.

Background: Intertrochanteric femoral fractures are one of the most common types of bone fractures that are usually caused by severe direct or indirect force. It has also been estimated that nearly 50% of all the fractures are intertrochanteric fractures and the remaining are unstable fractures. Also, it has been found that the mortality related to hip fractures is as high as 15-20%. With an increase in the life expectancy of people, there has been a substantial increase in the number of patients with postmenopausal or senile osteoporosis. Aim: To compare Proximal femoral nail anti-rotation with cementless bipolar hemiarthroplasty for unstable femoral intertrochanteric fracture Methods: It was a retrospective study carried out at the Government Medical College, Baramati for a period of 1 year. One hundred patients were included for the scope of the study. Out of which 50 patients belonged to the PFNA group, and 50 patients belonged to the CPH group. Results: The number of patients in the PFNA group was 50 and that in the CPH group was 50. Both groups show male preponderance. The mean age among both the groups was almost the same, and there was no statistically significant difference among the two groups regarding the mean age. The mean operation time for PFNA was 54.15±16.1 mins, and that of the CPH group was 76.69±15.89 mins. The mean bleeding time for PFNA was 133.12±33.16 ml, and that of the CPH group was 289.25±44.01 ml. There was no statistically significant difference among the ASAA grade scores of the two groups. There was no statistically significant difference among the Evans-Jensen classification of the two groups. The mean length of hospital stay for PFNA group was 7.89±2.0 days, and the mean hospital stay for CPH group was 6.54±1.9 days. Conclusion: The current study depicted that CPH and PFNA are both safe and effective methods of treating elderly patients suffering from intertrochanteric fractures. However, it was found in the current study that CPH was found to have more mean operative time and increased blood loss. Still, the recovery and hospitalization time was almost similar in both the groups. Both the groups had almost similar ASA and Evans Jensen scores that made both the techniques equally safe

Ossification of the posterior longitudinal ligament (OPLL) is seen most commonly in men, in the elderly, and in Asian population [1].The disease usually starts with minimal or no symptoms, but some patients slowly progress to develop symptoms of myelopathy and radiculopathy.The present study aims to find out the relationship between serum CRP and ESR levels in patients with OPLL and its relationship with radiological classification of OPLL. In this cross sectional correlation study we have included all patients fulfilling the inclusion criteria from the year July 2019 to December 2020 in tertiary care hospital.Our study comprising of total 50 patients will show the relationship between OPLL with level of serum CRP and ESR (normal or raised).In our study it was found that majority of the patients were above 50 years of age with male predominance.In the present study it was found that the level of CRP was raised in 83.4% cases of continuous type,100% cases of localised type,69.2% cases of mixed type and 92.8% cases of segmental type.In the present study it was found that the level of ESR was raised in 83.4% cases of continuous type,66.7% cases of localised type,61.5% cases of mixed type and 75.0% cases of segmental type. It is possible that raised serum levels of CRP and ESR may be associated with OPLL and thus inflammation may be the cause of OPLL.

Spinal trauma is a common problem in modern Orthopedics. Spine surgery has recently been transformed significantly by the growth of minimally invasive surgery (MIS). Easily acceptable to patients as less invasive with smaller incisions, MIS is often perceived as superior to traditional open spine surgery. This study aims to study the functional outcome of minimally invasive surgery (MIS) in posterior thoracolumbar instrumentation in spine fractures. Present study was prospective in nature conducted among 35 patients. All patients fulfilling inclusion criteria and exclusion criteria were taken up for the study. Study was carried out over a period of 1.5 years. Majority of the patients was in the age group of 30-50 years and most of them were male. Mean VAS score & ODI functional outcome scores significantly reduced after MIS. Incidence of complications after MIS was 5.71%. 86% patients had excellent to good outcome after MIS according to McNab criteria. Minimal invasive surgery is safe and effective procedure with minimal complications and good post-operative outcome.