Background: Posterior spinal surgery for adolescent idiopathic scoliosis is aimed at correcting deformity and stopping deformity progression to improve the health related quality of life. The correlation between radiological outcome and health related quality of life is yet unclear. This study aimed to assess the correlation between radiological outcome and health related quality of life.Methods: A descriptive cross-sectional study of 31 cases of adolescent idiopathic scoliosis who underwent posterior spinal surgery at our center from July 2013 to August 2019, was done. Radiological outcomes were measured by the Cobb’s angle before and after surgery in standing whole spine X-ray and compared by paired t-test. Health related quality of life was measured by Scoliosis Research Society-30 questionnaire. Correlation between radiological outcomes and Scoliosis Research Society-30 and its domains were assessed by Pearson’s correlation coefficient, and Spearman’s rank correlation coefficient.Results: There were 18 females (58.06%) and 13 males (41.93%) with a mean age of 14.81 years (range 12-18 years). Average post-operative follow-up was 37 months (range 6-82 months).The mean amount of deformity correction post-operatively was 460 (range 300-740). The mean of total SRS-30 score was 137.64±7.84. The post-operative Cobb angle correlated significantly with the mean total Scoliosis Research Society-30 score (p=0.046). Self-image/appearance and satisfaction with management correlated significantly with residual deformity and amount of deformity correction. Self-image/appearance and pain correlated significantly with satisfaction with management. Self-image/appearance had a significant positive correlation with mental health (p=0.004). Conclusions: Posterior spinal surgery for adolescent idiopathic scoliosis provided better radiological outcomes, and a positive correlation with health related quality of life. There was significant improvement of self-image/appearance and satisfaction after surgery, which in turn, improved mental health. Keywords: Adolescent idiopathic scoliosis; health related quality of life; posterior spinal surgery; radiological outcome

Introduction: Lumbosacral transitional vertebra is a normal anatomical variant at the L5-S1 junction with an incidence as high as 4-36%. This alteration results in incorrect identification of vertebral segments leading to wrong surgery. The aim of the study was to find out the prevalence of lumbosacral transitional vertebra among patients visiting the department of orthopaedics in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted from 11 September 2021 to 31 May 2022, after receiving ethical clearance from the Institutional Review Committee (Reference number: IRC-2021-9-10-09). The patients with plain radiographs of the lumbosacral spine (anteroposterior view) were assessed and evaluated by a fellow and consultant of the orthopaedic spine and classified as per Castellvi's radiographic classification. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 1002 patients, lumbosacral transitional vertebra was detected in 95 (9.48%) patients (9.40-9.56, 95% Confidence Interval). Out of 95 (9.48%), patients with the lumbosacral transitional vertebra, 67 (70.53%) had sacralisation and 28 (29.47%) had lumbarization. The mean age of the patients at the time of the study included in the study was 41.6±15.12 years (range 18-85 years). The lumbosacral transitional vertebra was more common in females than males. According to the Castellvi classification, type IIa was the most common type 47 (49.47%). Conclusions: The prevalence of lumbosacral transitional vertebra was similar to other studies done in similar settings.

Introduction: The discordance in the diagnosis of osteoporosis is characterized by the variation in bone mineral density measurements at different skeletal sites. The presence of discordance significantly alters the treatment plan as different treatment is required for different skeletal sites. The aim of this study was to find out the prevalence of hip-spine discordance in bone mineral densities in patients undergoing dual-energy x-ray absorptiometry scans for suspected osteoporosis. Methods: A descriptive cross-sectional study was conducted among patients undergoing dual-energy x-ray absorptiometry scans from 1 December 2020 to 30 October 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: IRC-2020-11-18-08). Patients undergoing dual-energy x-ray absorptiometry scans for suspected osteoporosis were included. Patients aged less than 50 years, already diagnosed and under treatment for osteoporosis, and incomplete information about T-scores of hips and spine were excluded. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 1028 patients, 602 (58.56%) (55.55-61.57, 95% Confidence Interval) had discordance in hip and spine bone mineral densities. The majority of them, 570 (94.68%) were female and 32 (5.71%) were male. Major discordance was observed in 101 (16.77%) patients and minor discordance was observed in 501 (83.22%) patients. Conclusions: The prevalence of discordance in hip and spine bone mineral densities in patients undergoing dual-energy x-ray absorptiometry scans was higher than that reported in other similar studies done in similar settings.

ntroduction: Subaxial cervical spine injuries are common following blunt trauma. Unstable cervical spine injuries are frquently managed with anterior decompression and instrumented fusion. This study aims to measure clinical and radiological outcome of anterior surgery for sub-axial cervical spine injuries done in our center. Methodology: This was a retrospective analysis of the cases operated from July 2015-June 2019. Patients aged 18-80 years, presenting with subaxial cervical fractures within 7 days of injury with Sub-axial Injury Classification system (SLIC) score more than 3, managed with anterior surgery were included in the study. Outcome was evaluated at 6 months and at one year with Neck Pain Disability Index and Bridewell Interbody Fusion Grading System. Results: Among 31 patients, ACDF was performed in 14 cases and ACCF in 17 patients. At final follow-up, 43.75% patients had improvement in at least one grade neurology following surgery. Among patients with complete neurological deficit, 25% had minimal disability, 35% moderate, 25% severe and 15% had very severe disability. Similarly, among patients with incomplete neurological involvement, minimal, moderate, severe and very severe disability was seen in 65%, 15%, 20% and none respectively. On average, 90.1% case had grade I fusion, 3.3 % each had grade II, grade III and grade IV fusion. 7 cases had dysphagia which relieved after few days. 1 patient had hoarseness of voice which relieved after few days. Pseudo-arthrosis was seen in 1 case and graft subsidence in 2 cases. Conclusion: Anterior cervical fusion for acute sub-axial cervical spine injuries gives good clinical and radiological outcome with minimal complications. Keywords: Subaxial cervical spine injury, ACDF, ACCF, Neck Pain Disability Index, Bridewell Interbody Fusion Grading System