Background:In anterior cervical discectomy and fusion (ACDF), the two most frequently used materials are allografts and polyetheretherketone (PEEK) cages. The aim of the study was to compare the functional and radiological outcomes of polyetheretherketone (PEEK) cages with iliac crest allografts in anterior cervical decompression and fusion (ACDF) in patients of symptomatic Cervical spondylotic myelopathy (CSM).Methods:In this cohort study, we included 70 (35 in each group) patients of symptomatic CSM having degenerative cervical disc disease who were planned for ACDF from Jan-2017 to Jan-2021 in Rawalpindi Medical University. All procedures were performed under general anesthesia in supine position, standard ACDF technique was used in all patients. Anterior cervical locked plates were used for fixation of PEEK cages or the iliac allografts in the inter-vertebral space. Radiologic and functional outcomes were determined till 6 months after surgery. Results:The baseline study characteristics were similar between the groups. Mean Modified Japanese Orthopaedic Association (MJOA) score at 06 months’ follow-up was same between the groups; 14.16±4.30 in group A and 13.54±3.24 in group B (p-value 0.49). Disc space height at 06 months’ follow-up was also similar between the groups; 10.01±0.67 mm in group A versus 10.11±0.70 mm in group B (p-value 0.54). Fusion rate at final follow-up was 31 (88.6%) in group A versus 30 (85.7%) in group B (p-value 0.72).Conclusion:PEEK cages have similar functional and radiologic outcomes in comparison to ileal crest allografts. So, PEEK cages can be used as a successful alternative to ileal crest allografts this will help to reduce donor site morbidity and will reduce longer surgical times associated with graft harvesting.

Objective:             To compare the analgesic and functional outcomes of intra-articular ketorolac with corticosteroids in patients of knee OA. Methods:             In this randomized comparative study, we included patients of knee OA who were planned for intra-articular injections from January-2020 to December-2020 in the Department of Anesthesia and Pain Medicine at Rawalpindi Medical University. Patients were allocated to two groups using block randomization, each block contained 30 patients and received injection of either triamcinolone (Group T) or ketorolac (Group K). VAS score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were noted at 1 week, 1 month and at 3 months of injection. Results: Mean baseline WOMAC score was 46.60±5.64 in group K and 47.0±5.27 in group T (p-value 0.74). Mean WOMAC score was reduced significantly at 1st week and 1 months and 3 months follow-up in both groups, with insignificant statistical difference in group K and T (p-value 0.39, 0.18 & 0.15 respectively). Baseline VAS score was 7.02±1.34 in group K versus 7.27±1.03 in group T (p-value 0.36). VAS score was also reduced at 1 week, 1 month and 3 months follow-up, however the mean VAS at intervals was not statistically different between group K and T with p-value of 0.13, 0.08 and 0.49 respectively. Treatment was successful in 22 (55%) patients in group K versus 24 (60%) patients in group T (p-value 0.65). Conclusion:             Intraarticular ketorolac has similar functional and analgesic outcomes as that of triamcinolone.