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- 저자 : Acharya Shankar (검색결과 4 건)
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Shankar Acharya,Varun Khanna,Manoj Kumar 대한척추외과학회 2022 대한척추외과학회지 Vol.29 No.4
Study Design: Cross-sectional, record-based. Objectives: To analyze the cervical sagittal (CS) and thoracic inlet (TI) parameters in asymptomatic adults and form predictive equations for cervical lordosis (CL) and T1 slope (T1S). Summary of Literature Review: Normative values of CS parameters, including physiological CL, and their relationship with TI parameters among healthy Indian adults have been scarcely documented in the literature. Methodology: We analyzed cervical radiographs of 171 healthy adult volunteers and estimated normative values of CS and TI parameters. The thoracic inlet angle (TIA), neck tilt (NT) and T1S were the TI parameters, while the cervical parameters included C2- C7 CL (Cobb’s method), the cervical sagittal vertical axis (cSVA), and C7 slope (C7S). T1S-CL was also calculated. The correlations were estimated and predictive equations were established using simple linear and stepwise multiple regression. The paired-sample t-test was used to evaluate the statistical significance of differences between the estimated and measured values. Results: The mean age of participants was 30±7.76 years. The mean TIA, T1S, NT, CL, cSVA, C7S, and T1S-CL were 79.6°±9.08°, 29.5°±8.6°, 49.3°±8.7°, 21.4°±16.5°,18.8±12.4 mm, 25.7°±7.9°, 8.7°±13.8° respectively. We established the following predictive equations: CL= 0.66 T1S+0.57 TIA - 0.68 SVA - 30.9 (r=0.72; R2 =0.53; p<0.01); CL=0.68 TIA - 30.4 (r=0.41, R2 =0.34; p=0.04) and T1S= 4.45+ 0.72 C7S (r=0.77; R2 =0.62; p<0.01). There was no statistically significant difference between the predicted and the measured values of CL (t=0.09, p=0.973) or T1S (t=0.14; p=0.84). Conclusions: This analysis of sagittal parameters in an asymptomatic adult population provides valuable reference points for the management of various cervical alignment disorders.
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Acharya Shankar,Khanna Varun,Chahal Rupinder Singh,Kalra Kashmiri Lal,Vishwakarma Gayatri 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.5
Study Design: This is a retrospective cohort study.Purpose: This study aimed to identify the clinicoradiological risk factors associated with the inability to achieve minimum clinically important difference (MCID) on the modified Japanese Orthopaedic Association (mJOA) Scale in operated cases of cervical spondylotic myelopathy (CSM).Overview of Literature: Only a few studies have evaluated the outcomes of surgery performed for CSM using MCID on the mJOA scale.Methods: We analyzed 124 operated CSM cases from March 2019 to April 2021 for preoperative clinical features, cervical sagittal radiographic parameters, and magnetic resonance imaging (MRI) signal intensities (SI). The risk factors associated with missing the MCID (poor outcome) on mJOA at the final follow-up were identified using binary logistic regression. Multivariate analysis was used to find significant risk factors, and odds ratios (OR) were computed.Results: A total of 110 men (89.2%) and 14 women (10.8%) with an average age of 53.5±13.2 years were included in the analysis. During the last follow-up, 89 cases (72.1%) achieved MCID (meaningful gains following surgery) while 35 (27.9%) could not. The final model identified the following parameters as significant risk factors for poor outcome: increased duration of symptoms (OR, 6.77; <i>p</i>=0.001), lower preoperative mJOA scale (OR, 0.75; <i>p</i>=0.029), the presence of multilevel T2-weighted (T2W) MRI SI (OR, 4.79; <i>p</i>=0.004), and larger change in cervical sagittal vertical axis (ΔcSVA) (OR, 1.06; <i>p</i>=0.013). Also, an increase in cSVA postoperatively correlated with a reduced functional recovery rate (<i>r</i>=−0.4, <i>p</i><0.001).Conclusions: Surgery for CSM leads to significant functional benefits. However, poorer outcomes are observed in cases of greater duration of symptoms, higher preoperative severity with multilevel T2W MRI SI, and a larger increase in the postoperative cSVA (sagittal imbalance).
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Prevalence and Risk Factors for Low Back Pain in 1,355 Young Adults: A Cross-Sectional Study
Sudhir Ganesan,Anita Shankar Acharya,Ravi Chauhan,Shankar Acharya 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.4
Study Design: Cross-sectional study. Purpose: To evaluate the prevalence and various risk factors for low back pain (LBP) in young adults in India. Overview of Literature: LBP is an emerging problem in adolescents, with an incidence that is the highest in the third decade of life worldwide. Various risk factors such as obesity, smoking, family history, stress, and exercise have been described in the literature. This study was conducted because of paucity of data in the Indian literature. Methods: A total of 1,355 (741 males and 641 females) young Indian Administrative Service aspirants and medical postgraduate aspirants aged 18–35 years were enrolled in the study. The subjects completed a detailed, semi-structured questionnaire that gathered data regarding their sociodemographic profile and factors considered to be risk factors for LBP. Anthropometric measurements, including height and weight, were measured and body mass index was calculated. Results: Most subjects (90.6%) were aged 20–29 years (mean, 24.49; range, 18–35 years). Results indicated that the following factors were associated with LBP in young adults: marital status, previous history of spine problems, strenuous exercise, job satisfaction, monotony, stress, daily number of studying hours, and family history of spine problems (p <0.05). However, age, sex, smoking, alcoholism, coffee intake, mode and duration of travel, diet, frequency of weightlifting, wearing heels, studying posture, and frequency and type of sports activities were not associated with LBP. Conclusions: The study identified various modifiable and non-modifiable risk factors that precipitated LBP in young adult Indians. Identifying these risk factors at an early stage will prevent LBP progression to a chronic disease state, thereby improving an individual’s quality of life and increasing productivity.
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Sacral Insufficiency Fractures Mimicking Lumbar Spine Pathology
G. Sudhir,Kalra K. L.,Shankar Acharya,Rupinder Chahal 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.3
Sacral insufficiency fractures (SIFs) are a common cause of back pain in the elderly. SIFs mimic the symptoms of lumbar spine pathology and so are commonly missed or underdiagnosed. Here we present four cases of missed SIFs that were subsequently identified and treated. One patient was treated as mechanical lower back ache, another patient underwent root block and two patients underwent surgery for lumbar canal stenosis. None experienced relief of their symptoms after these procedures. Retrospective analysis of X-ray and magnetic resonance imaging data revealed SIFs that were confirmed by computed tomography scans. All four patients were treated for underlying osteoporosis. Two patients who underwent surgery were treated conservatively and other two were treated by sacroplasty involving injection of cement into the fracture. Sacroplasty produced immediate pain relief and early mobilization compared to the conservative group. SIFs should always be considered in the differential diagnosis of an elderly patient presenting with low back symptoms. Sacroplasty can be considered for immediate pain relief and rapid mobilization.
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