Posts

Showing posts from December, 2011

Baastrup disease: Lumbar interspinous bursitis

Image
This disease is named after Danish radiologist (1855 - 1950) Christian Ingerslev Baastrup. Introduction & Epidemiology: It is claimed that Baastrup disease is responsible for intractable LBA (1). Though it is reported in mostly lumbar spine it’s cervical spine variant is also reported (2). Gardella called Baastrup disease as spinous process syndrome (3). It is reported in many occupational areas such as miners (4) & heavy vehicle drivers (8). Among of much debate now it is considered mostly a case of aging related problem. Let us discuss in little more detail: The Baastrup disease is characterized by the development of abnormal contact between adjacent spinous processes of the lumbar spine that results in rubbing against each other producing a bursitis which further result in focal midline pain and tenderness relieved by flexion and aggravated by extension. Epidemiology: It tends to be more common in the elderly. According to Maes et al (5) the prevalence of Baas...

Classification of spinal cord injury: ASIA classification Vs Frankel classification

Image
Clinicians have long used a clinical scale to grade severity of neurological loss in SCI. First devised at Stokes Manville before World War II and popularized by Frankel in the 1970's, the original scoring approach segregated patients into five categories. Frankel classification: Grade A:  no function Grade B: sensory only Grade C: some sensory and motor preservation Grade D: useful motor function Grade E: normal function ASIA classification: Grade A:  Complete. No motor or sensory function preserved in the sacral segments (S4-S5) Grade B: Incomplete. Sensory function is preserved but motor function is affected below the neurological level & includes the sacral segments (S4-S5) Grade C: Incomplete. Motor function is preserved below the neurological level, and more than half of the key muscles below the neurological level have a muscle grade less than 3. Grade D: Incomplete. Motor function is preserved below the neurological level, and more than half of the key muscles...

Shoulder: Bankart surgery rehabilitation

Image
Bankart surgery: Bankart lesion is an injury of the anterior (inferior) glenoid labrum due to repeated (anterior) shoulder dislocation. Repeated dislocation forms a pocket at the front of the glenoid that allows the humeral head to dislocate into it. It is often accompanied by a Hill-Sachs lesion (damage to the posterior humeral head seen as a depression on X-ray). A bony bankart is a Bankart lesion that includes a fracture in of the anterior-inferior glenoid cavity. Bankart lesion warrants surgery. In Bankart surgery the anterior (inferior) glenoid labrum is reattached to the glenoid. Generally there is a anterior approach to this shoulder operation. Rehabilitation is the key to successful reinstitution of functional activities. As it is a very common injury in sports like javelin throwing return to sports is heavily dependant on post operation physiotherapy. The following is an sample schema of physiotherapy & rehabilitation approach to the Bankart surgery.  ...