Browsing by Author "Gautam, Samaj"
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Publication Post-operative Unilateral Visual Loss and Ophthalmoplegia following Cervical Spine Surgery in Prone Position: A Case Report(Nepal Medical Association, 2024) Gautam, Samaj; Bhusal, Suzit; Chaudhary, Ashlesha; Shrestha, Reshika; Rijal, Badri; Darjee, Prakash; Lama, Surya BajraAbstract Visual loss following a spine surgery in a prone position is a disastrous and irreversible complication. Moreover, the recommended treatment for such visual loss is lacking and the outcome is not so satisfactory. A 38-year-old gentleman developed profound right sided visual loss after an uneventful cervical spine surgery in a prone position that lasted approximately two and half hours. Immediate ophthalmic consultation was done and the case was diagnosed as right-sided central retinal artery occlusion. Despite the initiation of vasodilatation, anticoagulation, and adequate fluid infusion, satisfactory improvement was not achieved. Extensive review of pertinent literature highlighted limited efficacy of treatments for postoperative visual loss after prone spinal surgery, further emphasizing the importance of preventive measures as the cornerstone in such procedures.Publication Thoraco-lumbar Burst Fractures among Patients Admitted to Spine Unit of the Department of Orthopedics of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Gautam, Samaj; Paudel, Krishna Prasad; Panta, SunilAbstract Introduction: Burst fractures are the most common fractures in the thoracolumbar junction. Unstable burst fractures are mostly associated with neural injury. Early neurological and mechanical stabilisation are the goals of treatment. The aim of this study was to find out the prevalence of thoracolumbar burst fractures among patients admitted to the spine unit of the Department of Orthopedics of a tertiary care centre. Methods: This descriptive cross-sectional study was done in a tertiary care centre from 1 January 2021 to 31 December 2021 after receiving ethical approval from the Institutional Review Committee (Reference number: 079/80-11/BHG). Demographic details, mode of injury, morphology, neurological level, and neurological grade using the American Association of Spinal injury, Visual analogue Scale, Oswestry Disability Index and kyphotic angle were recorded. A convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Among 85 patients, the thoracolumbar burst fractures was found in 30 (35.25%) (26.73-43.77, 90% Confidence Interval). The mean age of patients was 39.73±13.91 years. Conclusions: The prevalence of thoracolumbar burst fracture was similar to other studies done in similar settings.Publication Traumatic Spinal Cord Injury among Patients Admitted to the Spine Unit in a Tertiary Care Centre(Nepal Medical Association, 2023) Gautam, Samaj; Rijal, Badri; Sharma, Laxmi KantaAbstract Introduction: Spinal cord injury usually results in disabling conditions. The incidence of spinal trauma is region-specific due to unique geography and demography. The epidemiology of spinal trauma changes with economic and social factors even in different periods. The aim of this study was to find out the prevalence of traumatic spinal cord injury among patients admitted to the Spine Unit in a tertiary care centre. Methods: A descriptive cross-sectional study was done in a tertiary care centre among patients admitted to the Spine Unit from 1 January 2022 to 31 December 2022 after receiving ethical approval from the Institutional Review Committee. Demographic details, mode of injury, level of injuries, neurological grading at the time of admission using American Spinal Injury Association grading, management methods, and complication if any were recorded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 465 patients, the prevalence of traumatic spinal cord injury was 316 (67.95%) (63.72-72.20, 95% Confidence Interval). A total of 243 (76.89%) cases were due to falls. The mean age of patients was 43.13±16.55 years. Conclusions: The prevalence of traumatic spinal cord injury patients was lower than the other studies done in similar settings.