Browsing by Author "Lakhey, RB"
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Publication Body Mass Index in Patients with Degenerative Spondylolisthesis: A descriptive cross-sectional study(Kathmandu University, 2025) Kafle, KR; Lakhey, RB; Ghimire, N; Paudel, S; Paudel, S; Kafle, DABSTRACT Background Low back pain is a leading cause of disability globally. Obesity, a product of modern lifestyle, is a well-established risk factor for many diseases including spine pathologies. Degenerative lumbar spondylolisthesis is a significant cause of low back pain in the middle-aged and elderly population. However, the literature on relationship between high body mass index and degenerative spondylolisthesis is inconsistent. Objective To investigate prevalence of obesity among the patients with degenerative spondylolisthesis. Method This cross-sectional study was conducted at Tribhuvan University Teaching Hospital, Nepal, involving 81 patients aged ≥ 40 diagnosed with degenerative spondylolisthesis at various lumbar vertebral levels and grades. Anthropometric measurements were obtained and analyzed using an Independent t-test to compare the mean age, height, weight, and body mass index across different levels, grades, and between sexes. Result Among the 81 patients, 59 were female, and 22 were male. The mean age and, BMI were 59.41 ± 10.97 years, and 26.04 ± 4.41 kg/m2, respectively. A notable 59.3% of patients had Body Mass Index ≥ 25. Patients with grade II spondylolisthesis exhibited significantly higher weight and Body Mass Index compared to those with grade I spondylolisthesis (p = 0.031, 0.013), particularly in female population (p = 0.003, 0.007) and at L4-L5 level (p = 0.003, 0.004). Conclusion Body mass index and weight were significantly higher in patients with grade II spondylolisthesis compared to grade I. This finding underscores the need for further research to understand the relationship between obesity and degenerative spondylolisthesis. KEY WORDS Body mass index, Epidemiology, Obesity, SpondylolisthesisPublication Correlation of Pelvic Parameters with Isthmic Spondylolisthesis(Kathmandu University, 2021) Shrestha, S; Lakhey, RB; Paudel, S; Kafle, D; Pokharel, RABSTRACT Background Spondylolisthesis is one of the major causes of low back pain. The anterior shift of the vertebra is mostly at L4 and L5 levels. Several types have been described, most common being the isthmic type. Pelvic parameters are said to be associated with development and progression of listhesis, and should be evaluated while treating it. Objective To study the correlation of Pelvic parameters with isthmic spondylolisthesis. Method It was a cross sectional case control study. In 68 cases with Isthmic Spondylolisthesis and of 34 cases with low back pain without listhesis (control), the spinopelvic parameters like lumbar lordosis, pelvic incidence, pelvic tilt and sacral slopes were measured together with degree of slip with lateral radiographs. Findings were analyzed and compared with control group. Result In control group, the pelvic incidence was 50.44±4.78o, the sacral slope was 34.38±6.79o, the pelvic tilt was 15.97±5.31o, and the lumbar lordosis was 46.76±6.78o. In Isthmic Spondylolisthesis group, the pelvic incidence was 60.85±6.79o, the sacral slope was 40.40±6.91o, the pelvic tilt was 20.63±7.51o, and the lumbar lordosis was 57.31±7.11o. The difference in spinopelvic parameters amongst control and Isthmic Spondylolisthesis group was statistically significant (p < 0.001). The degree of slip was directly proportional to the pelvic incidence angle (grade I=52o, II =62o and III 72.5o). Conclusion Spino-pelvic parameters are higher in isthmic spondylolisthesis group and is significantly associated with severity of the slip. KEY WORDS Isthmic spondylolisthesis, Lumbar lordosis, Pelvic incidence, Pelvic tilt, Sacral slopePublication New method of defining existing deformities and new operative procedure for correcting the deformities in the congenital clubfeet (Hussain's procedure)- early results in primary surgery(Institute of Medicine, 2016) Lakhey, RBAbstract Abstract: Introduction: A new method of defining the existing/persisting deformities in congenital clubfoot and a new operative procedure for correcting the deformities has been proposed. Methods: We retrospectively evaluated 43 feet of 30 patients (12 girls, 18 boys) who underwent the new surgical procedure for congenital clubfoot. The patients were evaluated with Cummings' modification of Laaveg and Ponseti score. The mean duration of follow-up was 10.7 months. Results: 81.3% of the cases of the idiopathic congenital clubfoot had excellent results, 16.2% had good results and 2.3% had fair results, when managed primarily with the new method of clubfoot treatment. Conclusion: While using the new method, exact existing/persisting deformities can be pointed out and adequate correction of the deformities can be done; thus there is less risk for over-and under-correction. The early results show that this method is effective. Long term results are awaited. Keywords: congenital clubfoot, new method, deformity definition, operative procedurePublication Osteoid-Osteoma of the Ilium Associated with Malignant Hypertension in an Adult Female(Institute of Medicine, 2014) KC, Bikash; Lakhey, RB; Shah, LL; Pokharel, RKAbstract Osteoid-osteoma, a benign bone tumor, is rare in the ilium bone. Its incidence is uncommon after third decades of life, and can represent a significant diagnostic challenge, resulting in a delay of treatment. We present a 38 years old lady who presented with history of severe right gluteal pam, more during night, and was relieved with non-steroidal anti-inflammatory drugs. Malignant hypertension was associated co-morbid condition without any underlying cause. Plain radiograph was initially normal and her diagnosis was delayed for more than six months until computed tomography (CT) scans and magnetic resonance imaging (MRI) showed a circumscribed lesion of the right ilium suggestive of Osteiod Osteoma. Keywords: iliac bone, gluteal pam, malignant hypertension, Osteoid esteoma Minimally invasive flouroscopy guided curettage was done, and histopathological findings confirmed the diagnosis of osteoid-osteoma, After surgery, the pain was significantly relieved and, surprisingly, the hypertension was controlled, and she was discharged on single antihypertensive drug in maintenance dosePublication Tubercular epidural abscess presenting as acute cauda equina syndrome(Institute of Medicine, 2015) Lakhey, RB; Kafle, D; Pokhrel, RKAbstract Tubercular epidural abscess without osseous and pulmonary involvement is an extremely rare scenario. Presentation of the same with cauda equina syndrome is even rarer. We present a case of tubercular epidural abscess in 31-year old male patient. He presented with acute cauda equina syndrome and was shown to have epidural abscess extending from L4-S3 vertebral level without any evidence of vertebral involvement in MRI. The patient did not have pulmonary involvement. The patient made an uneventful recovery following surgical decompression and anti-tubercular chemo- therapy. The diagnosis was confirmed by histo-pathological demonstration of tubercular granuloma in the biopsy specimen. Keywords: tuberculosis, epidural abscess, cauda equina syndrome, decompressionPublication Tubercular epidural abscess presenting as acute cauda equina syndrome(Institute of Medicine, 2015) Lakhey, RB; Kafle, D; Pokhrel, RKAbstract Tubercular epidural abscess without osseous and pulmonary involvement is an extremely rare scenario. Presentation of the same with cauda equina syndrome is even rarer. We present a case of tubercular epidural abscess in 31-year old male patient. He presented with acute cauda equina syndrome and was shown to have epidural abscess extending from L4-S3 vertebral level without any evidence of vertebral involvement in MRI. The patient did not have pulmonary involvement. The patient made an uneventful recovery following surgical decompression and anti-tubercular chemo- therapy. The diagnosis was confirmed by histo-pathological demonstration of tubercular granuloma in the biopsy specimen. Keywords: tuberculosis, epidural abscess, cauda equina syndrome, decompression