Browsing by Author "Thapa, Bishnu Babu"
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Publication Functional and Radiological Outcome of Short Same Segment Instrumentation in Thoracolumbar Burst fracture(Nepal Health Research Council, 2023) Thapa, Bishnu Babu; Shah, Rajesh PratapAbstract Background: Thoracolumbar region is important biomechanics transition zone in which rigid thoracic and flexible lumbar spine meet. This area is highly vulnerable to traumatic spinal fracture.Among all spine fracture, compression type is most common and managed conservatively. Thoracolumbar spine fracture can be associated with neurological deficit, spinal instability. The optimal treatment for these injuries is still controversy and subject for research. Methods: This retrospective study included 30 patients with single level thoracolumbar fracture.All the patients clinical and radiological parameters were evaluated preoperative, post-operative and 1 year follow up. Clinical parameters were included Visual analogue score, Oswestry disability index. Radiologic measurement were regional kyphotic angle by cobb’s method and anterior vertebral body height loss (Mumford’ santerior body compression equation method) in X-ray. All the data were analysed in SPSS version 20. Results: A total of 30 patients were included in this study,19 were male.The mean age of the patients were 40.8±13.The main cause of injury was fall from height,26 patients. The most common level of fracture vertebra was L1,11 patients.The mean difference of preop and postop kyphosis was 11.70±50 with P<0.05.The mean difference of preop Oswestry disability index and postop Oswestry disability index score was 30.7±7.6 with T score 22(P<0.05).The preop and postop Visual analogue score score also improved ,mean difference was 2.8±1(P<0.05). Conclusions: Short segment instrumentation with placement of pedicle screw at fracture vertebra is one option in the treatment of thoracolumbar burst fracture. Keywords: Burst; instability; kyphosis; neurological; thoracolumbarPublication Orthopedic Implant Removal in the Department of Orthopedics of a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Bhandari, Ravi; Dawadi, Pravakar; Magar, Mohit Thapa; Sinha, Ritesh; Kayastha, Nirab; Shah, Rajesh Pratap; Thapa, Bishnu Babu; Magar, Sushil RanaAbstract: Introduction: Implant removal surgery is one of the common surgical procedures done in orthopedics. Studies report that a major portion of orthopedic surgeries carried out in different institutions comprises implant removal procedures. This can be challenging in limited manpower and infrastructure availability scenarios, like in developing countries like Nepal. This study aims to study the prevalence of orthopedic implant removal procedures carried out among overall surgical procedures in the orthopedic department of a tertiary care center in Nepal. Methods: A descriptive cross-sectional study was performed on the medical records of the department of orthopedics of a tertiary care center after approval from the institutional review committee. The data included records from the starting of 2018 to the end of 2019. Data related to the number of implant removal procedures, types of implants, indications, fracture sites, anesthesia use, gender and age distribution were studied. Statistical Package for Social Sciences version 20 was used to study descriptive data. Results: Out of 2557 orthopedic operations carried out in the study duration, 458 (17.91%) of implant removal procedures were done in the department. The most common age group was the young adult age group, 255 (55.68%). Medium-sized implants were the commonly removed ones, 337 (73.58%). Elective procedures were the most common indication, 369 (80.57%). Conclusions: Implant removal procedures cover a major fraction of overall orthopedic operations carried out by the department, most of which are elective procedures. In limited-resource settings, this can be challenging, and a proper evaluation with counseling could be done before implant removal surgery.