Browsing by Author "Kumar, Vishal"
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Publication An analytical review of contributory factors in intervertebral disc degeneration(2022) Kumar, Vishal; Neradi, Deepak; Maheshwari, Shivam; Quinteros, Guisela; Yurac, RatkoObjective: To summarize current trends in the pathogenesis and management of disc degeneration and suggest areas where more researchwould be of benefit. Methods: The available literature relevant to Lumbar disc degeneration (LDD) was reviewed. PubMed, MEDLINE, OVID, EMBASE, Cochrane, and Google Scholar databases were used to review the literature. Institutional Review Board approval was not applicable for this study. Results: This article summarizes trends in the pathogenesis and factors associated with disc degeneration. Conclusions: The genetic contribution to lumbar disc degeneration is a newer concept, still being researched in different populations around the world. Investigators have demonstrated a familial predisposition in the etiology of lumbar disc degeneration. The effect sizes of most genetic variants are small and, thus, individual gene-environment studies must have very large sample sizes to provide compelling evidence of any interactionPublication Management of mild degenerative cervical myelopathy and asymptomatic spinal cord compression: an international survey(2024) Brannigan, Jamie; Davie, Benjamin; Mowforth, Oliver; Yurac, Ratko; Kumar, Vishal; Dejaeghe, Joost; Zamorano, Juan; Murphy, Rory; Tripath, Manjul; Anderson, David; Harrop, James; Molliqaj, Granit; Wynne-Jones, Guy; Joefrey, Jose; Kato, So; Ito, Manabu; Wilson, Jefferson; Romelean, Ronie; Dea, Nicolas; Graves, Daniel; Tessitore, Enrico; Martin, Allan; Nouri, AriaObjective: Currently there is limited evidence and guidance on the management of mild degenerative cervical myelopathy (DCM) and asymptomatic spinal cord compression (ASCC). Anecdotal evidence suggest variance in clinical practice. The objectives of this study were to assess current practice and to quantify the variability in clinical practice. Methods: Spinal surgeons and some additional health professionals completed a web-based survey distributed by email to members of AO Spine and the Cervical Spine Research Society (CSRS) North American Society. Questions captured experience with DCM, frequency of DCM patient encounters, and standard of practice in the assessment of DCM. Further questions assessed the definition and management of mild DCM, and the management of ASCC. Results: A total of 699 respondents, mostly surgeons, completed the survey. Every world region was represented in the responses. Half (50.1%, n = 359) had greater than 10 years of professional experience with DCM. For mild DCM, standardised follow-up for non-operative patients was reported by 488 respondents (69.5%). Follow-up included a heterogeneous mix of investigations, most often at 6-month intervals (32.9%, n = 158). There was some inconsistency regarding which clinical features would cause a surgeon to counsel a patient towards surgery. Practice for ASCC aligned closely with mild DCM. Finally, there were some contradictory definitions of mild DCM provided in the form of free text. Conclusions: Professionals typically offer outpatient follow up for patients with mild DCM and/or asymptomatic ASCC. However, what this constitutes varies widely. Further research is needed to define best practice and support patient care.Publication Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish Optimizing Management and Minimizing Risk of Osteoporotic Vertebral Fractures - Perspectives of the AO Spine KF Trauma and Infection Group Key Opinion Leaders(2024) Joaquim, Andrei; Bigdon, Sebastian; Bransford, Richard; Chhabra, Harvinder; Yurac, Ratko; Kumar, Vishal; El-Sharkawi, Mohammad; Benneker, Lorin; Karamian, Brian; Canseco, Jose; Scherer, Julian; Hassan, Ahmed; Schroeder, Gregory; Öner, Cumhur; Rajasekaran, Shanmuganathan; Vialle, Emiliano; Kanna, Rishi; Vaccaro, Alexander; Tee, Jin; Camino, Gaston; Fisher, Charles; Dvorak, Marcel; Schnake, Klaus; AO Spine Knowledge Forum Trauma & InfectionStudy design: Literature review with clinical recommendations. Objective: To highlight important studies about osteoporotic spinal fractures (OF) that may be integrated into clinical practice based on the assessment of the AO Spine KF Trauma and Infection group key opinion leaders. Methods: 4 important studies about OF that may affect current clinical practice of spinal surgeons were selected and reviewed with the aim of providing clinical recommendations to streamline the journey of research into clinical practice. Recommendations were graded as strong or conditional following the GRADE methodology. Results: 4 studies were selected. Article 1: a validation of the Osteoporotic Fracture (OF)-score to treat OF fractures. Conditional recommendation to incorporate the OF score in the management of fractures to improve clinical results. Article 2: a randomized multicenter study comparing romosozumab/alendronate vs alendronate to decrease the incidence of new vertebral fractures. Strong recommendation that the group receiving romosozumab/alendronate had a decreased risk of new OF when compared with the alendronate only group only. Article 3: a systematic literature review of spinal orthoses in the management of. Conditional recommendation to prescribe a spinal orthosis to decrease pain and improve quality of life. Article 4: post-traumatic deformity after OF. A conditional recommendation that middle column injury and pre-injury use of steroids may lead to high risk of post-traumatic deformity after OF. Conclusions: Management of patients with OF is still complex and challenging. This review provides some recommendations that may help surgeons to better manage these patients and improve their clinical practice.