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1.  Clinical Comparative Study: Efficacy and Tolerability of Tolperisone and Thiocolchicoside in Acute Low Back Pain and Spinal Muscle Spasticity 
Asian Spine Journal  2012;6(2):115-122.
Study Design
We performed a multicentric, randomized, comparative clinical trial. Eligible patients were randomly assigned to receive 150 mg of Tolperisone thrice daily or 8 mg of Thiocolchicoside twice daily for 7 days.
To assess the efficacy and tolerability of Tolperisone in comparison with Thiocolchicoside in the treatment of acute low back pain with spasm of spinal muscles.
Overview of Literature
No head on clinical trial of Tolperisone with Thiocolchicoside is available and so this study is done.
The assessment of muscle spasm was made by measuring the finger-to-floor distance (FFD), articular excursion in degrees on performing Lasegue's maneuver and modified Schober's test. Assessment of pain on movement and spontaneous pain (pain at rest) of the lumbar spine was made with the help of visual analogue scale score.
The improvement in articular excursion on Lasegue's maneuver was significantly greater on day 3 (p = 0.017) and day 7 (p = 0.0001) with Tolperisone as compared to Thiocolchicoside. The reduction in FFD score was greater on day 7 (p = 0.0001) with Tolperisone. However there was no significant difference in improvement in Schober's test score on day 3 (p = 0.664) and day 7 (p = 0.192). The improvement in pain score at rest and on movement was significantly greater with Tolperisone (p = 0.0001).
Tolperisone is an effective and well tolerated option for treatment of patients with skeletal muscle spasm associated with pain.
PMCID: PMC3372546  PMID: 22708015
Tolperisone; Thiocolchicoside; Skeletal muscle relaxant; Low back pain; Muscle; Spasm
2.  Anterior versus posterior procedure for surgical treatment of thoracolumbar tuberculosis: A retrospective analysis 
Indian Journal of Orthopaedics  2012;46(2):165-170.
Approach for surgical treatment of thoracolumbar tuberculosis has been controversial. The aim of present study is to compare the clinical, radiological and functional outcome of anterior versus posterior debridement and spinal fixation for the surgical treatment of thoracic and thoracolumbar tuberculosis.
Materials and Methods:
70 patients with spinal tuberculosis treated surgically between Jan 2001 and Dec 2006 were included in the study. Thirty four patients (group I) with mean age 34.9 years underwent anterior debridement, decompression and instrumentation by anterior transthoracic, transpleural and/or retroperitoneal diaphragm cutting approach. Thirty six patients (group II) with mean age of 33.6 years were operated by posterolateral (extracavitary) decompression and posterior instrumentation. Various parameters like blood loss, surgical time, levels of instrumentation, neurological recovery, and kyphosis improvement were compared. Fusion assessment was done as per Bridwell criteria. Functional outcome was assessed using Prolo scale. Mean followup was 26 months.
Mean surgical time in group I was 5 h 10 min versus 4 h 50 min in group II (P>0.05). Average blood loss in group I was 900 ml compared to 1100 ml in group II (P>0.05). In group I, the percentage immediate correction in kyphosis was 52.27% versus 72.80% in group II. Satisfactory bony fusion (grades I and II) was seen in 100% patients in group I versus 97.22% in group II. Three patients in group I needed prolonged immediate postoperative ICU support compared to one in group II. Injury to lung parenchyma was seen in one patient in group I while the anterior procedure had to be abandoned in one case due to pleural adhesions. Functional outcome (Prolo scale) in group II was good in 94.4% patients compared to 88.23% patients in group I.
Though the anterior approach is an equally good method for debridement and stabilization, kyphus correction is better with posterior instrumentation and the posterior approach is associated with less morbidity and complications.
PMCID: PMC3308657  PMID: 22448054
Anterior approach; extracavitary approach; posterior approach; Pott's spine
3.  Diagnostic accuracy of bedside emergency ultrasound screening for fractures in pediatric trauma patients 
Bedside ultrasound (BUS) can effectively identify fractures in the emergency department (ED).
To assess the diagnostic accuracy of BUS for fractures in pediatric trauma patients.
Setting and Design:
Prospective observational study conducted in the ED.
Material and Methods:
Pediatric patients with upper and lower limb injuries requiring radiological examination were included. BUS examinations were done by emergency physicians who had undergone a brief training. X-rays were reviewed for the presence of fracture and the results of BUS and radiography were compared.
Statistical analysis:
STATA version 11 was used for statistical analysis of the data.
Forty-one patients were enrolled in the study. The sensitivity of the BUS in detecting fracture was 89% [95% confidence interval (CI): 51% to 99%] and the specificity was 100% (95% CI: 87% to 100%). The positive predictive value of BUS was 100% and negative predictive value was 97%.
BUS can be utilized by emergency physicians after brief training to accurately identify long bone fractures in the pediatric age-group.
PMCID: PMC3214497  PMID: 22090734
Emergency department; fracture; pediatric; ultrasound

Results 1-3 (3)