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1.  Recurrent Echinococcal Infection of the Lumbar Spine: An 11 Year Follow-up 
Asian Spine Journal  2013;7(1):39-43.
Spinal hydatid cyst is a rare occurrence in non endemic countries. We present a case of recurrent lumbar hydatid disease in a 21-year-old male who following initial treatment had a good functional outcome and healing for 8 years, following which he came back with complaints of low back ache and neurological deficit. Patient underwent a second surgery with global debridement of L3-L5 vertebrae followed by medical management for two years. He had a good surgical outcome with recovery from the neurological deficit. Patient has returned to his routine activities and is being reviewed every year; there is no evidence of recurrence in the past 3 years. To the best of our knowledge recurrence after 8 years of initial treatment, followed by good clinical and radiological outcome for 3 years after surgery and treatment of the recurrence has not been reported in literature.
doi:10.4184/asj.2013.7.1.39
PMCID: PMC3596583  PMID: 23508512
Echinococcosis; Lumbar vertebrae; Albendazole
2.  Chondrosarcoma of the Spinous Process: A Rare Presentation 
Asian Spine Journal  2012;6(4):279-283.
Chondrosarcomas are malignant cartilage forming tumours. They form the second most common primary malignant tumour involving the vertebral axis. We present a rare presentation of a secondary chondrosarcoma from the spinous process of lumbar vertebra and discussed its management. The main emphasis is on the rare presentation and the need for awareness and suspicion of the pathology.
doi:10.4184/asj.2012.6.4.279
PMCID: PMC3530703  PMID: 23275812
Chondrosarcoma; Spinous process; Diagnosis; Treatment
3.  Left Second Rib Exostosis, Spinal Cord Compression and Left Upper Thoracic Scoliosis: A Rare Triad 
Asian Spine Journal  2012;6(3):207-210.
Exostosis of the rib with neural foraminal extension as a cause of spinal cord compression and scoliosis has to the best of our knowledge not been reported. We describe a young male with hereditary multiple exostosis who presented with a spastic gait, lower limb weakness and a deformity of the upper back. Radiographic imaging revealed a lesion arising from the left second rib which was encroaching the spinal canal and a scoliotic deformity of the upper thoracic spine. Through a single T shaped posterior approach he underwent a decompressive laminectomy of T1 and T2 vertebra and excision of the lesion. The diagnosis of osteochondroma was confirmed by histopathological studies. He was followed up at one year when his neurological condition had returned to normal however the scoliosis had increased.
doi:10.4184/asj.2012.6.3.207
PMCID: PMC3429613  PMID: 22977702
Rib; Osteochondroma; Cord compression; Scoliosis; Excision
4.  The Use of Titanium Mesh Cages in the Reconstruction of Anterior Column Defects in Active Spinal Infections: Can We Rest the Crest? 
Asian Spine Journal  2011;5(3):155-161.
Study Design
Retrospective clinical series.
Purpose
To assess whether titanium cages are an effective alternative to tricortical iliac crest bone graft for anterior column reconstruction in patients with active pyogenic and tuberculous spondylodiscitis.
Overview of Literature
The use of metal cages for anterior column reconstruction in patients with active spinal infections, though described, is not without controversy.
Methods
Seventy patients with either tuberculous or pyogenic vertebral osteomyelitis underwent a single staged anterior debridement, reconstruction of the anterior column with titanium mesh cage and adjuvant posterior instrumentation. The lumbar spine was the predominant level of involvement. Medical co-morbidities were seen in 18 (25.7%) patients. A significant neurological deficit was seen in 32 (45.7%) patients. At follow up patients were assessed for healing of disease, bony fuson, and clinical outcome was assessed using Macnab's criteria.
Results
Final follow up was done on 64 (91.4%) patients at a mean average of 25 months (range, 12 to 110 months). Pathologic organisms could be identified in 42 (60%) patients. Forty two (60%) patients had histopathological findings consistent with tuberculosis. Thirty of 32 (93.7%) patients showed neurological recovery. The surgical wound healed uneventfully in 67 (95.7%) patients. Bony fusion was seen in 60 (93.7%) patients. At final follow up healing of infection was seen in all patients. As per Macnab's criteria 61 (95.3%) patients reported a good to excellent outcome.
Conclusions
Inspite of the theoretical risks, titanium cages are a suitable alternative to autologous tricortical iliac crest bone graft in patients with active spinal infections.
doi:10.4184/asj.2011.5.3.155
PMCID: PMC3159063  PMID: 21892387
Thoracolumbar spine; Discitis; Anterior column reconstruction; Titanium cage

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