Hartshill loop fixed by sublaminar wiring in a case of Potts spine D6 collapse

This 32 yr old male was admitted with Hx of spastic paraperesis for 1 yr .

O/E power 1/5 brisk knee and ankle reflex with sustained clonus Babinski positive .

Both dorsal column and spinothalamic sensation lost. Sensory level T6

MRI showed D6 vertebral collapse with signal changes in the spinal cord at same level

Operation was done today . Decompresion of the cord with fixation by sublaminar wiring to Hartshill loop done .

Post operatively he had remarkable improvement of right lower limb (power 3/5 MRC scale)

and the left limb power 2/5 MRC scale

with continous physiotherapy hope he will remarkable improve

1 am and still fresh

So much for today two cases - one basilar invasion and next Proptosis due to basilar encaphalocele
And see the coincidence this term basilar is cracking my brain
Well tomorrow is a big day well its today already . Ah !! the OT day .
I have to reach the theatre at 8 am sharp .
3 major cases - 2 spinal decompression both dorsal vertebral spine TB planned for heart shell loop wiring and fixation
one lumbar disc hernia L4-5 and one Hydrocephalus .
My plan grab the opportuntity to do VP shunting and assist the spine case
Now time to update Nepal news

Basilar Invasion

This gentleman 60 yrs old prented with gross physical deformities . Scoliosis , Pes Cavus

MRI was done which show odontoid process more than 5 mm above Chamberlain's line

So its a case of Basilar Invasion asociated with some congenital syndrome .

Case still open for discussion

Now we have planned for Odontoidectomy Transoral approach

Proptosis

This little child had eccentric proptosis . Vision normal . No conjunctival ejection . It was non pulsatile .

Diagnosis Basilar Encephalocele