Journal of Spinal Studies and Surgery

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Background and Objective: Spinal cord injury (SCI) is a medically complex and life-disrupting condition that carries a high risk of morbidity and mortality. Dry mouth from xerostomia-causing medications, barriers to dental care access, dependence on others for oral hygiene significantly increase the risk of oral health problems. Hence, this study is contemplated to assess the association between oral health status and oral health-related quality of life (OHRQoL) among SCI patients. Materials and Methods: This cross-sectional study was conducted among 55 SCI patients. Data pertaining to the demographic details and socioeconomic status were also recorded through the Modified Kuppuswamy scale, 2016. The oral health status was recorded using the World Health Organization Proforma, 2013, and OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14) questionnaire. Descriptive statistics included computation of percentages, means, and standard deviations. Wilcoxon-signed ranks test was used to compare the association between mean OHIP and oral health status. Results: Forty-five of them had incomplete level of spinal injury and ten had complete level of spinal injury. Incomplete injury patients had higher decayed, missing, and filled teeth, gingival bleeding, and periodontal pocket, OHIP score compared to complete injury patients. The mean OHIP was 16.22. There was a significant association between mean OHIP and oral health status of the study participants (P = 0.000). Discussion and Conclusion: Oral health appears to be compromised in people with SCI. There was a significant association between the oral health status and OHRQoL. Oral health education for patients and caregivers on oral health-care issues should be encouraged and facilitated.

Cauda equina syndrome (CES) is an orthopedic emergency. The common causes of CES are intervertebral disc prolapse and traumatic injuries of the spine. We report an unusual case of vertebral endplate erosion into the spinal canal leading to CES. We report a 37-year-old male patient who had a history of low back pain radiating to both the legs for 1 month. He was receiving treatment at a local hospital. He presented to our emergency department with the inability to stand, walk, or void for 1 day. Radiographs and magnetic resonance imaging confirmed CES due to intervertebral disc prolapse. Our patient's diagnosis of vertebral endplate extrusion was made intraoperatively when the extruded material was found to be hard in consistency, and histopathological analysis confirmed the diagnosis. A diagnosis of vertebral endplate causing CES has been reported only in adolescents but never in adults. Preoperative computed tomography scans can help in easy diagnosis.

Granulicatella species commonly known as nutritionally variant streptococci (NVS) are part of the normal oral flora and are found in the endocardium, dental plaques, dental abscesses, and endodontic infection. Severe complications may arise due to its ability to cause a variety of serious infections. The presence of Granulicatella species in spine or surgical site was never noticed or reported. Here, we present a rare case of G. adiacens in the muscular plane of L5–S1 vertebrae which were diagnosed radiologically and also microbiologically to give appropriate treatment to the patient for recovery.

Online since 27^th January, 2017