Harvinder Singh Chhabra

Indian Spinal Injuries Centre | ISIC

Background: The epidemiological international landscape of traumatic spinal cord injury (SCI) has evolved over the last decades along with given inherent differences in acute care and rehabilitation across countries and jurisdictions. However, to what extent these differences may influence neurological and functional recovery as well as the integr...

Objectives This case series looks at the role of intra-operative ultrasound in spine surgery for extradural pathologies Methods 10 cases of different pathologies were included. Following posterior laminectomy, intra-operative ultrasound was used to determine the adequacy of decompression. The surgical approach and the extent of surgery was then de...

A 55-year-old man presented with upper backache for one month, inability to move both the lower limbs for two weeks and retention of urine for five days. Examination revealed spastic paraplegia and reduced breath sounds in the right upper zone. Initial imaging revealed a soft tissue lesion in the apex of the right lung, suggesting a Pancoast tumor....

Good health of bones is of the utmost importance to human beings. Smart materials like lead zirconate titanate (PZT) patches are small in size and carry less weight, which makes them most apt for biomedical structural health monitoring (BSHM). In the past, focus on the development of low-cost non-invasive techniques for real-time monitoring of crit...

Development and validation of fracture classification system. To develop and validate a Simplified Classification System (SCS) for Thoraco-Lumbar (TL) fractures (SCS – TL fractures). Tertiary Spinal Injuries Centre, New Delhi, India Based on the International Spinal Cord Society Spine Trauma Study Group (ISCoS STSG, n = 23) experts’ clinical consen...

Achondroplasia is a rare autosomal dominant condition characterized by stenosis in spinal canal. Multilevel Ossification of the ligamentum flavum in the spine is a rare occurrence which too can contribute to stenosed canal. We report a case of an Indian achondroplasic dwarf with multilevel ossification of ligamentum flavum (OLF) at thoracic and lum...

Study design: Cross sectional study Purpose: We performed this study to understand the spectrum of sagittal spino-pelvic parameters, segmental lumbar parameters and the location of lumbar apex in asymptomatic adult population and analyse their correlations with each other. Overview of literature: Roussouly et al. reported that PI(Pelvic incidence)...

Design: Retrospective case-control study Purpose: This study was performed to analyse the radiological and clinical outcomes of transpedicular decompression in spinal TB with and without anterior reconstruction with PEEK and Mesh cages. Overview of literature: There is lack of adequate literature on the outcomes of transpedicular decompression with...

Study design: Retrospective case-control study Purpose: Our objective was to investigate the factors affecting static LF ‘hypertrophy’ and dynamic LF ‘buckling’. Overview of literature: The literature has not distinguished between ligamentum flavum (LF) ‘hypertrophy’ and ‘buckling’ when addressing cervical spondylotic myelopathy. The identification...

Background: Compensatory changes in cervical sagittal alignment after C1-C2 arthrodesis have been reported in a few studies. No studies have explored the differences in these compensatory changes between traumatic and non-traumatic pathologies. Conflicting reports exist on the correlation between cervical sagittal parameters and neck pain or functi...

Introduction Pressure injury (PI) is a potentially serious condition that is often a consequence of other medical illnesses. It remains a challenge for the clinicians and the researcher to fully understand and develop a technique for comprehending pathogenicity, prevention and treatment. Several animal models have been created to understand the mul...

Unfortunately, the original version of this article has been published with misplaced data under the heading “Meta-analysis”.

Context: Cervical radiculopathy and myelopathy is one of the most frequent ailments encountered by spine surgeon. Motion-preserving surgeries in cervical spine is a standard of care due to its certain advantages such as biomechanical anatomical conformity, reduced chances of adjacent segment degeneration, and revision surgeries. While there is abu...

Study design: Retrospective observational Objectives: This study aimed to document the safety and efficacy of lumbar corpectomy with reconstruction of anterior column through posterior-only approach in complete burst fractures. Methods: In this retrospective study, we analyzed complete lumbar burst fractures treated with corpectomy through posteri...

Purpose: Corrective manouvres in an angular kyphotic deformity has its own problems including early complications such as neurological deficit and late complications such as PJK and PJF. This article discusses the probable mechanisms leading to PJK in pediatric severe angular kyphotic deformities and preventive strategies for the same. We will also...

With technological advancements being introduced and dominating many fields, spine surgery is no exception. In view of the patient safety and surgeon's comfort, robotics has been introduced in spine surgery. Due to small corridors for work, little room for inaccuracy, lengthy and tedious procedures, spine surgery is an ideal scenario for robotics t...

Abstract: Introduction: Osteoid osteoma is a rare benign tumor of the spine that involves the posterior elements with 75% tumours involving the neural arch. The common presenting symptoms include back pain, deformity like scoliosis, and rarely radiculopathy. Methods: From 2011- 2017, we evaluated cases of osteoid osteoma managed by posterior surgi...

NTRODUCTION :Chondrosarcomas of the spine most commonly present with pain and neurological involvement and surgical resection is the standard of care. However,involvement of three contiguous vertebral bodies is rare and surgical en bloc resection may not be possible in all cases, particularly when there is extra compartmental spread. MATERIALS AND...

Introduction: Few studies have reported on the long-term outcomes of Goel and Harms C1-C2 fusions in the Asian population. Methods: This was a retrospective analysis of 53 patients undergoing Goel and Harms fixation (2010 -2018). Clinical outcomes were assessed utilizing the NDI (Neck Disability Index), JOA (Japanese Orthopaedic Association) score,...

With technological advancements being introduced and dominating many fields, spine surgery is no exception. In view of the patient safety and surgeon's comfort, robotics has been introduced in spine surgery. Due to small corridors for work, little room for inaccuracy, lengthy and tedious procedures, spine surgery is an ideal scenario for robotics t...

Introduction: Hydatid disease is caused by the parasite Echinococcus granulosus which is also known as the dog tapeworm. This disease is a relatively uncommon cause of spinal cord and dural compression. Case Report: We came across a peculiar case in a 41-year-old male patient who presented to us with pus discharge from a surgical wound over lower b...

Varicella zoster virus (VZV) presenting as a radicular pain in thoracic region is not uncommon but presentation in lumbar and thigh region is not frequently seen. Characteristic segmental vesicular–bullous rash in a dermatomal distribution associated with pain and allodynia is a prominent feature. Pain appears prior to rash. It is not uncommon for...

Purpose The Spinal Cord Society constituted a panel tasked with reviewing the literature on the radiological evaluation of spinal trauma with or without spinal cord injury and recommend a protocol. This position statement provides recommendations for the use of each modality, i.e., radiographs (X-rays), computed tomography (CT), magnetic resonance...

Multicenter prospective cohort. To discern neurological- and functional recovery in patients with a traumatic thoracic spinal cord injury (TSCI), conus medullaris syndrome (CMS), and cauda equina syndrome (CES). Specialized spinal cord injury centers in Europe. Lower extremity motor score (LEMS) and spinal cord independent measure (SCIM) scores fro...

Purpose Spinal Cord Society (SCS) and Spine Trauma Study Group (STSG) established a panel tasked with reviewing management and prognosis of acute traumatic cervical central cord syndrome (ATCCS) and recommend a consensus statement for its management. Methods A systematic review was performed according to the PRISMA 2009 guidelines. Delphi method w...

Purpose The Spinal Cord Society constituted a panel tasked with reviewing the literature on the radiological evaluation of spinal trauma with or without spinal cord injury and recommend a protocol. This position statement provides recommendations for the use of each modality, i.e., radiographs (X-rays), computed tomography (CT), magnetic resonance...

Background: Intradural lumbar disc herniation is rare, with an incidence of 0.3%-1%, but has been well reported in the literature. Transdural migration of the disc penetrating both ventral and dorsal dura is extremely rare, and there is a dearth of literature in the pathophysiology and surgical management of transdural herniation. Lack of knowledg...

Study design: Global mapping project of ISCoS for traumatic spinal cord injury (T-SCI) highlighted paucity of data from low and middle income countries (LMICs). Recognizing this gap, IDAPP study of one year duration was proposed as the first step to develop an International SCI database. Objectives: Primary objective was to assess database varia...

Background Mobile health (mHealth) is emerging as the most convenient way to deliver rehabilitation services remotely, and collect outcomes in real time, thus contributing to disease management by transferring care from hospital to home. It facilitates accessibility to healthcare, enhances patients’ understanding of their condition, and their willi...

Study design: Online survey. Objectives: To understand the prevailing scenario of the comprehensive management of spinal cord injuries (SCI) in India and in the Asian Spinal Cord Network (ASCoN) region, especially with a view to document the challenges faced and its impact. Setting: Indian Spinal Injuries Centre. Methods: A questionnaire was...

Objective: To determine from a societal perspective the cost-effectiveness and cost-utility of telephone-based support for management of pressure ulcers. Study design: Cost-effectiveness and cost-utility analysis of a randomised clinical trial. Setting: Tertiary centre in India and Bangladesh. Methods: An economic evaluation was conducted al...

Purpose The aim of this multicentre study was to determine whether the recently introduced AOSpine Classification and Injury Severity System has better interrater and intrarater reliability than the already existing Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries. Methods Clinical and radiological dat...

A three-year-old girl presented with primary complaint of severe low back pain with radiation to both lower limbs below the knees since 2 months following history of fall and marked restriction of her daily routine activities. After clinicoradiological evaluation she was diagnosed of having dysplastic L5-S1 spondyloptosis. A staged procedure was pl...

Introduction: This was a descriptive study with the primary objective of describing two Massive Open Online Courses (MOOCs) about the physiotherapy management of spinal cord injuries. We sought to determine the number of participants who registered and then completed the MOOCs, and changes in participants' knowledge. The secondary objective was to...

Study design: A multicentre, prospective, assessor-blinded, parallel randomised controlled trial. Objectives: The objective of the trial was to determine the effectiveness of telephone-based management of pressure ulcers in people with spinal cord injury (SCI) in low- and middle-income countries. Methods: One hundred and twenty people with SCI...

Study Design Retrospective study. Purpose The aim of this study was to analyze various diagnostic tools, including GeneXpert, for the management of tuberculosis of the spine. Overview of Literature Traditional diagnostic methods of microscopy, histology, and culture have low sensitivity and specificity for the management of tuberculosis of the sp...

A 46 years female sustained post-traumatic paraplegia with burst-fracture L1, with ASIA-A neurology, and underwent surgical decompression and stabilization. On 4th post-operative day, patient developed ascending myelopathy with neurological deterioration upto C5, along with fever, neck rigidity, high counts, with MRI showing myelitis. An aggressive...

Spinal Cord Series and Cases, Published online: 29 September 2016; | doi:10.1038/scsandc.2016.24

Objective: The objective of this study was to determine the reliability of measuring wound undermining in people with spinal cord injury (SCI). Study design: A psychometric study. Setting: The study was conducted at the Indian Spinal Injuries Centre, New Delhi, India. Participants: Thirty people with a complete or incomplete SCI and a pressure ulce...

Objectives: The purpose of the study was to study demographics of tuberculosis of spine and analyze factors that might affect neurological improvement in such patients. Methods: Of the 638 suspected cases of spinal tuberculosis, 312 cases with confirmed diagnosis with at least 1-year follow-up were selected for retrospective analysis. Two hundre...

Study design: Psychometric study. Objectives: To determine the intra- and inter-rater reliability and content validity of the International Spinal Cord Injury (SCI) Musculoskeletal Basic Data Set (ISCIMSBDS). Setting: Four centers with one in each of the countries in Australia, England, India and the United States of America. Methods: A tota...

Neglected severe and rigid spinal deformities pose a big challenge to spine surgeons. The neglect adds other risk factors like decompensated respiratory function, fused rigid curve and neurological deficit to an already complex problem. Single stage and anterior surgery are fraught with complications in an already compromised lung condition. The vi...

The purpose of the study was to study demographics of tuberculosis of Spine and analyze factors that might affect neurological improvement in patients suffering from tuberculosis of spine.

Geriatric patients with cervical spine injuries are known to have high morbidity and mortality. Our aim was to evaluate the acute outcomes of geriatric cervical spine injuries in terms of morbidity, mortality, and factors influencing it during hospitalization and after discharge, and the differences between young and old elderly patients.

Introduction In low-income and middle-income countries, people with spinal cord injury (SCI) are vulnerable to life-threatening complications after they are discharged from hospital. The aim of this trial is to determine the effectiveness and cost-effectiveness of an inexpensive and sustainable model of community-based care designed to prevent and...

[This corrects the article DOI: 10.1038/scsandc.2015.20.][This corrects the article DOI: 10.1038/scsandc.2015.20.].

Giant cell tumor (GCT) is a benign aggressive tumor, which affects axial as well as a peripheral skeleton. It affects epiphysis of long bones and can result in pathological fractures. GCT affects cervical spine rarely and has been known to affect almost all vertebra in the human body. It has a predilection for fixed spine, that is, sacrum though it...

Study design: A retrospective study was performed. Objectives: To analyze the outcome of two neglected sacral fractures who presented late to us after 6 weeks of injury with main complaints of incontinence and numbness in sacral region. There are no guidelines for management of complex fractures of sacrum who present late, and available literatu...

Current treatments for disc degeneration fall into two categories: 1) Conservative, nonsurgical management which entails analgesics, rehabilitation programs, and lifestyle adjustments such as weight loss and 2) Surgical intervention which involves spinal fusion and disc arthroplasty. Conservative management is the preferred treatment method for mos...

Phase- I/II, prospective, randomized, single-blind, controlled pilot study. To determine the safety and feasibility of autologous bone marrow transplantation in patients with acute spinal cord injury (SCI) via two routes of transplantation as compared with controls. Indian Spinal Injuries Center, New Delhi. Twenty-one subjects with acute, American...

Spinal Cord is the official journal of the International Spinal Cord Society. It provides complete coverage of all aspects of spinal injury and disease.

One year, prospective, observational study in an Indian subpopulation to assess back pain in patients with severe osteoporosis treated with teriparatide or antiresorptives in a clinical setting. One hundred and nineteen teriparatide-naοve Indian men and postmenopausal women (mean age 68.0 years) with previous osteoporotic vertebral fracture partici...

Introduction: Pressure ulcers are a common and severe complication of spinal cord injury, particularly in low-income and middle-income countries where people often need to manage pressure ulcers alone and at home. Telephone-based support may help people in these situations to manage their pressure ulcers. The aim of this study is to determine the...

Objectives: To report a rare case of spontaneous chronic subdural haematoma presenting with paraparesis and to highlight that subdural haematoma as one of the differential diagnoses for unexplained paraparesis. Summary of background data: Chronic subdural haematoma is common in elderly people usually presenting with altered mental status, monopl...

The existing literature is limited and inconclusive regarding management of spinal tuberculosis with neurological deficit during advanced pregnancy. None of the previously published case series concerning this problem during the second trimester of pregnancy have explored the option of simultaneous surgical intervention for it along with maintenanc...

Introduction: Solitary plasmacytoma of bone is a local primary bone tumour consisting of malignant plasma cells without systemic involvement. These tumours are known for large amount of blood loss, and the use of electrocautery is helpful in reducing blood loss and performing surgery in a relatively bloodless field; however, use of unipolar cauter...

To assess the influence of financial constraints on access to different components of spinal cord injury (SCI) management in various socio-economic strata of the Indian population. Indian Spinal Injuries Centre (ISIC). One hundred fifty SCI individuals who came for follow-up at ISIC between March 2009 and March 2013 with at least 1 year of communit...

Abstract: Stem cell-based interventions aim to use special regenerative cells (stem cells) to facilitate neuronal function beyond the site of the injury. Many studies involving animal models of spinal cord injury (SCI) suggest that certain stem cell-based therapies may restore function after SCI. Currently, in case of spinal cord injuries, new disc...

Spinal cord injury (SCI) is an injury to the spinal cord from traumatic or non traumatic causes. Data collection on the basis of income allows SCI statistics to meaningfully describe countries within a socioeconomic context. High-income countries have around one-fifth or more of their populations over 60 years of age, whereas lower income countries...

Study design: Online questionnaire survey. Objective: To obtain the opinion of experts on whether the currently available classification systems for thoracolumbar and subaxial cervical spine injuries meet their expectations with regard to the desired objectives of a good classification system and practical implementability. Methods: An online...

Introduction Congenital lordoscoliosis is an uncommon pathology and its management poses formidable challenge especially in the presence of type 2 respiratory failure and intraspinal anomalies. In such patients standard management protocols are not applicable and may require multistage procedure to minimize risk and optimize results. Case descrip...

Oswestry disability index modified English version.