S Munigangaiah
@SMunigangaiah
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Adult and Paediatric Spine Surgeon. @AlderHey and @RJAH_NHS, @BritScoliosis Exec member, Spine fellowship director
Shrewsbury, England
Joined September 2017
My wife and I grew up in Bangalore, Southern Indian state of Karnataka, (previously known as princely state of Mysore) is known for its rich cultural heritage! Both of us work for @NHSEngland NHS has the most diverse workforce in the world! South Asian Heritage Month 16th July to 17th August. #Southasianheritagemonth #SAHM
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@DeakinSue1 Very true! Working in NHS, I don’t have get an approval from corporate boss to do what is right for my patients! But if we are not careful UK 🇬🇧 will end up like this soon !
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Congenital scoliosis with truncal shift in an 8-year-old! I have been monitoring this child closely and the spine remained well balanced for a few years. However, left L1 hemivertebra started driving the deformity that caused a truncal shift. Fortunately, the left T7 hemivertebra and right T9 are balancing each other out, allowing me to focus on addressing the L1 hemivertebra through resection and short segment fusion. This approach has successfully realigned and balanced the rest of the spine. I decided to go 2 levels up and 2 levels down mainly to restore truncal shift ! My dilemma here is if I had gone one level above and one level below, I don’t really know if I could have have similar correction, alignment and balance ! As one would want fuse minimal levels in a child of this age. Utilizing a 3D printed model and intraoperative 3D navigation is great adjunct that helps in complete hemivertebra resection in my opinion. #CongenitalScoliosis #Hemivertebra
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Cauda Equina Syndrome (CES) is a rare spinal emergency characterized by bilateral severe radicular pain, peri-anal numbness, and loss of bladder and bowel control. Emergency decompression and discectomy are recommended to alleviate radicular symptoms and prevent further decline in bladder, bowel, and sexual function. CES, akin to compartment syndrome of the spine, often impacts young individuals and has enduring effects on both personal and family life, despite prompt medical intervention. #SpinalHealth #EmergencyCare
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Points well made 👏 Robotics have made not much impact on dealing with paediatric deformity correction surgery. However I could see some use of navigation as enabling technology to help in the more severe curve that you have shown as an adjunct to free hand technique can be quite helpful in getting more fixation points. Intra operative low dose CT scan also reduces return to theatre for malposition.
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RT @MattCBellamy: Delighted to share our latest publication from @SheffChildrens and @sheffielduni looking at the outcomes of spinal bracin…
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A Caucasian lady in her seventies presented with severe progressive cervical myelopathy attributed to ossification of the posterior longitudinal ligament (OPLL). While OPLL is more commonly observed in individuals of Asian descent, its prevalence in the Caucasian population remains understudied. Notably, the impressive nature of OPLL allows for clear visualization on X-rays without the need for a CT scan. In cases of myelopathy, surgical intervention can sometimes lead to unexpected outcomes. Following surgery, the patient experienced transient weakness in the C5 myotome on one side, a rare occurrence compared to the recognized complication of bilateral C5 palsy post long posterior cervical decompression and fusion. Immediate postoperative MRI was conducted to rule out a postoperative hematoma as the cause of this unusual weakness, revealing successful decompression and restoration of the cerebrospinal fluid column around the spinal cord. Remarkably, the arm weakness showed improvement within a matter of hours. While the primary surgical objective is typically to halt the progression of myelopathy, in this instance, not only was further deterioration prevented, but the patient also reported some enhancement in hand function after one year. However, there was no notable improvement in balance. #Myelopathy #Cervicalmyelopathy #OPLL
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Here's our recent publication on returning to sports activities after scoliosis surgery in adolescents. The discussion around this topic has been ongoing, particularly regarding the comparison between selective thoracic fusions and long fusions down to L4. Our study focused on adolescents with Lenke type 1 and 2 curves who underwent selective thoracic fusions. The findings revealed that individuals in this group were able to return to collision, non-contact, and contact sports at the same pre-operative levels much earlier In contrast, those who underwent longer fusions down to L4 in other Lenke type curves!
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