Dr.Shrish Nalin

neurosurgeon,associate professor with interest in spine,braintrauma,cvj,onco,vascular,functional ,endoscopic neurosurgery

[Dr.Shrish Nalin @iDrShrishNalin]

Diagnosis and managemment

[Dr.Shrish Nalin @iDrShrishNalin]

Patient present with sudden vision loss
What can be the reason???
Comments

[Dr.Shrish Nalin @iDrShrishNalin]

Post op xray of
#OLIF PROCEDURE
Initial complaints:-
Left leg radiculopathy
Failure of conservative treatment
WhyOLIF:-
Minimal invasive
Increase disc height restoration
Large cage size

[Dr.Shrish Nalin @iDrShrishNalin]

a nice initiative by @sdm kangra
#fit kangra initiative
#health
#fitness

[🌴🍃 @stillmomentss]

Peace a way🛣️🌳🌲🌿

[Nature's Beauty @Nature_Beauty11]

Storm chaser Jonas Piontek captures a dramatic supercell time-lapse over a wheat field, where frequent lightning illuminates the cloud structure against a clear starry night sky

[Pure Nature @purenature_1]

Clear stream rushing over rocks 💧 #relax

[Nature's Beauty @Nature_Beauty11]

This video captures the view from Aiguille du Midi at 3842 meters in the French Alps, reached by a 20-minute cable car from Chamonix with 360-degree panoramas of Mont Blanc and surrounding peaks.

[VIEW @viewsoff]

Mount Fuji, Japan 🇯🇵

[Erik Solheim @ErikSolheim]

Incredible India 🇮🇳!

Not the Swiss Alps. This is Kangra Valley, Himachal Pradesh.

Nestled in the lap of the Himalayas and surrounded by the majestic Dhauladhar Range, Kangra Valley looks straight out of a postcard.

[Manish Taneja @resusdoc]

Learn to read head CT with me…

#Foamed #foamcc #foam #medtwitter #radiology #neetpg

[Nature's Beauty @Nature_Beauty11]

Daniel captures a peaceful golden-hour sunrise in the Allgäu forest, where crepuscular rays pierce through mist along a gravel path for a meditative, cinematic nature scene.

[Dr.Shrish Nalin @iDrShrishNalin]

@atmghn True

[Ali A. Baaj MD @AliBaajMD]

What are the key, practical alignment parameters in cervical spinal deformity surgery? Hope colleagues find this brief review on this topic helpful. https://t.co/bXT7II5cwf

[Oren Gottfried, MD @OGdukeneurosurg]

Awesome kypho-scoliosis deformity correction from vaquinha do Razoes

[The Universe @TheUniverse_CBS]

India gliding beneath the International Space Station, seen from just 70 km above Earth 🇮🇳🌍

A breathtaking perspective of our incredible planet from space.

#India #ISS #EarthFromSpace #Space

[Physio Meets Science @PhysioMeScience]

Pain Mechanisms in Fibromyalgia: An Integrative Narrative Review of Central, Peripheral, Neuroimmune, and Psychobiological Factors

https://t.co/dc9oHiPqqE

[Oren Gottfried, MD @OGdukeneurosurg]

Spinal cord structures and pathways. What is your favorite tract?

[Lea Alhilali, MD @teachplaygrub]

Do you feel there’s a back-log of findings in a spine MRI report?

Everyone talks about discs & facets, but not everyone talks about the endplates.

Do you?

Do you need to talk about degenerative changes (Modic changes) of the endplates?

Here’s thread w/all you need to know!

Over 30 years ago, Modic et al. found there were 3 types of degenerative endplate changes:

(1) T2 bright changes (indicating edema, Modic 1)
(2) T1 bright changes (indicating fat, Modic 2)
(3) T1 & T2 dark changes (indicating sclerosis, Modic 3)

But what do they mean?

MODIC 1
--Bright on T2, indicating edema.
--Pathology shows inflammation, vascular granulation tissue, & high cellular turnover
--Vascular granulation tissue means these can enhance on post contrast images—mimicking discitis!

MODIC 2
--Bright on T1, indicating fat.
--Show fatty conversion of the marrow & low cellular turnover.
--I think of them as the middle-aged dad bod of degenerative change—lots of fat & slow to change!

MODIC 3
--Dark on T1 & T2, indicating sclerosis
--Pathology showsdense fibrous tissue & sclerosis.
--Like endplates get fossilized—once you turn into rock, you are never going back.

I remember these bc the forces at work in the endplates are like the famous astrology signs—almost.

Earth (sclerosis)
Wind (fatty changes, when you feel fat & full, you tend to give off wind!)
Fire (inflammation, edema)

Now you can use this when you go BACK to work on reading spine MRIs!