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Results and clinical outcome of a prospective multicenter clinical study involving 100 patients under-going a lumbar interbody fusion procedure using an unilateral approach to the spine to introduce a new surgical technique as a viable and less invasive alternative to standard posterior (PLIF) or transforaminal (TLIF) lumbar interbody fusion techniques : For certain indications clinical data show that unilateral lumbar interbody fusion (ULIF) offers the surgeon a considerable time advantage compared to standard lumbar interbody fusion techniques.

CD instrumentation has been presented as a system which is able to achieve a 3-dimensional correction of idiopathic scoliose. We performed a prospective study about the apex derotation following CD instrumentation.24 consecutive patients with idiopathic scoliosis were included in this study. On pre- and postoperative CT scans the rotation angle relative to the sagittal plane according to Aaro and Dahiborn (RA sag) were measured the pre- and postoperative changes were evaluated with paired T-tests together with the significance. Kruskal Wallis tests were performed to correlate the mean values of those calculated changes with the number of instrumented levels and with the different King types of scoliosis.There was no statistical significant increase or decrease of the rotation if we consider the sag without taking into account the type of curve.The different ways to measure rotation in scoliosis are presented. The limits of the method we used (RA sag) are also discussed. We reviewed the literature concerning derotation with CD instrumentation to compare it with our results.The evaluation of rotation in scoliosis is not easy. The CT scan seems to be the best method. Nevertheless, the postoperative changes of the morphology of the patient can be a factor of error in rotational measurement.

We have carried out a biomechanical study to investigate the effect on flexion, extension, and rotation of seven systems of fixation on five cadaveric lumbar spines. Pedicle fixation proved the most effective method to restrict these movements. Facet screw fixation was also successful. Harrington distraction rods, the Hartshill rectangle and the Luque technique, although restricting slight flexion and extension, exerted little control over rotation. We conclude that pedicular fixation and facet joint fixation provide the greatest overall stability and might, therefore, be the best systems to consider for multilevel fusions in the lumbosacral region.

Two cases of closed ruptures of the flexor carpi radialis which resulted from attrition of the tendon caused by bony spurs secondary to Scapho Trapezo Trapezoidal (STT) osteoarthritis are described. Treatment is conservative.

In both radiological and orthopedic journals the value of MRI for diagnosing internal derangement of the knee has been assessed recently. However, results vary widely and no study reports on the differentiation among types of ACL tears. As far as meniscal pathology is concerned, attention has been drawn by Reicher et al. (11) and Glashow et al. (5) upon the false positive tears of the posterior horn of the medial meniscus. Where most authors consider signal inversion in the posterior horn of the meniscus as a normal finding in children--due to the higher water content--the same fact in adults can be interpreted as a false positive image or a missed tear at arthroscopy (5).

Numerous methods for the treatment of displaced supracondylar humerus fractures of the extension type are described in the literature. From 1974 until 1988, we treated conservatively 33 children with such fractures with Dunlop traction. Twenty-nine patients (88%) were re-examined. Four patients (12%) were interviewed by telephone. Good or excellent results were obtained in 31 patients. The Dunlop method is a simple, well-tolerated and safe method that permits surveillance for possible complications. In comparison with other methods, it yields good and reproducible results.

In this series spondylolisthesis was treated operatively in children and adolescents who had a displacement greater than 50% even if they were asymptomatic. In youngsters with less than 50% displacement and in adults, operative stabilization was performed if the displacement was progressive or if there were persistent symptoms unresponsive to conservative treatment that interfered with the patient's normal activities. The operation consisted of a posterolateral fusion in situ. Usually a laminectomy was not performed unless there were signs of severe neural compression. No reduction of the spondylolisthesis was attempted. We reviewed 38 cases treated operatively with a mean follow-up of 7 years. Twenty patients were younger than 20 years at the time of operation and 10 of these had greater than 50% displacement. The results were good to excellent in 90% (18 patients). In the adult group (18 cases) the results were less favorable, but still good to excellent in 72% (13 patients). In the adult group pseudarthrosis frequently occurred at the L4-L5 level. There were no neurologic complications postoperatively. Fusion in situ for spondylolisthesis is a safe operation giving satisfactory results.