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The spine is the most common site of skeletal metastases with its involvement occurring in up to 40% of patients. Metastatic spinal involvement can cause a number of sequelae like pain, instability and neurologic compression. About 10% of patients with involvement of the vertebral column will subsequently develop neurologic compression.The metastatic spinal lesions mostly affect the vertebral body and pedicle (85%). Management of spinal metastases remains controversial. Recent reports attest to the beneficial role of surgery. The role of decompressive laminectomy without stabilization, has been questioned. The Involvement of Vertebral Body and anterior compression had led to an increasing attention to anterior decompressive procedures, reconstruction and Stabilization. We Review here the Techniques described in literature for anterior reconstruction after vertebral corpectomy.

Three-dimensional imaging is an emerging technique in radiology. It might be used to help view the spine and assist in improving evaluation of scoliosis. These images are currently computer generated and although very effective are actually optical iflusions. Questions remain as to the reliability and validity of these images which are important considerations when treatment regimens are being developed and surgery contemplated. Using a constructed three-diemnsional image of a box, this study assessed the inter- and intra-reliability of viewing a specific point on this box and also the inter-reliability of identifying the coordinates of this same point. There was good reliability for viewing a single point in the X and Z axes which formed the plane of the computer but there was a 10X decrease in reliability along the Y-axis (depth). This pattern was repeated when considering the relationship between observers to identify the actual coordinates of the same point.

The aetiology of adolescent 5 coliosis remains unknown and hindering research is the absence of an appropriate animal model. It is now well-established that pinealectomy in young chickens results in the development of scoliosis that has many of the characteristics seen in patients with adolescent idiopathic scoliosis but the mechanism underlying this phenomenon remains elusive. The principle product of the pineal gland is melatonin and so many studies have focused on studying the effects of reduced levels of this hormone. The results have been mixed and the role of melatonin remains unclear. As melatonin production is inhibited by light, it was hypothesised that providing the chickens with an environment consisting of intense, continuous light would reduce serum melatonin levels and avoid any of the potential artifacts involved with the pinealectomy surgery. Consequently, pinealectomised and normal chickens were exposed to very intense light for complete 24 h in each day. At the end of 22 days in this environment serum melatonin levels had been reduced to very low levels in all chickens. Most importantly, 15% of the normal chickens had developed scoliosis and the number of pinealectomised chickens that developed scoliosis increased from 50% to 80%. The results showed that a method for reducing serum melatonin without pinealectomy has been established and which can be used in further experiments. Furthermore, the results also showed that reduced levels of serum melatonin has significant effects on the development of scoliosis. The indication is that there is a threshold level of serum melatonin below which scoliosis may develop probably in conjunction with some other factor which has yet to be identified.