European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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To determine the mid-term clinical and radiographic impact of pedicle screw fixation in patients with adolescent idiopathic scoliosis (AIS). ⋯ Intermediate follow-up of patients with AIS treated with an all pedicle screw construct demonstrates maintenance of their coronal, and sagittal plane correction between 2- and 5-year follow-up. At 5 years, improvements in SRS scores were consistent with 2-year values, except for a decline in pain and mental health scores.
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Surgery for spinal metastasis is often associated with significant morbidity. Despite a number of preoperative scoring systems/scales and identified variables that have been reported to predict complication risk, clinical studies that directly evaluate this issue using multivariate analysis are scarce. The goal of our study was to assess independent predictors of complication after surgery for spinal metastasis. ⋯ Patients older than 40 years or patients who have metastatic lesions involving three or more contiguous vertebral levels appear to be at higher risk for complication. Patients older than 65 years have the greatest likelihood of complication.
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To provide an overview of the tuberculosis (TB) and multi-drug resistant tuberculosis (MDR-TB) in the WHO European Region and evolution of public health response with focus on extra-pulmonary tuberculosis and Pott's disease. ⋯ There is a need to further analyze country data to document the extent of Pott's disease and develop specific guidelines for timely diagnosis and treatment of Pott's disease.
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Review Historical Article
Historical aspects of Pott's disease (spinal tuberculosis) management.
Spinal tuberculosis has existed in human beings since the ascent of man on earth. Historically, the management has progressed from regional orthodox therapies to the current, more effective, drugs. ⋯ Broad conclusions based upon the published data and personal observations (1959-2011) are summarized as follows: If diagnosis is made at predestructive stage and the patient is treated by standard drugs, the infection would heal in about 95 % patients without significant deformities and complications. Neural complications are still encountered in general hospital outpatients. Diagnosis and treatment at early stages would resolve the neurology without operation in about 40 % of cases. Nearly 60 % of patients would require to be operatively decompressed without jeopardizing mechanical stability. However, despite current treatment approximately 8 % of tuberculous paraplegics do not recover functionally. Immunocompromised state and multidrug resistance to standard drugs (8 to 10 %) are the current (and future) challenges to the doctors and the society.