Fractures and dislocations of the lower cervical spine: surgical treatment. A review of 83 cases.

The authors examine 83 consecutive cases of fracture and dislocation of the lower cervical spine submitted to surgery over a period of 5 years. Sixty-five patients were monitored with minimum 5-months follow-up, 5 died, 13 could not be traced. Lesions were classified based on the method proposed by Argenson3 with the purpose of identifying guidelines for surgical treatment.

Posterior lumbar interbody fusion a mid-term review of 60 cases.

It is the purpose of this study to evaluate the clinical and radiographic medium-term results of a series of 60 patients submitted to intersomatic lumbar fusion by posterior approach, using a system constituted by carbon wedges to be associated with bone grafts for intersomatic fusion, and by steel or titanium plates or bars used for posterior pedicle osteosynthesis. Satisfactory clinical results were obtained in 88.2% of cases and complete radiographic fusion in 91.

The treatment of thoracic and lumbar spine fractures: a study of 123 cases treated surgically in 101 patients.

For a total of 123 thoracolumbar traumatic lesions treated surgically in 101 patients over approximately 2 years (all monitored clinically and radiographically up to consolidation by follow-ups after from 6 to 26 months, mean 10 months) the technique used, complications and treatment are reported. The treatment procedure included: emergency surgery decompression, osteosynthesis, and fusion (posterior and possibly intersomatic); immediate recovery of function and loading; clinical and radiographic monitoring within 4-6 weeks, and possible anterior fusion in case of insufficient reconstruction of the anterior column. The complications observed out of 123 fractures were: collapse of the implant (4 cases), infection (5 cases), liquoral fistula (1 case), transitory paralysis of the abdominal muscles homolateral to the lombotomic incision (1 case), TVP (2 cases), bronchial pneumonia (2 cases), paralytic ileum (1 case).

Autogenous patella as replacement for a resected femoral or tibial condyle. A report on 19 cases.

The size and shape of the patella make it suitable for the partial replacement of a femoral or tibial condyle resected for tumour, or destroyed by trauma. It can provide a good articular surface and may give satisfactory knee function. Nineteen cases of patellar grafts are presented, with follow-up from two to nine years.

Pseudo-tumoral ossification of the muscles and/or periosteum. (A study of 57 cases).

The authors present a study of fifty-seven cases of pseudo-tumoral ossification of the muscles ("circumscribed ossifying myositis") and of the periosteum, supported by clinical, radiographic and histological evidence. This pathological condition is characterised by the formation of hyperplastic bone callus in muscle or periosteum, with a typical radiographic appearance, and with a relationship to trauma. We have excluded from our study pseudo-tumoral periosteal ossification in conditions of congenital origin (osteogenesis imperfecta, neurofibromatosis, Sane et al.

Auto-immunity and intervertebral disc disease.

The immunological approach to intervertebral disc disease is based on a number of clinical and biological facts observed in human pathology. Even allowing for the fact that the number of cases reported in recent research is small, and that the methods of clinical and biological investigation have not been standardised, and that there are differences of opinion concerning the nature of the disc antigen, encouraging results have nonetheless been reached in support of the immunity hypothesis. The importance of the immunity phenomenon in the multifactorial pathogenesis of disc disease still remains open to discussion.

Giant cell tumour in a vertebra affected by Paget's disease of bone.

A case of giant cell tumor in a vertebra affected by Paget's disease of bone is presented. This lesion, which is quite rare, has usually been observed in the bones of the skull and face, and is benign. It is probably hyperplastic rather than neoplastic in nature.

Adjuvant chemotherapy associated with surgery in the treatment of osteosarcoma. Preliminary results.

The results are presented of thirty five cases of osteosarcoma in which radical surgery was associated with cyclic chemotherapy with vincrystin, adriamycin and methotrexate. Nine patients had pulmonary metastases at intervals of from three to twenty one months after operation; of these, seven died between six and twenty six months after operation. The remaining twenty six patients are in good health and show no signs of disease at follow up varying from twelve to forty eight months.

Aneurysmal bone cyst (a study of 127 cases, 72 with longterm follow up).

127 cases of aneurysmal bone cyst are analysed, seventy two of which were followed up from one to fifteen years after treatment. Statistics on sex, age, site and localisation are reported. Symptoms, radiographic features, histological appearances and differential diagnosis are discussed.