Expert's comment concerning Grand Rounds case entitled "L5-S1 disc replacement after two previous fusion surgeries for scoliosis" (by S. Jehan, S. Elsayed, J. Webb and B. Boszczyk).

The attempt to preserve motion below a long fusion is certainly praiseworthy even if it is clearly understood with the patient that the result might be only temporary, buying some good years in the most active part of life. The analysis of the case presented here suggests that such an approach could be recommended in the right patient, with the right team. More experience and reports are necessary to evolve from an anecdotal report to a new path in the treatment of adult scoliosis.

Efficacy of aprotinin as a blood conservation technique for adult deformity spinal surgery: a retrospective study.

Study Design: A retrospective study that involved a total of 82 adult deformity patients who underwent spinal fusion surgery with instrumentation of 6 or more levels.

Objective: The purpose of this study is to assess the efficacy and safety of aprotinin in reducing blood loss in adult spinal deformity patients.

Summary Of Background Data: Aprotinin is an antifibrinolytic agent, which has been proven to be effective as a blood-conserving agent in cardiac surgery.

The eggshell technique for prevention of cement leakage during kyphoplasty.

Cement extravasation during kyphoplasty occurs between 4% and 9%, a much lower incidence than with vertebroplasty. However, because of the potential complications of cement in and around the spinal canal, any egress of cement outside the vertebral body is extremely concerning. Aborting the procedure will cease the extraosseous leakage and minimize potential immediate complications.

Differences in the Risser grading systems in the United States and France.

Unlabelled: A grading system for ossification of the iliac apophysis (Risser sign) came into use in the mid 1950s in the United States and was adopted sometime later with modifications in France and other European countries. Although called by the same name, these systems have important differences that could lead to different choices of how and when to treat patients with spinal deformity. In a retrospective study, two experienced examiners (FDB and KPV) independently reviewed 301 randomly selected spine radiographs from 167 patients with adolescent idiopathic scoliosis and graded them for bilateral iliac crest apophyseal excursion each using a different system.

Aprotinin in spine surgery: review of the literature.

Based on a literature review, this article evaluates the efficacy of aprotinin to limit blood transfusion during spine surgery. Most prospective studies confirm this effect. However, broader studies are required to evaluate adverse effects.

The use of short and rigid anterior instrumentation in the treatment of idiopathic thoracolumbar scoliosis: a retrospective review of 24 cases.

Study Design: The results of short anterior rigid rod instrumentation used to treat thoracolumbar scoliosis in 24 patients were reviewed retrospectively.

Objective: To assess the safety and efficiency of anterior correction of thoracolumbar scoliosis using a single rigid rod with segmental fixation.

Summary Of Background Data: This method of treatment results from the historical difficulties noted in obtaining adequate correction in both planes for this particular type of curve while saving as many segments as possible.

Quality of life in osteogenesis imperfecta.

The purpose of this study was to quantify the physical and mental health of a diverse adult cohort of patients with osteogenesis imperfecta (OI) utilizing a validated health self-assessment questionnaire (SF-36). In addition, a specific demographic questionnaire and a functional questionnaire were utilized to assess more specifically the physical limitations imposed by osteogenesis imperfecta in adulthood. The results of the SF-36 revealed significantly lower physical function scores compared to the U.