[Surgical treatment of spinal metastases].

Spinal metastasis often lead to two main complications: back pain and para or tetraplegia. Performed alone radiotherapy may be too slowly efficient to allow a neurological recovery. Laminectomy may improve the neurological signs but does not induce any change on root pain and it increases instability.

[Salter's innominate osteotomy in the treatment of congenital dislocation of the hip. Apropos of 129 cases].

The authors studied a series of 129 innominate osteotomies performed for the treatment of a congenital dislocation of the hip (C.D.H.

[Contribution of somatosensory evoked potentials in the surveillance of the spinal cord during spinal surgery].

This study shows the results obtained in 51 patients, children and adolescents by monitoring somatosensory evoked potentials during spinal surgery: Cotrel-Dubousset instrumentation, surgical anterior correction by plating, spondylolisthesis and hemivertebra surgery. The recordings were made in preoperative, peroperative and postoperative periods; the electro-physiological and anaesthetic conditions allowed us to obtain reliable recordings. Analysis of the peroperative somatosensory evoked potentials showed significant differences in latencies, but also in amplitudes and morphology during distraction in scoliosis or spondylolisthesis.

[Gastropericardial fistula. Late complication of the treatment of hiatal hernia].

An exceptional case of gastropericardial fistula is reported, the lesion developing from a gastric ulcer on an antireflux valve instituted ten years previously. A literature review showed 31 similar cases: 14 gastropericardial fistulae, 16 esophagopericardial fistulae and one jejunopericardial fistula. Three features common to all these fistulae were determined: the frequency of hiatus hernia in the genesis of these lesions, either from an ulcer on esophagitis or herniated stomach or from surgical complication; the extremely high mortality of these fistulae (68% mortality); the need for aggressive treatment.

[Surgical treatment of spinal metastases by stabilization using posterior plates screwed into the vertebral pedicles].

Ninety spinal metastases were treated by plating using a posterior approach. Fifty were thoracic or thoraco-lumbar, 11 in the upper cervical spine, 14 in the lower cervical spine and fifteen in the lumbar spine. Surgical fixation was followed by radiotherapy, chemotherapy or hormone therapy, when indicated.