Definition of safe zone in vertebral body in relation to anterior instrumentation.

Objectives: We set out to determine the "safe zone" for anterior instrumentation in scoliosis surgery assessing the relationship of the great vessels to the spine.

Methods: A total of 34 children undergoing posterior idiopathic scoliosis surgery were included in the study between 2010 and 2016. The preoperative scans were assessed to identify the position of the great vessels relative to the spine from T4 to L4.

Targeted Distraction: Spinal Growth in Children With Early-Onset Scoliosis Treated With a Tail-gating Technique for Magnetically Controlled Growing Rods.

Study Design: Prospective cohort study OBJECTIVE.: To understand the efficacy of a tail-gating technique (TGT) to mirror the normal spinal growth of children with early-onset scoliosis (EOS) treated with magnetically controlled growing rods (MCGR).

Summary Of Background Data: MCGR allow outpatient distraction and guided spinal growth without the need for repeat surgery.

Paper #25: Quantifying the 'Law of Diminishing Returns' in Magnetically Controlled Growing Rods.

The 'law of diminishing returns' can also be observed following serial distraction in MCGR. In comparison to previously published data for CGRS, there is a gradual linear decline as opposed to a rapid initial decline in lengthening. In the older, heavier child a reduced distraction ratio in the concave rod of the MCGR device is noted over time.

Paper #31: The Oxford 5 year observational study on 35 patients with Magnetically Controlled Growing Rods (MCGR).

MCGR controls scoliosis progression and allows growth. Functional activity also improves generally. Primary infection rates are low.

Quality of Life and Surgical Outcomes After Soft-Tissue Reconstruction of Complex Oncologic Defects of the Spine and Sacrum.

Background: Tumor-related spinal surgery has been revolutionized by recent advances in spinal stabilization, modern neuroimaging, and perioperative intensive medicine. This study examines clinical outcomes and factors associated with complications following reconstruction of complex oncologic defects of the spine and sacrum, in an attempt to increase preoperative recognition of high-risk patients with diminished wound-healing capacity and to optimize clinical outcomes in this cohort.

Methods: We performed a retrospective analysis of fifty-five consecutive patients who underwent soft-tissue reconstruction with or without osseous stabilization of defects following spinal or sacral tumor resection at a quaternary referral center over a twelve-year period.

The analgesic effect of epidural clonidine after spinal surgery: a randomized placebo-controlled trial.

Background: Clonidine is an alpha(2) adrenoreceptor and imidazoline receptor agonist, which has analgesic, sedative, and minimum alveolar anesthetic concentration-sparing effects. It has been used orally, IV, and epidurally. In spinal surgery, there is a reluctance to use local anesthetic-based epidural analgesia postoperatively because of fears of masking important signs of nerve root or spinal cord injury.

The MRC spine stabilization trial: surgical methods, outcomes, costs, and complications of surgical stabilization.

Study Design: A review of the surgical costs and results in a group of patients randomly allocated to surgery as part of a large prospective randomized trial of patients with chronic back pain.

Objective: To report the observational data from the surgical arm of a randomized trial comparing surgery with intensive rehabilitation for chronic low back pain. Clinical and economic data are reported.

Rotatory atlanto-axial dislocation in an infant with osteogenesis imperfecta.

This is a case report of a 15-month-old patient with osteogenesis imperfecta (OI) who sustained atlanto-axial dislocation. Our objective is to report a unique case of traumatic atlanto-axial subluxation in a child with osteogenesis imperfecta associated with bilateral femoral fractures. The management is discussed.

The diagnosis and management of infection following instrumented spinal fusion.

A 10-year retrospective audit. (1) The incidence of infection; (2) causative organisms; (3) whether eradication of infection is achievable with spinal implant retention; (4) patient outcome. The reported incidence of infection following posterior spinal instrumentation is between 2.

Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial.

Objectives: To assess the clinical effectiveness of surgical stabilisation (spinal fusion) compared with intensive rehabilitation for patients with chronic low back pain.

Design: Multicentre randomised controlled trial.

Setting: 15 secondary care orthopaedic and rehabilitation centres across the United Kingdom.

Surgical stabilisation of the spine compared with a programme of intensive rehabilitation for the management of patients with chronic low back pain: cost utility analysis based on a randomised controlled trial.

Objective: To determine whether, from a health provider and patient perspective, surgical stabilisation of the spine is cost effective when compared with an intensive programme of rehabilitation in patients with chronic low back pain.

Design: Economic evaluation alongside a pragmatic randomised controlled trial.

Setting: Secondary care.

Aneurysmal bone cyst as a rare cause of spinal cord compression in a young child.

Study Design: Case report.

Objectives: To report: 1) one of the youngest cases of aneurysmal bone cysts presenting with cord compression at the cervicothoracic junction with 7-year follow-up; and 2) the technique we used to stabilize such a small spine.

Summary Of Background Data: Aneurysmal bone cyst is an uncommon but well-recognized tumor affecting the spine of children.