Cervical transforaminal epidural steroid injections for radicular pain : a systematic review.

Aims: Cervical radiculopathy is a significant cause of pain and morbidity. For patients with severe and poorly controlled symptoms who may not be candidates for surgical management, treatment with transforaminal epidural steroid injections (CTFESI) has gained widespread acceptance. However, a paucity of high-quality evidence supporting their use balanced against perceived high risks of the procedure potentially undermines the confidence of clinicians who use the technique.

Bilateral reconstructive costoplasty for razorback deformity correction in adolescent idiopathic scoliosis.

Background: Correcting the chest wall deformity is an important goal of scoliosis surgery. A prominent rib hump deformity may not be adequately addressed by scoliosis correction alone. It has been shown that costoplasty in conjugation with scoliosis correction and instrumented spinal fusion is superior to spinal fusion alone in addressing the chest wall deformity.

Safety of fluoroscopy guided percutaneous access to the thoracic spine.

Background: Fluoroscopy-guided percutaneous access to thoracic vertebrae is technically demanding due to the complex radiological anatomy and close proximity of the spinal cord, major vessels and pleural cavity. There is a trend towards computed tomography (CT) guidance due to a perceived reduction in the risk of spinal canal intrusion by instrumentation causing neurological injury. Due to limited access to CT guidance, there is a need for safe fluoroscopy-guided percutaneous access to the thoracic spine.

Do Independent Sector Treatment Centres (ISTC) impact on specialist registrar training in primary hip and knee arthroplasty?

Introduction: The introduction of Modernising Medical Careers (MMC) is likely to reduce specialist registrar (SpR) operative experience during higher surgical training (HST). A further negative impact on training by local Independent Sector Treatment Centres (ISTCs) could reduce experience, and thus competence, in primary joint arthroplasty at completion of higher surgical training.

Patients And Methods: Retrospective case note and radiograph analysis of patients receiving primary hip and knee arthroplasty in a teaching hospital, before and after the establishment of a local ISTC.

A study of the radiologic predictors of curve flexibility in adolescent idiopathic scoliosis.

Study Design: A study of flexibility of 101 idiopathic scoliosis antero-posterior radiographs.

Objective: To discover if there are any parameters on plain antero-posterior radiographs that can predict the flexibility of scoliosis curves.

Summary Of Background Data: Previously the flexibility index, generated from fulcrum bending x-rays, has been shown to be an accurate measure of curve stiffness.

Bioelectrical impedance: a new method for measuring post-traumatic swelling.

Objectives: The aim of this pilot study was to investigate whether measurement of the bioelectrical impedance of the lower limb could be used to measure the swelling resulting from acute ankle fracture.

Methods: The impedance of each ankle was measured in 14 patients with isolated acute ankle fracture. The degree of ankle swelling was also directly assessed by measurement of the ankle circumference and diameter and by the water displacement method.