Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background.

Introduction: Spinal cord injury (SCI) causes significant and permanent disability affecting motor, sensory and autonomic functions. We conducted a survey on the priorities of functional recovery and preferences for community rehabilitation services in a cohort of Chinese individuals with SCI as well as the primary caregivers. The study also investigated their views on advanced technology and research.

Surgical repair of a large intrathoracic meningocele associated with neurofibromatosis type 1 after failed cystoperitoneal shunts: illustrative case.

Background: Surgical treatment of intrathoracic meningoceles, commonly associated with neurofibromatosis type 1 (NF1), aims to reduce sac size for symptomatic relief. The procedures can be divided into cerebrospinal fluid diversion and definitive repair. The authors describe the management of an intrathoracic meningocele in a 56-year-old female with preexisting NF1.

Knowledge Gaps in Biophysical Changes After Powered Robotic Exoskeleton Walking by Individuals With Spinal Cord Injury-A Scoping Review.

In addition to helping individuals with spinal cord injury (SCI) regain the ability to ambulate, the rapidly evolving capabilities of robotic exoskeletons provide an array of secondary biophysical benefits which can reduce the complications resulting from prolonged immobilization. The proposed benefits of increased life-long over-ground walking capacity include improved upper body muscular fitness, improved circulatory response, improved bowel movement regularity, and reduced pain and spasticity. Beyond the positive changes related to physical and biological function, exoskeletons have been suggested to improve SCI individuals' quality of life (QOL) by allowing increased participation in day-to-day activities.

Outcomes of a Multicenter Safety and Efficacy Study of the SuitX Phoenix Powered Exoskeleton for Ambulation by Patients With Spinal Cord Injury.

To examine the safety and efficacy of ambulation utilizing a semi-passive and lightweight powered exoskeleton by spinal cord injury (SCI) patients. This is a multi-center, open-label, prospective cohort study across three facilities. A cohort of 40 individuals with SCI from T4-L5 was recruited into a 20-session training and assessment protocol, utilizing the SuitX Phoenix.

Multidisciplinary programme for rehabilitation of chronic low back pain - factors predicting successful return to work.

Background: There are no clear indicators for predicting return to work for patients with chronic low back pain (LBP). We aim to report the outcomes of a 14-week multidisciplinary programme targeting patients with chronic LBP who failed conventional physiotherapy to provide functional rehabilitation. Also, this study will identify factors predicting successful return to work (RTW).

Intrathecal Baclofen Pump Infection With Meningitis: Effective Treatment by Radical Debridement and Intrareservoir Baclofen-Vancomycin Co-Infusion.

Objectives: Intrathecal baclofen pump associated central nervous system (CNS) infection and meningitis is a rare but serious complication and may have dire consequences. Due to bacterial biofilm formation, the optimal treatment strategy is usually for removal of the pump, followed by systemic antibiotics for treatment of local and CNS infection. We describe this case of a patient with recurrent Staphylococcus aureus pump site empyema and meningitis leading to status dystonicus, who was successfully managed with radical debridement and intrareservoir baclofen-vancomycin co-infusion.

What every orthopaedic surgeon should know about COVID-19: A review of the current literature.

The coronavirus (COVID-19) pandemic has severely affected the medical community and stopped the world in its tracks. This review aims to provide the basic information necessary for us, orthopaedic surgeons to prepare ourselves to face this pandemic together. Herein, we cover the background of COVID-19, presentation, investigations, transmission, infection control and touch upon emerging treatments.

Predictive factors for neurological deterioration after surgical decompression for thoracic ossified yellow ligament.

Purpose: To investigate the rate and predictive factors of post-operative neurological deterioration in ossified yellow ligament (OYL) surgery.

Methods: A retrospective review was conducted for all patients with thoracic OYL causing myelopathy requiring surgical decompression from January 1998 to December 2012. Clinical parameters under study included clinical presentation, distribution of OYL, pre-operative walking score, pre- and post-operative neurological status, status of intra-operative neurophysiological monitoring, and modified Japanese Orthopaedic Association (mJOA) score.

A rare postoperative complication of anterior lower thoracic instrumentation: diaphragmatic laceration with hemothorax.

Purpose: To highlight the importance of preventing visceral injury due to prominent anterior implants at the spinal column.

Methods: A 52-year-old man with cord compression was treated with a T9/10 discectomy and instrumented fusion via a right thoracotomy and trans-pleural approach. Postoperatively, he had improved lower limb numbness.

Efficacy of Postoperative Pain Management Using Continuous Local Anesthetic Infusion at the Iliac Crest Bone Graft Site in Patients with Adolescent Idiopathic Scoliosis: A Parallel, Double-Blinded, Randomized Controlled Pilot Trial.

Study Design Randomized controlled trial. Objective Adolescent idiopathic scoliosis (AIS) is a common spinal deformity that affects every population. In severe deformity, surgical intervention is performed.

Antimicrobial prophylaxis to prevent surgical site infection in adolescent idiopathic scoliosis patients undergoing posterior spinal fusion: 2 doses versus antibiotics till drain removal.

Purpose: There is much variation in the choice, timing and duration of antimicrobial prophylaxis for preventing surgical site infections (SSI) but no guideline exists for scoliosis surgery. The aim of study was to compare the efficacy of two antimicrobial prophylaxis (AMP) protocols with cephazolin in preventing SSI in adolescent idiopathic scoliosis (AIS).

Methods: A retrospective comparative analysis of two post-operative AMP protocols (two postoperative doses versus continued antibiotics till drain removal) was performed.

Disappearing bone disease of the humerus and the cervico-thoracic spine: a case report with 42-year follow-up.

Background Context: Disappearing bone disease (DBD) is a rare idiopathic musculoskeletal disorder that is distinguished by bone resorption without bone formation, vascular or lymphatic vessel proliferation, and soft-tissue swelling. Long-term follow-up of a patient with DBD has rarely been reported in the literature.

Purpose: The following is a case report of a female patient with DBD of the humerus and the spine who was followed for 42 years, documenting the progression of the disease and outcomes.

A population-based cohort study of 394,401 children followed for 10 years exhibits sustained effectiveness of scoliosis screening.

Background Context: The value of scoliosis screening has been recently shown in a multicenter randomized controlled trial. However, the long-term sustainability of the clinical effectiveness of scoliosis screening as a routine health service remains unknown.

Purpose: The aim of this study was to assess the sustainability of the clinical effectiveness of school scoliosis screening.

Acute spinal subdural hematoma complicating lumbar decompressive surgery.

Study Design:  A case report.

Objective:  To report a rare case of acute spinal subdural hematoma (SSH) complicating lumbar spine surgery, its characteristic presenting symptoms, diagnostic imaging, possible cause, and pitfall in management.

Methods:  A 59-year-old woman with lumbar spinal instability and stenosis underwent laminectomy and decompression at L3-L5 with instrumentation and fusion from L3-S1.

The predictive value of the fulcrum bending radiograph in spontaneous apical vertebral derotation in adolescent idiopathic scoliosis.

Study Design: A prospective cohort study of Cobb angles (CA) and apical vertebral rotations (AVR) in 25 patients who had adolescent idiopathic scoliosis.

Objective: To assess in vivo the concomitant vertebral derotation occurring with correction of scoliosis deformity as a result of coupling effect by using the fulcrum bending radiograph and to assess whether the fulcrum bending radiograph can predict the amount of postoperative apical derotation when no additional intraoperative apical derotation maneuver is used.

Summary Of Background Data: Adolescent idiopathic scoliosis (AIS) is a 3-dimensional coupling deformity.

Magnetically controlled growing rods for severe spinal curvature in young children: a prospective case series.

Background: Scoliosis in skeletally immature children is often treated by implantation of a rod to straighten the spine. Rods can be distracted (lengthened) as the spine grows, but patients need many invasive operations under general anaesthesia. Such operations are costly and associated with negative psychosocial outcomes.

The proximal thoracic curve in adolescent idiopathic scoliosis: surgical strategy and management outcomes.

There is no consensus on the definition of a structural proximal thoracic curve (PTC) and the indications for fusion. As such, we assessed a single institute's experience in the management of large PTCs (>35 degrees) in patients with adolescent idiopathic scoliosis (AIS) who were either fused or not fused. A retrospective radiographic analyses of 30 consecutive AIS patients with double thoracic curves who underwent PSF with a minimum of 2 years' follow-up were included for review.

Natural history of spinal deformity in a patient with Ehlers-Danlos syndrome: case report with 20-year follow-up.

Background Context: Scoliosis can present in patients with Ehlers-Danlos syndrome (EDS) and can be surgically treated despite possible complications. The long-term natural history of the progression of spinal deformity, particularly scoliosis, and associated complications in EDS patients remains relatively unknown.

Purpose: To assess the progression of spinal deformity and associated complications in a patient with EDS, who was not surgically treated for her spine condition and was followed up for 20 years.

A multidisciplinary rehabilitation programme for patients with chronic low back pain: a prospective study.

Purpose: To examine the effectiveness of a multidisciplinary rehabilitation programme for patients with chronic low back pain in Hong Kong, and to identify factors associated with work resumption.

Methods: 57 men and 8 women aged 20 to 56 (mean, 39) years who had a more than 3-month history of low back pain and were unresponsive to more than 6 months of conventional treatment participated in a 14-week multidisciplinary rehabilitation programme involving physical conditioning, work conditioning, and work readiness. Training protocols entailed flexibility and endurance training, hydrotherapy, weight lifting, and work stimulation.

The "X-Factor" index: a new parameter for the assessment of adolescent idiopathic scoliosis correction.

The correction rate (CR) and fulcrum bending correction index (FBCI) based on the fulcrum bending radiograph (FBR) were parameters introduced to measure the curve correcting ability; however, such parameters do not account for contributions by various, potential extraneous "X-Factors" (e.g. surgical technique, type and power of the instrumentation, anesthetic technique, etc.

Infective spondylitis in Southern Chinese: a descriptive and comparative study of ninety-one cases.

Study Design: A retrospective review of infective spondylitis patients assessed at a major, tertiary referral centre in Hong Kong.

Objective: To assess the prevalence, risk factors, clinical features, and prognostic outcomes associated with tuberculous spondylitis to that of pyogenic spondylitis in Southern Chinese treated at a single institution.

Summary Of Background Data: Previous studies in Asia suggest that tuberculous spondylitis is the predominant infection unless proven otherwise.

Predictability of the fulcrum bending radiograph in scoliosis correction with alternate-level pedicle screw fixation.

Background: The fulcrum bending radiograph accurately predicts scoliosis curve correction in patients with thoracic adolescent idiopathic scoliosis who are managed with hooks. We assessed the predictive value of the fulcrum bending radiograph in the context of alternate-level pedicle screw fixation of the scoliotic spine.

Methods: A prospective radiographic analysis of patients with thoracic adolescent idiopathic scoliosis who were managed operatively with alternate-level pedicle screw fixation at a single institution was performed.

C5 nerve root palsy after cervical laminoplasty and posterior fusion with instrumentation.

Study Design: Consecutive case series.

Objective: To compare the incidence and clinical characteristics of postoperative fifth cervical nerve root palsy (C5 palsy) in patients with cervical myelopathy treated by laminoplasty alone and laminoplasty with posterior instrumentation.

Summary Of Background Data: In patients who have multilevel cervical myelopathy with reducible kyphosis or instability, the authors have performed laminoplasty together with instrumented fusion to restore lordosis and stability.

Quality of life of traumatic spinal cord injured patients in Hong Kong.

Objective: To assess the health-related quality of life of patients with traumatic spinal cord injury living in Hong Kong.

Design: A cross-sectional retrospective study.

Subjects: Subjects with paraplegia following traumatic spinal cord injury were recruited from our department, which is one of the 3 main regional spinal cord injury rehabilitation centres in Hong Kong.