Erythrocyte sedimentation rate and C-reactive protein display a significantly higher reaction after spinal surgery with instrumentation. Renewed elevation of C-reactive protein, white blood cell count, and body temperature after postoperative days 4 to 7 may be a critical sign of postoperative infection.

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The rhBMP-2/collagen composite implant was an effective bone graft substitute for achieving posterolateral spinal fusion. When combined with a collagen carrier, the optimal rhBMP-2 dose for achieving posterolateral spinal fusion seemed to be approximately 50 micrograms per segment in rabbits.

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✓ Two cases of eosinophilic granuloma (EG) of the spine associated with neurological deficits are presented. The patients were treated conservatively by using external fixation with a brace as well as bed rest. Neurological deficits and pain diminished and finally disappeared as the tumor mass decreased in size, as seen on magnetic resonance (MR) imaging. During the 5-year follow-up period no recurrence of the tumors was detected on MR images. Surgical treatment for spinal EG in children presenting with typical vertebra plana is not recommended except for those with severe or progressive palsy and for those in whom the disease requires differential diagnosis.

The purpose of this article is to introduce a new procedure for the surgical planning of thoracic anterior spinal instrumentation via endoscopy. For accurate and safe anterior screw insertion via the endoscopic approach, we devised a surgical plan based on the preoperative chest computed tomography (CT) findings obtained with radiographic markers. Using this method, we performed endoscopic thoracic spinal instrumentation surgery in 14 patients. Nine patients underwent anterior endoscopic correction and fusion of idiopathic scoliosis by Cotrel-Dubousset instrumentation, and five patients underwent anterior endoscopic spinal fixation with instrumentation. The accuracy of screw insertion was evaluated postoperatively by CT scanning. One interbody fusion cage and 53 screws were inserted in the 14 patients using endoscopy. Postoperative CT scans revealed that the screws were all accurately inserted without any neurologic complications. In conclusion, using this novel procedure for surgical planning based on CT findings obtained with radiographic markers, anterior screws can be inserted safely and accurately via an endoscopic approach.

Object. A new dorsolateral decompressive procedure involving a unilateral approach has been devised for the treatment of cervical compressive myelopathy. In this operation, the posterior spinal elements of the contralateral side are not disturbed, and thus, postoperative deformity of the cervical spine can be avoided. Following decompressive surgery via the unilateral approach, the cervical spine was kept more stable compared with the results obtained after wide laminectomy or other expansive laminoplasty procedures. Methods. Twenty-six patients underwent dorsolateral decompressive surgery, and the patients' clinical and radiological results were examined during the follow-up period to evaluate neurological function and postoperative deformities of the cervical spine. The underlying conditions for myelopathy were cervical spondylosis (19 patients), ossification of posterior longitudinal ligament (three patients), and ossification of yellow ligament (four patients). The follow-up period ranged from 6 to 110 months (average 35.5 months). Functional recovery, which was rated by using the Japanese Orthopaedic Association scoring system, was an average of 56% in all patients (100% being equal to full recovery). The recovery rate was compatible with those attained after other expansive laminoplasty procedures. Radiographically, progression to swan-neck or kyphotic deformity was not observed in any patient. No postoperative spinal instability was noted. Based on computerized tomography myelograph evaluation, the average transectional area of the dural tube at the C4–5 level was expanded from 122 mm2 to 169 mm2, and the transectional area of the spinal cord at the C4–5 level was expanded from 39.6 mm2 to 52.9 mm2 after surgery. Conclusions. The authors conclude that this operative procedure could be used as a new option for the treatment of cervical compressive myelopathy.