Stress profilometry is an effective investigation of the mechanics of intervertebral discs in vivo. Discogenic pain is caused by changes in the pattern of loading of the posterolateral anulus or nucleus pulposus.

The results of the first 50 consecutive patients using the Graf stabilisation system are presented. The average age of the patients was 41 years; there were 32 women and 18 men in the group. All patients suffered from intractable symptomatic degenerative disc disease which could be localised to one or more levels. All patients gave a history of chronic back pain, but the mean period of severe disability was 24 months. The mean preoperative disability score (Oswestry questionnaire) was 59%. The average period of follow-up was 24 months (range 19-36 months). At the latest review, the mean disability score was 31%. The clinical results were classified as "excellent" or "good" in 72% of patients, "fair" in 10%, "the same" in 16% and "worse" in 2%. All but three patients felt that surgery was worthwhile. The results have not deteriorated over the period of follow-up.

This study shows a poor correlation between Pavlov's ratio and the space available for the cord. Therefore, this ratio cannot be solely relied upon to predict the area changes in that plane of the cervical spinal canal.

We describe the development and validation of a scoring system for auditing orthopaedic surgery. It is a minor modification of the POSSUM scoring system widely used in general surgery. The orthopaedic POSSUM system which we have developed gives predictions for mortality and morbidity which correlate well with the observed rates in a sample of 2326 orthopaedic operations over a period of 12 months.

We describe the development and validation of a scoring system for auditing orthopaedic surgery. It is a minor modification of the POSSUM scoring system widely used in general surgery. The orthopaedic POSSUM system which we have developed gives predictions for mortality and morbidity which correlate well with the observed rates in a sample of 2326 orthopaedic operations over a period of 12 months. The assessment of outcome after surgical intervention is not a new science. As early as 1750 BC King Hammurabi of Babylon issued a number of decrees relating to surgeons and their surgery. The most infamous of these codices was that if a surgeon operated on a free man and the patient became blind or worse still died, the surgeon should have his operating hand cut off. While, to some a modification of this codex may still seem to be in operation, many have attempted to devise more reliable and robust methods for assessing the outcome of surgical intervention.