We report the case of a girl with a dystrophic neurofibromatosis lumbar scoliosis with asymptomatic progression and spread of dystrophic characteristics over 18 years. Resorption of almost the entire anterior column of L1-L4 had occurred despite a previous posterior instrumentation and fusion. A vascularized fibula bone graft wrapped in titanium mesh was used as an anterior structural graft. With close follow-up, the need for this type of salvage surgery might have been averted. Further follow-up showed no graft resorption and unchanged sagittal alignment after 3 years.
We report the updated results for a previously evaluated surgical treatment for adult low-grade isthmic spondylolisthesis. In 12 patients a decompressive laminectomy was performed followed by a circumferential fusion using posterior pedicle screw instrumented reduction and staged anterior cage-assisted interbody fusion. Average time to follow-up was 5.6 (range 4.9-6.6) years. The average Oswestry Disability Index at last follow-up was 14 compared to 13 at 2.1-year follow-up. The average VAS score for back pain at last follow-up was 2.3 compared to 2.8 at 2.1-year follow-up. Ten patients had resumed their pre-symptom work status. This study demonstrates maintenance of the good clinical and radiological 2.1-year outcome after 5.6-year follow-up with no deterioration of back-pain scores.
Boneloc bone cement was introduced in the Netherlands in 1992. Inferior short-term results were reported which led to the withdrawal of Boneloc from clinical use in 1995. However, little is known about the long-term outcome of hip arthroplasties with Boneloc. Between April 1992 and August 1994, Boneloc was used in 163 Mallory-Head primary total hip arthroplasties in 163 patients. Follow-up analysis was performed in 2003. To date, 27 hips (17%) have been revised for aseptic loosening of the femoral component. Median time to revision was 5.5 years. Survival analysis based on revision for aseptic loosening showed 77% cumulative survival at 11 years. With revision for aseptic loosening and/or definite radiological loosening according to Harris as endpoint, cumulative survival was 59% at 11 years. In 27 of 43 patients with definite radiological loosening, a cement fracture was seen at a median of 2.9 years.
These results show failure of Boneloc cemented total hip arthroplasties occurring even during the later follow-up. Continuing periodic clinical and radiological examination is recommended.
Boneloc bone cement was introduced in the Netherlands in 1992. Inferior short-term results were reported which led to the withdrawal of Boneloc from clinical use in 1995. However, little is known about the long-term outcome of hip arthroplasties with Boneloc. Between April 1992 and August 1994, Boneloc was used in 163 Mallory-Head primary total hip arthroplasties in 163 patients. Follow-up analysis was performed in 2003. To date, 27 hips (17%) have been revised for aseptic loosening of the femoral component. Median time to revision was 5.5 years. Survival analysis based on revision for aseptic loosening showed 77% cumulative survival at 11 years. With revision for aseptic loosening and/or definite radiological loosening according to Harris as endpoint, cumulative survival was 59% at 11 years. In 27 of 43 patients with definite radiological loosening, a cement fracture was seen at a median of 2.9 years. These results show failure of Boneloc cemented total hip arthroplasties occurring even during the later follow-up. Continuing periodic clinical and radiological examination is recommended. (Hip International 2004; 14: 229-32).
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