No abstract

The use of the FBT alone in school scoliosis screening is insufficient. We need large, retrospective cohort studies with sufficient follow-up to properly assess the clinical effectiveness of school scoliosis screening.

To our knowledge, this is the largest scale genetics study to date using MRI to define precisely degenerative disc disease in the Southern Chinese population. We showed that the t allele of vitamin D receptor Taq I is associated with a high risk of degenerative disc disease and disc bulge developing, especially in individuals younger than 40 years.

The fulcrum bending correction index takes into account the curve flexibility and is therefore better than the correction rate for comparing curve correction and use of instrumentation systems between different series of patients. A fulcrum bending correction index of close to 100% suggests that the instrumentation has taken up all the flexibility revealed by the fulcrum bending radiograph. It is recommended that the fulcrum bending correction index be used in the future as part of the postoperative assessment of frontal plane correction in cases of thoracic scoliosis.

Both cultural adaptation and linguistic translation are essential in any attempt to use a HRQL questionnaire across cultures. The Chinese version of the SRS-22 outcome instrument has satisfactory internal consistency and excellent reproducibility. It is ready for use in clinical studies on idiopathic scoliosis in Chinese-speaking societies.

This report describes the first large population-based study with a long-term follow-up indicating that a scoliosis screening program can have sustained clinical effectiveness in identifying patients with adolescent idiopathic scoliosis needing clinical observation. As the prevalence of adolescent idiopathic scoliosis increases, scoliosis screening should be continued as a routine health service in schools or by general practitioners if there is no scoliosis screening policy.

Cervical spondylotic myelopathy is a common clinical problem. No study has examined the pattern of neurological recovery after surgical decompression. We conducted a prospective study on the pattern of neurological recovery after surgical decompression in patients with cervical spondylotic myelopathy. Patients suffering from cervical spondylotic myelopathy and requiring surgical decompression from January 1995 to December 2000 were prospectively included. Upper limbs, lower limbs and sphincter functions were assessed using the Japanese Orthopaedic Association (JOA) score. Assessment was done before the operation, at 1 week, 2 weeks, 1 month, 3 months, 6 months, 1 year and then yearly after surgery. Results were analysed with the t-test. Differences with Pvalues less than 0.05 were regarded as statistically significant. Fifty-five patients were included. The average follow-up period was 53 months. Thirty-nine patients (71%) had neurological improvement after the operation with a mean recovery rate of 55%. The JOA score improved after surgery, reaching statistical significance at 3 months and a plateau at 6 months. Thirty-six patients (65%) had improvement of upper limb function. Twentyfour patients (44%) had improvement of lower limb function. Eleven patients (20%) had improvement of sphincter function. The recovery rate of upper limb function was 37%, of lower limb function was 23% and of sphincter function was 17%. Surgical decompression worked well in patients with cervical spondylotic myelopathy. Seventy-one percent of patients had neurological improvement after the operation. The neurological recovery reached a plateau at 6 months after the operation. The upper limb function had the best recovery, followed by lower limb and sphincter functions.Résumé Les myélopathies cervicales sont un problème courant. Aucune étude n'a examiné la récupération neurologique après décompression chirurgicale. Nous avons conduit une étude prospective sur ce sujet, chez des patients ayant bénéficié d'une décompression pour myélopathie cervicale. Les patients opérés entre janvier 1995 et décembre 2000 ont été inclus dans cette étude. Les fonctions des membres supérieurs, des membres inférieurs et les fonctions sphinctériennes ont été évaluées selon le score de la JOA (Association Japonaise d'Orthopédie). L'évaluation a été réalisée avant l'opération, une semaine, deux semaines, un mois, trois mois, six mois, un an et chaque année après l'intervention chirurgicale. Les résultats ont été analysés selon le P test et en appréciant ensuite les résultats statistiquement ou non statistiquement significatifs. Cinquante-cinq patients ont été inclus. Le suivi moyen a été de 53 mois, 39 patients (71%) ont montré une amélioration neurologique après l'intervention avec un taux de récupération complète de 55%. Le score de la JOA a été amélioré à 3 mois avec un plateau de récupération à 6 mois. Trente-six patients (65%) ont vu une amélioration au niveau des fonctions du membre supérieur, 24 (44%) au niveau des membres inférieurs, 11 (5%...

Objective: To investigate the improvement in the reliability of intraoperative spinal cord monitoring by applying time-frequency analysis to somatosensory evoked potentials (SEP). Methods: 34 patients undergoing scoliosis surgery were studied. SEP were recorded during different stages of scoliosis surgery. Averaged SEP signals were analysed intraoperatively by short time Fourier transform (STFT). The time-frequency characteristics of SEP were observed during surgery. The main peak in the time-frequency interpretation of SEP was measured in peak time, peak frequency, and peak power. The changes in these variables were compared with the changes in latency and amplitude during different surgical stages. Results: During different surgical stages, changes in peak times and peak powers were found to correlate with the changes in latency and amplitude, respectively. Peak time showed more variability than latency (p < 0.01), while peak power showed less variability than amplitude (p < 0.01). The peak frequency of SEP appeared to be unchanged during surgery. SEP signals were found to have specific time-frequency characteristics, with the time-frequency distribution of the signals being located in a particular time-frequency space. Conclusions: Time-frequency analysis of SEP waveforms reveals stable and easily identifiable characteristics. Peak power is recommended as a more reliable monitoring parameter than amplitude, while peak time monitoring was not superior to latency measurement. Applying time-frequency analysis to SEP can improve the reliability of intraoperative spinal cord monitoring.