Since February 2012, no patient has required intraoperative or postoperative allogeneic blood product transfusion in this hospital. The routine use of antifibrinolytic medications in patients undergoing surgery for adolescent idiopathic scoliosis has effectively eliminated the need for allogeneic blood products.

No abstract

The proximity to heavy machinery and livestock pose significant risk for spinal injuries. This study should encourage increased efforts to improve farm safety.

Patients with ankylosing spondylitis are at risk of spinal fracture and associated spinal cord injury after relatively minor trauma. Delayed diagnosis places the patient at risk of neurological compromise, and thus a high index of suspicion is needed when assessing this patient group.

Staging of primary breast cancer can radically alter the management if stage IV disease is accurately detected. A systematic review and meta-analysis were performed to determine whether conventional CT TAP or PET-CT provides the optimum staging modality. A meta-analysis involving 158 patients with primary breast cancer showed that PET-CT was more sensitive than CT-TAP for detection of metastatic disease (OR 3.28, 95% CI 2.37 -4.53, p < 0.0001). A systematic review of 1780 patients undergoing PET-CT was compared with 709 patients having a CT TAP for staging. The sensitivity/specificity of PET-CT was 75-100%/91-98%. Sensitivity/ specificity of CT TAP was 83-97.7%/85-100%. PET-CT is therefore the optimum staging imaging modality to detect metastatic breast cancer. Large multicentre randomized controlled trials comparing PET-CT with conventional CT TAP are required to support the findings of this study. However, in the absence of such robust data, clinicians may be guided by the results of this analysis.General variance methods were used to combine data across studies with fixed and random effects models. The fixed effects analysis weighted the natural logarithm of each study's OR by the inverse of its variance plus an estimate for the between-study variance in the presence of between-study heterogeneity. Analyses were conducted using Stats direct version 2.5.6 (Stats Direct Limited, Cheshire, UK) and SPSS version 12.0 (SPSS, Inc., Chicago, IL). All statistical tests were two-tailed.