Conservative treatment remains a good option for patients with incomplete cervical cord injuries. It is hoped the current study will be a good basis for comparison of the neurologic outcomes of different treatment modalities.

A variety of stimuli including neurological insult may provoke primitive mesenchymal cells to differentiate into bone forming cells. Such a sequel following spinal cord injury can delay rehabilitation, enhance the spasticity and reduce the range of movement in the affected joint. It is characterised by an initial inflammatory phase followed by heterotopic bone formation. The early inflammatory lesion clinically mimics deep vein thrombosis, a developing pres sure sore, infection, and tumour. An early diagnosis at a time of clinical uncertainty, before the plain radiographic features develop, has distinct advan tages and therapeutic implications.The unique pathological evolution and maturation of the lesion is clearly demonstrated by sequential sonographic (ultrasonic) assessment with depiction of the 'zone phenomena' seen on histology. Sonographic scans in 7 spinal injury patients proved diagnostic, before there was radiographic evidence of bone formation, and confidently excluded HBF in a further 18 patients without any false negative results.

A prospective study of post-operative morbidity in 258 elderly general surgical patients is reported. In 35% of patients no post-operative complications developed. Respiratory, wound and cardiac complications were the leading types of post-operative morbidity encountered, occurring in 39.5, 16.3, and 12.4% of patients, respectively. Life-threatening complications developed after surgery in 18.6% of patients, and the post-operative mortality rate (excluding ‘non-viable’ patients) was 5.8%. A statistical analysis of the effect of sex, age, urgency of surgery, type of surgery, and patient fitness on the pattern of post-operative morbidity revealed a number of significant associations which have not been previously identified in the elderly surgical patient.

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