European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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The authors report on the first known application in the spine of percutaneous ablation of osteoid osteoma using radio-frequency waves. The technique involves a CT-guided biopsy of the lesion followed by introduction of a 1-mm probe connected to a radio-frequency lesion generator. ⋯ The technique++ described may become the procedure of choice in the surgical treatment of osteoid osteoma, as it minimises surgical trauma and post-operative pain. Longer follow-ups are required to monitor the incidence of recurrence.
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Between 1984 and 1993 we treated 21 consecutive patients who had progressive thoracic kyphosis due to ankylosing spondylitis by polysegmental posterior lumbar wedge osteotomies. In 19 patients we used the Universal Spinal Instrumentation System and in the last 2 patients the H-frame. The average correction in 20 of 21 patients at follow-up was 25.6 degrees (range 0 degrees-52 degrees), with a mean segmental correction of 9.5 degrees and a mean loss of correction after operation of 10.7 degrees (range 0 degrees-36 degrees). ⋯ Two patients required reoperation at long-term follow-up. Five out of seven deep wound infections required removal of the implant. Polysegmental lumbar wedge osteotomies for correction of progressive thoracic kyphosis in ankylosing spondylitis is only recommended in patients at a mild stage of the disease with mobile discs and in combination with strong instrumentation.
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Comparative Study
Three-dimensional measurement of wedged scoliotic vertebrae and intervertebral disks.
Idiopathic scoliosis involves complex spinal intrinsic deformations such as the wedging of vertebral bodies (VB) and intervertebral disks (ID), and it is obvious that the clinical evaluation obtained by the spinal projections on the two-dimensional (2D) radiographic planes do not give a full and accurate interpretation of scoliotic deformities. This paper presents a method that allows reconstruction in 3D of the vertebral body endplates and measurement of the 3D wedging angles. This approach was also used to verify whether 2D radiographic measurements could lead to a biased evaluation of scoliotic spine wedging. ⋯ There was no statistical relation between the 2D radiographic angles and the locations of the 3D intervertebral wedging angles. These results clearly indicate that VB and ID endplates are wedged in 3D, and that measurements on plain radiographs allow incomplete evaluation of spinal wedging. Clinicians should be aware of these limitations while using wedging measurements from plain radiographs for diagnosis and/or research on scoliotic deformities.