OBJECTIVEInfection of the cervical spine is a rare disease but is associated with significant risk of neurological deterioration, morbidity, and a poor response to nonsurgical management. The ideal treatment for cervical spondylodiscitis (CSD) remains unclear.METHODSHospital records of patients who underwent acute surgical management for CSD were reviewed. Information about preoperative neurological status, surgical treatment, peri- and postoperative processes, antibiotic treatment, repeated procedure, and neurological status at follow-up examination were analyzed.RESULTSA total of 30 consecutive patients (17 male and 13 female) were included in this retrospective study. The mean age at procedures was 68.1 years (range 50–82 years), with mean of 6 coexisting comorbidities. Preoperatively neck pain was noted in 21 patients (70.0%), arm pain in 12 (40.0%), a paresis in 12 (40.0%), sensory deficit in 8 (26.7%), tetraparesis in 6 (20%), a septicemia in 4 (13.3%). Preoperative MRI scan revealed a CSD in one-level fusion in 21 patients (70.0%), in two-level fusions in 7 patients (23.3%), and in three-level fusions in 2 patients (6.7%). In 16 patients an antibiotic treatment was initiated prior to surgical treatment. Anterior cervical discectomy and fusion with cervical plating (ACDF+CP) was performed in 17 patients and anterior cervical corpectomy and fusion (ACCF) in 12 patients. Additional posterior decompression was performed in one case of ACDF+CP and additional posterior fixation in ten cases of ACCF procedures. Three patients died due to multiple organ failure (10%). Revision surgery was performed in 6 patients (20.7%) within the first 2 weeks postoperatively. All patients received antibiotic treatment for 6 weeks. At the first follow-up (mean 3 month) no recurrent infection was detected on blood workup and MRI scans. At final follow-up (mean 18 month), all patients reported improvement of neck pain, all but one patients were free of radicular pain and had no sensory deficits, and all patients showed improvement of motor strength. One patient with preoperative tetraparesis was able to ambulate.CONCLUSIONSCSD is a disease that is associated with severe neurological deterioration. Anterior cervical surgery with radical debridement and appropriate antibiotic treatment achieves complete healing. Anterior cervical plating with the use of polyetheretherketone cages has no negative effect of the healing process. Posterior fixation is recommended following ACCF procedures.

This article shows that a relational approach to the notion of cultural capital may shed light on how stratification and the mechanisms of social domination have developed in France. By using several studies focused on a range of social classes, it demonstrates how cultural capital is being used in changing ways, at every level of the social hierarchy. The article is intended to move away from a substantialist definition of cultural capital, which cannot be solely defined by its contents, such as an educational degree or a collection of cultural practices. In order to understand the transformations of the boundaries between social classes, it is necessary to analyse developments in the relationship between cultural and economic capitals, and between cultural capital's incorporated, objectified and institutionalized forms.

Résumé Les voyages s’intègrent dans un ensemble de dispositifs éducatifs qui contribuent à la socialisation internationale des classes supérieures. Dans la tradition du « grand tour » aristocratique, le voyage de formation est d’autant plus distinctif qu’il témoigne de la possession de biens rares. Dans la grande bourgeoisie d’affaires, le voyage est l’occasion d’éprouver la dimension internationale du patrimoine familial et il permet la transmission d’éléments de savoir être et de savoir faire constitutifs de l’identité bourgeoise. Il forme « l’esprit d’entreprise » particulier des grands patrons internationaux et prépare souvent directement à l’occupation de positions de pouvoir. La prise en compte de ces usages sociaux du voyage conduit à rompre avec un certain nombre de catégorisations, et notamment à repenser l’opposition entre voyage touristique et voyage d’affaires, ou entre voyage d’exploration et retour dans un lieu familier.

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