Background and objectiveApiFix (OrthoPediatrics, Warsaw, IN) is an internal brace used for the correction of adolescent idiopathic scoliosis (AIS) classified as Lenke 1 or 5 with a Cobb angle of 35-60 degrees that decreases to ≤30 degrees on lateral side-bending radiographs. Since the indications are very specific, it is not a common procedure. Our study aimed to evaluate the incidence of surgical site infection (SSI) and its recurrence following treatment with ApiFix. Materials and methodsA retrospective study of 44 cases of AIS treated at our center from 2016 to 2022 with ApifiX was conducted. Two patients who presented with SSI were initially treated with irrigation and debridement (I&D) following antibiotic therapy. ResultsA total of 44 patients with a mean age of 15.1 years were evaluated. Two of our patients presented with early-onset infection while one of them presented after the end of treatment with a skin ulcer due to septic screw loosening. The removal of the ApiFix implant revealed a pedicle abscess during the screw removal. ConclusionsIn this study of 44 patients, we observed two cases of infection and one case of reinfection. Given the limited muscle detachment and short operating time needed for Apifix, statistics suggest that the risk of SSI is always present. Further randomized trials are needed to gather more evidence on this subject.

Diabetic amyotrophy, also known as diabetic lumbosacral radiculoplexus neuropathy (DLRN), is a condition associated with sudden pain apparition and progressive distal extremities weakness leading to ambulatory status. A wide range of causes and pathologies may be involved, rendering the diagnosis challenging. Uncontrolled type 2 diabetes mellitus (T2DM) can be a trigger factor for such disorders. Here, we present the case of a 71-year-old patient with chronic left quadriceps weakness and atrophy, accompanied by radiculopathy, who underwent a single-level posterior lumbar fixation and decompression. The patient with a history of T2DM postoperatively showed immediate relief regarding the pain and started the rehabilitation protocol on the second post-op day. One month postoperatively, he presented with accusations of sensory impairment, motor weakness, and pain.

Limbus vertebra is a common radiological finding in an adult, especially in the mid-lumbar region. However it is less commonly seen in the mid cervical region.A case of an anterior limbus vertebra seen on the cervical spine on an adult suffering from a T5 fracture is reported.

A 54-year-old male was admitted to our emergency department by air transport after being hit as a pedestrian by a motorcycle. He presented with impaired motor function in the upper extremities bilaterally while sensation was spared. He presented no motor or sensory impairment of the lower extremities. A computed tomography scan revealed a displaced type II odontoid fracture. Treatment consisted of open reduction and internal fixation of the odontoid with a single screw. The patient’s functional outcome was excellent during the two-month follow-up. Cruciate paralysis is a relatively rare although well-defined neurological condition which results from injury at pyramid decussation. In this case, the presence of a posterior bony spike of the fractured dens was responsible for the development of cruciate paralysis. Early diagnosis and adequate treatment can have successful results.

The aim of this case report is to present a rare case of acute slipped femoral capital on a chronic slipped capital femoral epiphysis (SCFE) after spinal fusion due to idiopathic scoliosis. A 14 year old male patient underwent posterior spinal fusion due to idiopathic thoracic scoliosis. Post-operatively, the patient presented with acute pain in the left hip and a reduced range of motion, which revealed acute SCFE. The patient was then referred to the Second Orthopaedic Department of Agia Sofia Children Hospital in Athens, and underwent percutaneous pinning of the left femur, after which he was discharged uneventfully. The follow up was excellent with no impact on the patient's daily life. The case described is extremely rare in the current literature. The significance of the pre-operative planning is underlined by this case, as well as the need for the spinal surgeon to be aware of the possibility of acute pain in the hip in young adolescents, as SCFE is more common amongst this demographic.