En bloc resection should be considered for Enneking stage III GCTs of the mobile spine. The choice of en bloc resection must be balanced with the inherent risks of the procedure. Intralesional resection of Enneking stage II tumors provides adequate local control. Patients should be followed for at least 5 years because local relapse can occur late.
We studied 51 patients with 64 fractures of the thoracolumbar and lumbar spine undergoing the surgical treatment by percutaneous trans-pedicular fixation and stabilization with minimally invasive technique. Patient follow-up ranged from 6 to 28 months (mean 14.2 months) and the patients were assessed by clinical and radiographic evaluation. The results show that percutaneous trans-pedicular fixation and stabilization with minimally invasive technique is an adequate and satisfactory procedure to be used in specific type of the thoracolumbar and lumbar spine fractures.
The aim of this work was to preliminarily evaluate the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of 68 Ga-citrate PET/CT in a population of patients with suspected bone infections. Methods: We enrolled 31 patients with suspected osteomyelitis or diskitis who underwent a total of forty 68 Ga-citrate PET/CT scans. The results were compared with different combinations of diagnostic procedures (MRI, radiography, CT, or white blood cell scintigraphy), biopsy (when diagnostic), and follow-up data (at least 1 y) to determine the performance of 68 Ga-citrate PET/CT. Results: We found a sensitivity of 100%, a specificity of 76%, a positive predictive value of 85%, a negative predictive value of 100%, and an overall accuracy of 90%. Conclusion: Although preliminary, these data confirm a possible role for 68 Ga-citrate in the diagnosis of bone infections, especially in consideration of its favorable characteristics.
Delta-SUVmax provided a higher sensitivity and specificity for identifying responders. SUV2 provided comparable sensitivity, but significantly lower specificity. CRP level performed less well for identifying responders. There was no significant difference in the global performance of the two tests (delta-SUVmax AUC and delta-CRP AUC). However, the higher sensitivity of delta-SUVmax for the early identification of responders may have an important clinical impact in guiding antibiotic therapy especially in patients with a noninformative CRP test at diagnosis.
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