Our findings suggest that CCV development is poorer in patients with than in patients without DM. Thus, we can speculate that DM is an important factor affecting CCV development.

Osteotomies may be life saving procedures for patients with rigid severe spinal deformity. Several different types of osteotomies have been defined by several authors. To correct and provide a balanced spine with reasonable amount of correction is the ultimate goal in deformity correction by osteotomies. Selection of osteotomy is decided by careful preoperative assessment of the patient and deformity and the amount of correction needed to have a balanced spine. Patient's general medical status and surgeon's experience levels are the other factors for determining the ideal osteotomy type. There are different osteotomy options for correcting deformities, including the Smith-Petersen osteotomy (SPO), pedicle subtraction osteotomy (PSO), bone-disc-bone osteotomy (BDBO) and vertebral column resection (VCR) providing correction of the sagittal and multiplanar deformity. SPO refers to a posterior column osteotomy in which the posterior ligaments and facet joints are removed and a mobile anterior disc is required for correction. PSO is performed by removing the posterior elements and both pedicles, decancellating vertebral body, and closure of the osteotomy by hinging on the anterior cortex. BDBO is an osteotomy that aims to resect the disc with its adjacent endplate(s) in deformities with the disc space as the apex or center of rotational axis (CORA). VCR provides the greatest amount of correction among other osteotomy types with complete resection of one or more vertebral segments with posterior elements and entire vertebral body including adjacent discs. It is also important to understand sagittal imbalance and the surgeon must consider global spino-pelvic alignment for satisfactory long-term results. Vertebral osteotomies are technically challenging but effective procedures for the correction of severe adult deformity and should be performed by experienced surgeons to prevent catastrophic complications.

Although intra-articular knee injection is not a complicated procedure, it could be difficult to assess whether the tip of the needle lies free in the joint or is embedded in synovium or other intra-articular soft tissues. The purpose of this study was to evaluate the accuracy rate of intra-articular injection using anteromedial (AM), anterolateral (AL), lateral midpatellar (LMP), and medial midpatellar (MMP) portals in cadavers. In this study 156 knees of 78 fresh cadavers were included. Anterolateral and AM injection to both knees of 39 cadavers (78 knees) were performed. MMP and LMP injection to both knees of other 39 cadavers were also performed. Accuracy rate was the highest (85%) in the AL injection portal and lowest in the MMP portal (56%). In conclusion, the accuracy obtained with use of the MMP portal was significantly lower than that obtained with the use of either the AM (P < 0.05), AL (P < 0.0001), or LMP (P < 0.05) portal. Although AL injection site resulted in good intra-articular delivery with 85% accuracy rate and with a lower incidence of soft tissue infiltration, the results were not statistically significant when compared to AM and LMP portals. Therefore, any of these three portals might be preferred depending on the experience of the physician. On the other hand, 100% accuracy could not be obtained through any portals in the study, which should be kept in mind when treating knee problems with intra-articular medications.

This study showed an overall 16.3% radiological PCE and 1.4% symptomatic PCE incidence when CAFPS were used due to severe osteoporosis. The symptomatic PCE risk was significant when CAFPS were > 7 levels; > 14 fenestrated screws; and > 20-25 cc cement volume is used and this may cause PAP increase and right ventricular dilatation.

This article reports the outcomes of 1072 consecutive patients surgically treated during a ten-year period. There are many new techniques for the treatment for lumbar disc hernia, but also the conventional standard discectomy procedure is still the most acceptable method today. 1072 consecutive, non-randomized patients with lumbar disc herniation were reviewed for a clinical retrospective study about the surgical outcome according to our functional grading system. The patients reported ruptured disc to be due to lifting (30.13%), trauma (9.42%), and sports (8.11%). Almost all patients had complained of radicular pain in a dermatomal distribution (90.39%) and 86.07% had low-back pain, 5.2% of the patients had complications. Eighty-five patients (7.92%) had a second lumbar disc operation. Thirty of these eighty-five patients underwent the operation at the same level. Patients were also rated to improve the ability. Almost 91% of the patients had excellent, good, and satisfactory outcome; 9% of patients had moderate and poor categories of outcome. Several conclusions can be drawn from this large series of patients who were operated for lumbar disc herniation. 1. Most patients had good-to-excellent surgical outcomes after lumbar discectomy. 2. The results of disc surgery depend not only upon operative technique and skill, the degree of neurological impairment but also upon the correct selection of cases.