Editorial Comment

Abstract

Progress and treatment of disorders of the spine became a focus for many orthopaedic surgeons, neurosurgeons, radiologists, engineers, anatomists, and other basic scientists who shared an interest in this subject. This symposium discusses biomechanical, diagnostic, and therapeutic issues related to spine disorders. It includes papers on biomechanical evaluation of occipitocervical and lower cervical spine fixation; issues related to spine trauma, treatment of complications related to spine surgery; and issues related to evaluation of low back pain and idiopathic adolescent scoliosis. Two studies are included on the biomechanical evaluation of cervical spine fixation. The first study compares the stability of two standard occipitocervical stabilization techniques with a new rod system. The second study on biomechanical evaluation of lower cervical spine fixation showed repeated stability tests in specimens from cadavers, even when done with physiologic loads, may compromise the screw-bone interface and this effect is not apparent in specimens that have greater bone mineral density. In a retrospective study, the diagnostic and therapeutic problems of patients with multiple noncontiguous spinal fractures are analyzed. The physician should highly suspect such lesions in patients with polytrauma, who should have detailed clinical and radiographic examination of the entire spine. Another study discusses the anterior approach as a safe and effective method of treating various traumas to the lower cervical spine. A prospective study assesses the efficacy of the classification of Gertzbein and the load sharing classification of the thoracolumbar burst spine fractures in the selection of operative procedure and in prognosis. The complications and problems developed during and after pedicle screw fixation for various spinal disorders and trauma are discussed. One article outlines the prevalence, the potential causes, and the appropriate treatment of acute postoperative spine infection. Percutaneous transpedicle approach for biopsy is shown to be a safe, efficacious, and cost-effective method for evaluation of spinal lesions. False-negative results, pitfalls, and complications can be avoided when adhering to the technical details of this procedure. Another study reviews the long-term clinical and radiographic results of posterior surgery for the treatment of pseudarthrosis in the thoracic spine. One study discusses end plate osteotomy with concave osteophyte excision as being a clinically valuable technique for the treatment of adults with fixed lumbosacral fractional curves. The Oswestry Disability Index and the Roland-Morris Disability Questionnaire are two disability questionnaires most commonly used as outcome measures in patients with low back pain. In one study, the lack of a reliable and valid instrument in the Greek language led the authors to prepare and test the Greek translations of these questionnaires. Finally, another study identified statistically significant correlations between clinical and radiographic parameters in patients with idiopathic adolescent scoliosis and created mathematical formulas that could predict the Cobb angle using the scoliometer measurements. It was an honor and distinct pleasure for the guest editors to closely cooperate with all the participating authors who entrusted their important clinical and research work to be part of this symposium. The guest editors would also like to express their appreciation to Dr. Carl Brighton, past Editor-in-Chief of Clinical Orthopaedics and Related Research, for his invitation, constant support, and exhortation in this symposium. We also thank Dr. Leonard Peltier, Deputy Editor, for his contribution in preparing the Classic article on Galen’s work on spine. Special thanks to the editorial staff at Clinical Orthopaedics and Related Research and especially to Ms. Christine Kucowski and to Dr. Petros Boscainos for their help in the preparation of this symposium.