Apical derotation in the treatment of idiopathic scoliosis.

STUDY DESIGN: A prospective study of the pedicular screw plate system in the treatment of idiopathic scoliosis. OBJECTIVES: To study the efficacy of apical derotation of pedicular screw plate system in idiopathic scoliosis correction and evaluate the feasibility of the technique. SUMMARY OF BACKGROUND DATA: In the surgical treatment of idiopathic scoliosis, the standard technique of fixation currently utilized the linkage of the pedicle screws via rods. Alternatively the technique of apical correction of the deformity by sagittally contoured plates found to be a convenient and effective mean of deformity correction and rigid fixation. MATERIAL AND METHOD: Twenty-five patients who were diagnosed as idiopathic scoliosis and underwent posterior spinal fusion and fixation with pedicle screws and plates were prospectively analysed. The parameters were compared between preoperative and postoperative by paired t-test. These parameters included Cobb angles, body height, shoulder height difference, coronal trunk balance, hump difference and vertebral rotation. RESULTS: There was statistically significant difference between the pre-op and post-op parameters studied. CONCLUSION: The instrument can effectively correct the scoliosis of moderately severed deformity in 3 dimensions especially regarding the vertebral derotation and restoration of thoracic kyphosis.

Floor activity score.

OBJECTIVE: To propose an instrument to measure the amount of floor activities performed by an individual. MATERIAL AND METHOD: A list of 12 questionnaires relating to floor activities is proposed. A cross-sectional survey of the response to the questionnaires was tried on 3 communities representing rural, urban and metropolitan areas. The total number of enrolled people was 733. The scores of the questionnaires were tested for statistical difference (p< 0.05) among the communities by Chi-square and ANOVA nonparametric tests. RESULTS: The total scores among the three communities were significantly different. The rural civilians achieved the highest score, whereas the metropolitan area had the lowest score. CONCLUSION: The proposed instrument measuring floor activities is able to discriminate the activities of civilians in rural, urban and metropolitan areas.

Cost analysis of osteoporotic hip fractures.

OBJECTIVE: To assess the total costs of hip fracture treatment subsequently incurred in 1 year MATERIAL AND METHOD: A cohort study was conducted from January 1, 2002 to December 31, 2004. All new osteoporotic hip fracture patients were enrolled with informed consent. A total cost was estimated, and multivariate analysis was performed to determine factors related to costs. RESULTS: A total of 37 patients were included. Average age was 75 +/- 11.8 years. Four of them (11%) died. Median total cost of hip fracture treatment in 1 year was 116,458.6 Baht (range 21,428.5-5,070,665.0). Median direct cost was 59,881.6 Baht (range 21,428.5-595,520.4). Direct cost per live-year saved was 118,168. 3 Baht. Preoperative status was the only factor related to direct cost. CONCLUSION: Cost incurred from hip fracture in 1 year was high. The appropriate solution to prevent hip fracture might bring about good health in the Thai elderly and reduce its cost in the future.