Osteoblastoma of the spine.

A retrograde analysis of 64 spinal osteoblastomas treated by surgery during the period 1963 - 2005 has been made. Spinal osteoblastomas were presented in 36% of all skeletal localizations. There were 44 male and 20 female patients. The average age of patients at the time of surgery was 14 years. Localizations of the osteoblastomas were cervical spine in 8 cases, dorsal spine in 16 cases, lumbar spine in 38 cases and sacrum in 2 cases. Osteoblastomas predominantly involved posterolateral vertebral elements, although in two cases a primary localization was in vertebral bodies. Neurological deficits were relatively moderate, but a paraplegia occurred in six patients. Scoliosis was present in 50% of cases, and their respective prognosis depended on the duration of the painful syndrome as well as on the age when the disease had set up. According to Enneking classification 30 patients were evaluated as stage 2 and 34 othe-rs as stage 3. Relapses were noticed in 8 (12.5%) pati-ents. Clearly delineated lesions were treated by an intralesional procedure, but aggressive ones were treated by a marginal surgery followed by additional radiotherapy (6 patients). The average follow-up period was 13 years.

[Treatment of occipitocervical instability by SUMMIT].

The occipitocervical junction with its complex anatomy and biomechanics represents unique anatomical structure difficult for operative treatment. Biomechanics forces in this region need to be resisted with rigid metallic construction to facilitate bone fusion. Surgeon must be careful about close relations of the bone, vascular and neurologic structures and must have good skills and knowledge to avoid serious complications during operations. Before 2004 for instability treatment in this region of spine wires and pin construction for fixation of bone grafts were used. In our Institute rod constructions with screws have been used to get more rigid construction since 2004. In this paper we will present our early results in occipitocervical instability treatment by SUMMIT instrumentation.

Low back pain--differential diagnosis, prognosis and treatment.

From January 2002 to February 2003, 137 patients complaining of low back pain were treated at the Institute for Orthopedic Surgery "Banjica", Belgrade, Serbia. There were 89 male and 48 female patients aged 13 to 77, mean age 42.2. Their condition was diagnosed through use of radiography, CT, MRI, EMNG, standard battery of neurological tests, and laboratory analyses (urine and blood analysis). Surgical treatment was performed on 39 patients; all other patients received some form of non-surgical care (physical therapy, medication or corset). Treatment efficacy was evaluated by use of the visual analog scales (VAS) and the Oswestry index, before and after treatment. The use Wilcoxon's pair test revealed statistically significant difference between before and after treatment data on VAS and Oswestry index for all patients.

[Non-specific sacroiliitis]. / Nespecificni sakroileitis.

We present retrospectively five cases of non-specific sacroileitis which were established and treated in Special Orthopaedic Hospital Banjica Belgrade in the period of 12 years, from 1982 to 1994. Patients have been from 17 to 27 years of age. All of them had been treated initially in other institutions under different diagnosis: specific sacroileitis, specific coxitis, specific spondylitis, abscess of gluteal region and discarthrosis and lumboishialgia. All of the patients have been treated by antibiotics, one by tuberculostatics, one surgically by drainage and one by coxofemoral spica cast. In spite of short period of follow up between 1.5 month and 2 years, we have had excellent clinical and laboratory recovery.