[Somatosensory evoked potentials during surgery of scoliosis: significance of epidural recording]. / Potentiels évoqués somesthésiques au cours de la chirurgie de la scoliose: intérêt du recueil épidural.

PURPOSE OF THE STUDY: To evaluate the usefulness of the epidural recording in scoliosis surgery in children or young adults. MATERIAL AND METHOD: We used somatosensory-evoked potentials in 60 children or young adults in surgical treatment of scoliosis. Somatosensory-evoked potentials were elicited and recorded using a standard method recording of cortical P40 and subcortical P27, simultaneously with the monitoring of spinal cord function using epidural electrode to record the ascending somatosensory volley (by tibial nerve stimulation) at a high thoracic level. RESULTS: The use of subcortical and epidural recording sites for the somatosensory-evoked potentials indicated that a reliable response could be obtained in 96 p. 100 of the patients. Cortical somatosensory-evoked demonstrated a 48 p. 100 false positive rate. DISCUSSION: Epidural recording in scoliosis surgery is safe and reliable. Combined subcortical and epidural recordings are especially useful in patients with neuromuscular scoliosis or with cerebral palsy that may not have reliable cortical potentials.

Kienböck's disease and multiple hereditary osteochondromata: a case report.

A case of bilateral forearm localization of multiple hereditary osteochondromata and unilateral Kienböck's disease is reported. Ulnar minus variance is frequent in both diseases. Carpal slip is often found in multiple hereditary osteochondromata. In this case, the extremity having both multiple hereditary osteochondromata and Kienböck's disease had no carpal slip. This might have produced an excess load on the lunate, which might have provoked Kienböck's disease.

The acetabular opening angle in Perthes' disease. Radiographic study of 62 unilateral cases.

Pelvis AP radiographs in 62 patients with unilateral Perthes' disease were studied in search of changes of the acetabulum throughout the active stages of this disease. The length of the acetabular roof, the diameter of the acetabulum, and the opening angle of the acetabulum, were compared with the contralateral hip. The length of the acetabular roof did not change, but the opening angle and the diameter of the acetabulum increased. This increase began in the earliest stage of the disease in half of the cases; it reached a maximum during the resorptive and the reconstructive stages, then it decreased to reach normal values at skeletal maturity. These changes were related to the extent of the epiphyseal necrosis. Probable causes were local hyperemia and a mechanical adaptation of the acetabulum to a cartilaginous coxa magna. The opening angle has a prognostic value and influences our choice of therapy.