Our aim in this prospective radiological study was to determine whether the flexibility rate calculated from radiographs obtained during forced traction under general anaesthesia, was better than that of fulcrum-bending radiographs before corrective surgery in predicting the extent of the available correction in patients with idiopathic scoliosis. We evaluated 33 patients with a Cobb angle > 60° on a standing posteroanterior radiograph, who had been treated by posterior correction. Pre-operative standing fulcrum-bending radiographs and those with forced-traction under general anaesthesia were obtained. Post-operative standing radiographs were taken after surgical correction.

The mean forced-traction flexibility rate was 55% (sd 11.3) which was significantly higher than the mean fulcrum-bending flexibility rate of 32% (sd 16.1) (p < 0.001). We found no correlation between either the forced-traction or fulcrum-bending flexibility rates and the correction rate post-operatively (p = 0.24 and p = 0.44, respectively).

Radiographs obtained during forced traction under general anaesthesia were better at predicting the flexibility of the curve than fulcrum-bending radiographs in curves with a Cobb angle > 60° in the standing position and may identify those patients for whom supplementary anterior surgery can be avoided.

Background: Spinal infections are rare, the reported incidence in the UK is between 1:50,000 and 1 in 250,000. Functional outcome following spinal infection is not widely reported in the literature

Methods: Over a 7-year period, all adult patients presenting to a tertiary referral centre with a diagnosis of primary pyogenic spinal infection (epidural abscess, osteomyleitis or spondylodiscitis) were identified. Data at presentation was collected and included: C-reactive Protein (CRP), white cell count (WCC), time interval between onset of symptoms and presentation to tertiary referral centre causative organism, level of spinal infection and surgery. Functional outcome was assessed using a validated tool – The Oswestry Disability Index (ODI)

Results: 96 patients were identified, mean age 61 years (22–87), 51 (53%) male. ODI was available for 78% of live patients; the mean follow-up period being 5.5 years (21–120 months). The median ODI was 42 (0–84). An elevated CRP was significantly associated with a poorer functional outcome (p=0.05). Surgical intervention was related to improved functional outcome but did not reach statistical significance. WCC and the presence of an abscess were not related to functional outcome.

Conclusion: In out study we have found that the higher the CRP at presentation the poorer the functional outcome.