Introduction: The purpose of the study was to evaluate the outcome of multiple spinal operations by an expert spinal surgeon HV Crock.

Materials and Methods: A retrospective review of 169 patients who had multiple spinal surgery including spinal Fusion and spinal decompression was undertaken. A special Questionnaire form was designed and sent to each patient to answer with an appointment for the patient to be seen and assessed in the spinal assessment clinic where data from the questionnaire, clinical notes and thorough clinical examinations were recorded in a spinal data base which covered the following sections:

Patients Symptoms

Results:

– 76 patients 66% of the patients who replied “were satisfied” with the surgery.

There were no significant post-operative neurogenic complications, such as cauada equina syndrome or severe leg weakness interfering with standing and walking retirement. There was always a temporary relief followed by deterioration of symptoms after a period ranging between 1–2 years.

Conclusions: Overall, patients with failed back syndrome need to be evaluated and treated in a multidisciplinary setting, where a group of Health Care Professionals from various fields, such as Physiotherapy, Pain Management and Clinical Psychologist work together, towards the common goal for the benefit of the patient

In this lecture, a summary of Ron Beetham’s life was presented, focused on the pivotal roles he played in the foundation of the Facet Club, (later to become the Spine Society of Australia), I.S.S.L.S. and on his contribution to orthopaedic education in Asia. Reflections based on 50 years in spinal surgery were presented, dealing with the highs and lows of this fast-evolving specialty. Unresolved aspects of disc pathology and spinal cord injury will be discussed.

* The Ron Beetham Memorial Lecture is an eponymous lecture for inclusion in the Annual Scientific Meeting of the Spine Society of Australia. (William) Ron Beetham (1925–2003) was a co-founder of the Facet Club in 1970. The Facet Club was the predecessor to the Spine Society of Australia which came into being in 1990. Ron Beetham was a notable spinal orthopaedic surgeon and humanitarian who practiced in Ballarat and was a major contributor to spinal surgery in Australia and overseas.

This lecture is to honour a founder of what has become the Spine Society of Australia and the eponymous lecture should make some historical reference to this effect. The Ron Beetham Memorial Lecturer will be selected by the Executive at its final meeting of the calendar year and invited by the President to give a half hour dissertation on a topic of mutual agreement between the President and the invited lecturer. The topic may be wide ranging and not necessarily confined to the science and practice of spinal surgery. The lecture will be delivered at the Annual Scientific Meeting following selection of the lecturer and subject to agreement. The occasion is marked by a presentation of an award.

We report a 72-year-old patient with thoracic myelopathy due to isolated ossification of the ligamentum flavum at T9-T10. Severe paraparesis had developed before the lesion was identified when thinning of a segment of the lower thoracic spinal cord was suspected on a second MRI examination. The diagnosis was then established by CT.

Low lumbar pain with radiation into the leg is a common symptom pattern caused by a number of pathological processes. Isolated disc resorption is one such entity which can be readily identified and is amenable to surgical treatment. This study consisted of two groups of patients. Group I were 50 patients suffering from isolated disc resorption at L5--S1 with ill-defined low backache extending into the buttocks and down one or both legs, but not into the feet. Clinical signs of nerve root dysfunction were found in 16 per cent of patients. Radiographic changes with loss of disc height, facet over-riding and intrusion into the nerve root canal and intervertebral foramen were common and frequently associated with sclerosis of the vertebral end-plate. Group II were a series of 45 patients with isolated disc resorption independently reviewed an average of 45 months after surgical decompression of the S1 (98 per cent) or lower lumbar nerve roots. Based on objective grading by the clinician and subjective assessment by the patient complete success was achieved in 62 per cent of the patients and partial success in 24 per cent. Provided there is full appreciation of the pathological anatomy, strict diagnostic criteria and meticulous surgery, decompression of the nerve root canal is a useful surgical procedure in severely disabled patients suffering from isolated disc resorption.

A system is presented for the analysis of failure after spinal operations: 1) outright failure; 2) temporary relief; 3) failure in spondylolisthesis; and 4) infections. With this system it is possible to trace the causes of failure and to correct some of them. When they are used as a guide before operation, the recommendations made should help to prevent many failures.