Introduction Radiographic parameters have been shown to have a poor correlation with clinical outcome after open scoliosis procedures. However this has not been previously addressed after endoscopic surgery. The purpose of our study was to prospectively examine the relationship between curve correction and clinical outcome for endoscopic scoliosis surgery.

Methods We studied 50 consecutive patients that underwent endoscopic instrumentation, with a minimum follow-up of two years. All patients were assessed pre-operatively and at 24 months post-operatively. Radiological parameters were measured from plain standing radiographs including the coronal Cobb angle, sagittal alignment, coronal alignment and shoulder elevation. Clinical outcome was assessed using the Scoliosis Research Society Outcomes Instrument (SRS-24). Correlation between radiological parameters and SRS-24 scores were determined using the Pearson correlation coefficient.

Results There were 45 females and 5 males with a mean age of 16.4 years (range, 10 to 46). The pre-operative coronal Cobb angle was mean 51.7 ± 8.5 and the postoperative instrumented Cobb angle was mean 20.4 ± 7.8 corresponding to a mean curve correction of 60.7%.

There was a positive correlation between instrumented Cobb angle and total SRS-24 score (p=0.03, r2=0.085) and between curve correction and total SRS-24 score (p=0.04, r2=0.081). No correlation was found between coronal alignment, sagittal alignment, shoulder elevation or size of rib hump and the SRS-24 scores (p> 0.05).

Discussion Overall endoscopic scoliosis surgery was associated with a good clinical outcome for our series of patients. Using a validated assessment instrument, clinical outcome correlated well with the amount of curve correction achieved.

Study Design: A prospective randomised controlled trial.

Objective: The early management of acute soft tissue injuries of the neck remains controversial. The aim of this study was to compare an early mobilisation regime versus with treatment with a soft collar for recovery of function and activity levels after soft tissue injuries of the neck.

Subjects: Over a one year period, 108 patients presenting with a soft tissue neck injury were enrolled in a prospective trial. Each patient was randomised to either early mobilisation using an exercise regime (55 patients) or 3 weeks treatment in a soft collar followed by the same exercise regime (53 patients). Patients were followed up at 3, 12 and 52 week intervals from injury.

Outcome Measures: Visual Analogue Scores for pain, range of neck movements, activities of daily living and time taken to return to work.

Results: No differences were found between the two groups for pain, range of neck movements or for activities of daily living at any of the follow up intervals. The collar treatment group took significantly longer to return to work after injury (21 days) compared to the early mobilisation group (9 days), p< 0.05.

Conclusions: Treatment in a soft collar had no clinical benefit compared to early mobilisation in terms of recovery of function, pain or range of neck movements, but was associated with an increased time to return to work.

Pain in the distribution of the sciatic nerve is common in the elderly. In the presence of a long-standing joint replacement, consideration should be given as to whether compression might be due to an extraspinal cause. We present three women, in whom a mass of wear debris from a previous total hip replacement caused compression of the sciatic nerve posterior to the hip. The symptoms were relieved immediately following operation.