The aim of this paper is to study patients who have had surgery for spinal tumors. Indications for surgical treatment are pain(not resolving with analgesics), impending as well as manifested neurologic symptomatology or spinal instability, compression of neighboring structures and failure of radiotherapy or chemotherapy. In this study we present 50 patients, 30 women and 20 men, aged 15 to 75, suffering from benign(10 pts), malignant(15 pts)and metastatic(25 pts) spinal tumors. All were treated surgically by wide excision during a four-year period (1997–2002) using an anterior, posterior, posterolateral or combined approach to the spine. Most of the 30 pts who presented with neurologic compromise improved to a significant degree postoperatively with the exception of 5 whose condition did not change. One patient, whose preoperative neurologic status was Frankel D, deteriorated postoperatively and underwent a second operation to no avail. One patient died on day 12 p.op. CT-assisted biopsy was not successful in half the patients with metastatic cancer. 18 patients suffering from malignancy(primary or metastatic) underwent angiography and selective embolism of the feeding vessels. All patients were evaluated preoperatively by CT-scan, MRI, bone scan and in most cases myelography as well. Complications that were observed were wound infection(3 pts), intraoperative meningeal trauma and CSF leak(2 pts) and lymfatic duct trauma and lymph leak(1 pt).

Purpose: the study of the correction of scoliotic deformity in young adults 18–21 years of age, compared to that of older adults with adult idiopathic scoliosis.

Materials and methods: in this retrospective study, 65 patients (7 male, 58 female), with a mean age of 25,3 years (range, 18–68) suffering from adult idiopathic scoliosis, who underwent posterior instrumentation with fixation systems utilizing transpedicular screws and hooks between January 1999 and May 2003, were included. Patients with scoliosis of another etiology were not included. Patients were divided in two age groups: the first group included patients 18–21 years old and the second group included patients over 21 years old. The preoperative and postoperative Cobb angle was measured and the percentage of correction of the deformity was compared between the two groups.

Results: The first group (18–21y) included 41 patients (5 male, 36 female). The mean Cobb angle was 44° pre-operatively and 15,9° postoperatively, with a mean correction of deformity of 64%. The second group (over 21y) included 24 patients (2 male, 22 female). The mean Cobb angle was 49° preoperatively and 26,1° postoperatively, with a mean correction of deformity of 47%. Comparing the correction of deformity between the two age groups resulted in statistically significant difference (p< 0,05).

Conclusion: The percentage of correction of the scoliotic deformity after posterior instrumentation with fixation systems utilizing transpedicular screws and hooks is significantly greater in young adults between 18 and 21 years of age, compared to older adult patients over 21 years of age, although a significant percentage of correction can also be achieved in the latter group of patients.

Purpose: The presentation of our experience in the operative treatment of adult idiopathic scoliosis (AIS) with different posterior instrumentation systems.

Materials and methods: 195 patients with AIS, who underwent posterior instrumentation between January 1989 and December 2002 were included. Patients with degenerative scoliosis were not included in this study. 151 patients were female (77%) and 44 male (23%), with a mean age of 29 years (range, 18–68). The distribution of the lesions according to type was: 48 Th (25%), 67 Th/L (34%), 28 ThL (14%), 50 L (26%) and 2 Th/Th (1,0%). The mean preoperative Cobb angle was 52° (range, 32°–90°). The main indication for surgical treatment in older patients was unremitting pain after 15 months of conservative treatment. Preoperatively, 57% of the patients complained about pain (75% axial back pain, 25% radicular pain) and 43% about deterioration of deformity. Correction of the deformity in pre-operative lateral bending films was 43%. The systems for posterior instrumentation used were: Harrington:15, Hartshill: 26, Isola:38, Colorado:1, TSRH:35, CD-Horizon:21, Synergy:26, Moss-Miami:30, Spine evolution:1, Isobar-Isolock:2.

Results: postoperative correction of the Cobb angle was 48% and subjective improvement of pain was reported by 71,2% of symptomatic patients. Postoperative complications occurred in14 patients (7%): 4 had deep wound infection, 2 had transient worsening of radicular symptoms, 1 had postoperative icterus, 1 had transient postoperative thoracic pain, 3 had implant failure that was symptomatic in 2 of them and were revised, 2 had CSF leak and 1 had postoperative back pain and had the implants removed after fusion had been achieved.

Conclusion: The operative treatment of adult idiopathic scoliosis with posterior instrumentation is a safe method that provides a great amount of correction of deformity and diminishes pain in symptomatic patients.