Aim

The primary aim of this pilot study was to assess and evaluate the SpineCor Pain Relief Brace as a method of reducing the pain experienced by patients diagnosed with degenerative scoliosis

Slipped Capital Femoral Epiphysis (SCFE) is a common paediatric disorder with documented racial predilection. No data exists regarding the Australian indigenous and Australian non-indigenous populations. This study provides a comprehensive demographic and epidemiologic analysis of SCFE in South Australia, with emphasis on establishing associations between increasing obesity and incidence.

A demographic review of all cases of SCFE managed in South Australian public hospitals between 1988 and 2007 was performed. Clinical presentation, surgical management and complication profile information was collected. Given that obesity is implicated in the biomechanical causation of SCFE due to increased shearing forces, particular emphasis was placed on gathering weight, race, gender and age data. A profile of the incidence and nature of SCFE was generated. Comparisons were then drawn between this profile and existing epidemiologic percentile data of weight, age and gender in South Australia.

A rising prevalence of obesity in South Australia corresponded with a rising incidence of SCFE. However, this relationship was not linear as the incidence of SCFE has doubled in the last 20 years and the average weight of SCFE patients has increased markedly.

The indigenous population was found to have higher rates of obesity than the non- indigenous population in South Australia. The indigenous population also has a relative risk of developing a SCFE of over three times the non-indigenous population.

The overall rate of complications in South Australian public hospitals was low, with avascular necrosis being recognised in our profile.

The rise in incidence of SCFE in South Australia; especially noticeable in the indigenous population is associated with an increasing prevalence of obesity. The considerable morbidity associated with SCFE was confirmed in our analysis and further highlights the importance of public health initiatives to tackle obesity in our community.

Purpose

To report a retrospective study of 103 cases of primary spinal infection, the largest ever such series from the UK, analysing presenting symptoms, investigations, bacteriology and the results of treatment.

We analysed the incidence of slipped capital femoral epiphysis (SCFE) in South Australia, investigating possible associations between an increased incidence of SCFE, the local indigenous population and the Australian obesity epidemic during the last 20 years. Data including race, age and gender were collected to obtain a profile of the South Australian SCFE patient, and were then compared with epidemiological data for South Australian adolescents. We concluded that the incidence of both obesity and SCFE is increasing. We also noted that the median weight of SCFE patients has increased and the mean age at diagnosis has decreased. Despite weight profiles comparable with those of the general population, we noted that an indigenous child was three times more likely to develop SCFE than a non-indigenous child. As far as we know there is no published literature on the predisposition of Aboriginal Australians to SCFE.

Introduction: Slipped Capital Femoral Epiphysis (SCFE) is the most common hip problem of adolescence. Obesity and African and Pacific Islander races have been associated with increased susceptibility. In the setting of increasing rates of obesity in Australian adolescents over the last twenty years, it is unknown whether the incidence of this condition is increasing. There are no studies to date on the Australian population and it is unknown whether there is an increased incidence in the local Aboriginal population.

Aims: The demographics of SCFE patients presenting to the Women’s and Children’s Hospital (W& CH) in Adelaide were studied, from 1988 to the present, with particular emphasis on weight and race. This was then compared to weight for age percentiles data in the Australian population. The issues of prophylactic pinning of the contralateral side and the efficacy of the department protocol of “pinning in situ” were also studied.

Method: Systematic chart review, statistical analysis, and comparison with data from the Australian Bureau of Statistics and the Centre for Applied Anthropometry, University of South Australia, pertaining to weight and racial mix in South Australia.

Results: SCFE was associated with obesity. Over 45% of the cohort was above the 95th percentile for weight. The mean weight was in the 85th percentile and the median weight was in the 94th percentile.

As an example, the average weight of children aged 12 to 14 years was 13kgs more than the median value of children in this age group.

There was a clear increase in incidence of this condition over the last twenty years which corresponds with increasing obesity rates in the community.

There was a higher incidence in the indigenous population as compared with the non-indigenous population.

Out of the 236 patients enrolled, 5 cases were complicated by avascular necrosis. The overall complication rate was low.

Rate of progression to contralateral slip was low as was the rate of prophylactic pinning.

Conclusions: Our complication rate when compared to other centres is relatively low and would seem to support our consistent protocol of “pinning in situ”. The low rate of progression to contralateral slip also supports our protocol of watchful surveillance rather than mandatory prophylactic pinning of the contralateral side.

We have shown that SCFE is associated with obesity in Australia when compared with general population data. Obesity is also more common in the Aboriginal population and we postulate that this explains the higher incidence of SCFE in this group. In keeping with increasing rates of obesity amongst Australian adolescents, the increasing incidence of this condition further highlights the importance of public health initiatives to tackle obesity in the community.

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.