We report our experience of the monitoring of spinal somatosensory evoked potentials in 60 patients with neuromuscular scoliosis. In 15 cases a significant change occurred in the trace when a sublaminar wire was tightened. There were no postoperative neurological deficits attributable to the surgery.
1. In Northern Ireland a campaign to eradicate congenital dislocation of the hip by neonatal demonstration of abnormal laxity and early splintage has been reviewed. The number of live births in the area covered is approximately 30,000 per annum. 2. The results to date suggest that the problem has been greatly over-simplified. The number of established dislocations has not fallen appreciably. 3. Failures have occurred both in early diagnosis and in early treatment. 4. To help close the diagnostic net all children should be screened again during the first year. Infants born by breech presentation and infants with a family history of dislocation should have radiographs taken in the early months, even if clinical tests are negative. 5. With regard to neonatal treatment, early splintage has failed to prevent established dislocation in about 2ยท4 per cent of the hips so treated. How to detect such resistant cases is an important problem.
1. A review of nineteen cases of malignant spinal tumour treated surgically is presented. 2. Four cases are presented in detail. 3. The results in terms of survival are not assessed, because the effect of operation on survival cannot be estimated in a small series without controls. However, if the patient does survive for a considerable time, the value of operation can be assessed in terms of its contribution to the quality of survival, in relieving pain or improving or protecting neurological function. 4. The limitations of laminectomy are compared with the possible advantages of anterior approaches.