The SRS-22 is a valid instrument for the assessment of the health related quality of life of patients with Idiopathic scoliosis. The SRS-22 questionnaire was developed in USA and has been widely used in the English speaking countries. Recently it has been translated and validated in many other languages. The purpose of this study is to evaluate the reliability and validity of the adapted Greek version of the refined Scoliosis Research Society-22 Questionnaire.

Somatosensory evoked potentials (SSEP) are being used for the investigation and monitoring of the integrity of neural pathways during surgical procedures. Intraoperative neurophysiologic monitoring is affected by the type of anesthetic agents. Remifentanil is supposed to produce minimal or no changes in SSEP amplitude and latency. This study aims to investigate whether high doses of remifentanil influence the SSEP during spinal surgery under total intravenous anesthesia.

It has been indicated that rotator cuff tears, especially large or massive ones, can cause suprascapular neuropathy. When such a diagnosis has been established, it is still unknown whether an arthroscopic release of the superior transverse scapular ligament during cuff repair can change the course of this neuropathy. This is a single-center, double-blinded randomized controlled trial for which 42 patients with large or massive repairable rotator cuff tears and suprascapular neuropathy will be recruited and followed up at 6 and 12 months. Nerve function will be measured by nerve conduction and electromyography studies preoperatively and at the selected follow-up periods. Patients will be randomly divided into equally numbered groups, the first one being the control group. Patients of this group will undergo arthroscopic repair of the rotator cuff without combined arthroscopic release of the superior transverse scapular ligament; in the second group the ligament will be released. The primary objective is to test the null hypothesis that arthroscopic repair of large/massive rotator cuff tears in patients with combined suprascapular neuropathy provides equivalent outcomes to one-stage arthroscopic cuff repair where the superior suprascapular ligament is additionally released. The secondary objective is to search for a relation between rotator cuff tear size and degree of suprascapular nerve recovery. The tertiary objective is to demonstrate any relation between rotator cuff muscle fatty infiltration grade and degree of suprascapular nerve function. Patients, clinicians during follow-up clinics and the neurologist will be blinded to the type of surgery performed. To the best of our knowledge, we are unaware of any prospective, randomized double-blinded studies with similar objectives. So far, the evidence suggests a positive correlation between massive rotator cuff tears and suprascapular neuropathy. However, there is mixed evidence suggesting that neuropathy can be effectively treated with rotator cuff repair with or without release of the superior transverse scapular ligament. ClinicalTrials.gov registration number NCT02318381 ; date of initial release: 5 December 2014.

To correlate patellar reflex inhibition with sympathetic knee joint effusion. 65 women and 40 men aged 45 to 75 (mean, 65) years underwent hip surgery. The surgery entailed dynamic hip screw fixation using the lateral approach with reflection of the vastus lateralis for pertrochantric fractures (n=49), and hip hemiarthroplasty or total hip replacement using the Watson-Jones approach (n=38) or hip hemiarthroplasty using the posterior approach (n=18) for subcapital femoral fractures (n=28) or osteoarthritis (n=28). Knee joint effusion, patellar reflex, and thigh circumference were assessed in both legs before and after surgery (at day 0.5, 2, 7, 14, 30, and 45). Time-sequence plots were used for chronological analysis, and correlation between patellar reflex inhibition and knee joint effusion was tested. In the time-sequence plot, the peak frequency of patellar reflex inhibition (on day 0.5) preceded that of the knee joint effusion and the thigh circumference increase (on day 2). Patellar reflex inhibition correlated positively with the knee joint effusion (r=0.843, p=0.035). These 2 factors correlated significantly for all 3 surgical approaches (p<0.0005). All 3 approaches were associated with patellar reflex inhibition on day 0.5 (p=0.033) and knee joint effusion on day 2 (p=0.051). Surgical trauma of the thigh may cause patellar reflex inhibition and subsequently knee joint effusion.

The case of a patient with a second recurrence of a chondrosarcoma of the pelvis and pubic symphysis is presented, in order to show the difficulties of the surgical treatment and the long course of the tumor.A 56-year-old woman having already been operated upon twice within two decades, presented with a large, mass of the pubic symphysis, extending into the left proximal thigh.Preoperative imaging revealed a large tumor occupying the pubic symphysis and the pubic bones up to the ischial tuberosities, extending into the soft tissues of the inner surface of the left thigh and displacing the urinary bladder, the urethra and the vagina.Intraoperatively, a radical excision of the tumor was performed, including removal of the osseous substrate of the anterior pelvis. The anterior abdominal wall was supported with a special synthetic mesh secured on the osseous stumps in order to prevent visceral herniation. Histological examination showed grade I to II chondrosarcoma, while the patient's postoperative course was uncomplicated.At the latest follow-up two years postoperatively, the patient is pain-free and ambulatory with no signs of tumor recurrence, genitourinary complications or visceral herniation.

This opinion article refers to the “double rib contour sign” and to the rib index (DRCS and RI), to their reliability study results in the chest radiographs of a control group and to their validity study results. These two parameters were introduced by the first author in this report. The introduction of the Segmental Rib Index (SRI) and its relation to spinal deformity is also discussed. The RI has been confirmed to be a strong surrogate for scoliometric readings in idiopathic scoliosis (IS). The clinical applications of the RI are analyzed for the following: (a) the documentation of deformity; (b) the assessment of physiotherapy outcomes (PSSEs); (c) the documentation of the outcomes of brace treatment; (d) the documentation of the pre- and post-operative assessment of thoracic deformity correction in different types of instrumentation; (e) its usage in prognosticating accelerated deterioration in skeletally mature adolescent idiopathic scoliosis (AIS) curves of 40–50 degrees; and (f) its usage in the recognition of the proper rib level for thoracoplasty/costoplasty. The emerging etiological–scoliogenic implications from the use of the DRCS and RI are described. The rotation of the trunk and vertebral bodies as interrelated, but distinct parameters are finally analyzed.