Background: Legg-Calvé-Perthes disease (LCPD) is the idiopathic avascular necrosis of the femoral head in childhood. The pathologic changes seen in the femoral head are likely a result of vascular factors. Blood neutrophil to lymphocyte (N/L) ratio is a simple marker of subclinical inflammation. This study aims to to analyse the predictive ability of N/L ratio for the prognosis in LCPD patients. Methods: Patients who had been diagnosed as LCPD from 2008 to 2014 were investigated retrospectively and 40 LCPD patients (33 male and 7 female) and 25 healthy age and sex-matched children (controls) were included in the study. LCPD patients were divided into 2 groups according to expected prognosis (good prognosis expected Herring A and B patients as Group I and poor prognosis expected Herring B-C and C patients as Group II) and healthy children (control) were included in Group III. All the patients’ hematological markers were analysed. Results: Mean age was 7.1 ± 2.0 years in group I (4.9-12 years), 8.3 ± 2.2 years (4-12.5 years) in group II and 7.8 ± 1.3 years (6-12 years) in group III. Mean values for Groups I, II and III for neutrophil to lymphocyte (N/L) ratio were 1.13 ± 0.65, 1.75 ± 0.95, 1.08 ± 0.37, respectively. The mean neutrophil to lymphocyte (N/L) ratio of Group II was higher than the other 2 groups (p = 0.003). Conclusions: N/L ratio may give us information about the natural course of LCPD and may be used as independent predictor of prognosis in patients with LCPD.

Treatment of thoracolumbar burst fractures using combined pedicle screw-laminar hook fixation

Background: Sanders maturation stages (SMS) 2 to 4 represent periods of rapid growth and are considered ideal candidates for growth modulation surgery, such as anterior vertebral body tethering. A detailed assessment of spine growth during these stages is essential but limited. This study aimed to clarify the differences in growth rates for spine and total body height across SMS 2, 3A, 3B, and 4, as well as to assess cumulative growth until skeletal maturity for these stages. Methods: This single-center, retrospective, case-control longitudinal study evaluated consecutive patients with idiopathic scoliosis staged SMS 2 to 4. T1-S1 spine height, total body height, and curve magnitude were measured at each visit. Monthly growth rates for spine and total body height were calculated between baseline and first follow-up visit (6-12 months). In a subset followed to skeletal maturity, cumulative spine and total body height gain were assessed. To account for height loss due to scoliosis, spine and total body height were adjusted for curve magnitude using validated formulas. Multivariate linear regression models were employed to evaluate the relationship between SMS and growth, adjusting for confounding factors. Results: A total of 517 patients (68% female) were included. Spine height growth was highest in patients at SMS 3A, approximately 1.4 times stage 2, 1.5 times stage 3B, and 1.8 times stage 4. Total body height growth rates were comparable between SMS 2 and 3A, both significantly exceeding SMS 3B and 4. Among 314 patients followed to skeletal maturity, cumulative growth in spine and total body height was greatest in patients at SMS 2. Conclusions: This study demonstrated that spinal growth was most pronounced in patients at SMS 3A, while total body height growth was greatest during SMS 2 and 3A. Less mature patients exhibited greater cumulative growth potential in both spine and total body height. These findings provide crucial insights for determining the optimal timing of growth modulation surgery. Level of Evidence: Level III Case-control study. See Instructions for Authors for a complete description of levels of evidence.