[Supra-acetabular cysts of the hip: results of surgical treatment]. / Nadpanewkowe torbiele stawu biodrowego--wyniki leczenia operacyjnego.

Results of surgical treatment for supraacetabular cystic changes in 8 middle-aged females are presented. Complete excision and filling the defect with iliac autografts has been performed, histological examination of the change followed in all cases. No inflammatory, systemic or neoplasmatic changes were identified. Good results were achieved and hip osteoarthritis delayed. Surgery proved useful in treatment for supraacetabular cystic changes in the hip.

[Congenital pseudoarthrosis of the clavicle: review of literature and a case report]. / Wrodzony staw rzekomy obojczyka--przeglad pismiennictwa i opis przypadku.

A review of literature is presented and a case of congenital pseudoarthrosis of the right clavicle is described. Resection of the pseudoarthrosis, reduction and fixation with a screw gave good anatomical and functional result what made authors to recall this rare defect.

[Thoracic intervertebral disk herniation]. / Przepuklina krazka miedzykregowego w czesci piersiowej kregoslupa.

The history of thoracic intervertebral disc herniation recognition as a distinct condition is presented on the ground of the literature. Pathogenesis, pathology, clinical signs and symptoms, diagnostics and differentiation is discussed. Evolution of surgical methods from laminectomy, through thoracotomy to lateral approach is presented. Comparison of results achieved by different methods proved disadvantageous for laminectomy. Increasing over recent decades contribution of orthopedic surgeons in treatment of thoracic intervertebral disc herniation is underlined. The issue is rarely present in Polish literature, thus the need to introduce it to orthopedic surgeons.

[Neurologic complications of lumbar osteochondrosis]. / Powiklania neurologiczne towarzyszace osteochondrozie kregoslupa ledzwiowego.

Four cases (2 females and 2 males aged 18-22) of lumbar spine osteochondrosis with massive defects within end-plates and vertebral bodies are presented. In 3 cases bony overgrowth of posterior vertebral body wall with marginal spur occurred. Huge prolapse of annulus fibrosus occurred in one case. Neurological deficits appeared in all 4 cases. Bony overgrowth has been excised in 3 cases, nucleotomy accompanied one of them. The remaining patient required excision of the disc and segmental fusion. Good results were achieved in all above patients. The author recommends this treatment in similar cases.

[Results of treatment of unilateral sacralization of transverse process of the fifth lumbar vertebrae]. / Wyniki leczenia jednostronnej sakralizacji wyrostka poprzecznego V kregu ledzwiowego.

Pathology and symptomatology of unilateral sacralization of transverse process of the fifth lumbar vertebrae articulating with sacral and iliac bone is presented. Five patients (4 females, 1 male) aged 27-42 are reported. Symptoms included spinal pain, radicular pain, L4/L5 disc prolapse, and lumbar scoliosis. Patients were operated on: resection of the transverse process has been done in all cases, discectomy in 2 cases. Good results were found at the mean follow-up of 3 years. Author's experience supports idea of early surgical intervention in described condition.

[Results of surgical treatment for the intervertebral disc protrusion within thoracic spine]. / Wyniki operacyjnego leczenia protruzji krazka miedzykregowego w czesci piersiowej kregoslupa.

Results of surgical treatment for intervertebral disc protrusion within thoracic spine in 4 cases are presented. Protrusion had caused spinal compression resulting in neurological impairment (plegia). There were 3 females and 1 male, all in their forties or fifties. Two cases are presented in details, with radiological investigations included. Lateral approach was used at surgery. Neurological deficits subsided completely in all cases. Follow-up ranged from 1-15 years, mean 8 years.

[Thoracic outlet syndrome]. / Barkowy zespól uciskowy peczka naczyniowo-nerwowego.

Results of surgical treatment for thoracic outlet syndrome in 7 patients are reviewed. The symptom has been caused by cervical rib in 5 cases, in 1 case by the first rib anomaly and in 1 case by disturbed attachment of m.scalenus anterior. A case of misdiagnosed cervical rib is described in details; the patient has been operated on peripherally and serious iatrogenic complications followed. Ineffectiveness of pharmacotherapy and physiotherapy is pointed out. Surgical treatment resulted in remission of symptoms in 6 cases; in case of patient with iatrogenic complications marked improvement has been achieved. The aim of this paper is to demonstrate, that thoracic outlet syndrome promptly diagnosed and surgically treated has good prognosis.

[Results of treatment for infective osteomyelitis of the spine with neurological impairment]. / Wyniki leczenia infekcyjnego zapalenia kregoslupa z powiklaniami neurologicznymi.

From among 35 cases of spinal osteomyelitis 2 were treated conservatively and 21 surgically. Minor neurological deficits were managed conservatively. Deep spastic or flaccid paresis and plegia were treated surgically with focal excision and anterior stabilization. Satisfactory results were achieved in both groups; surgery within thoracic spine was markedly more beneficial. Four fatalities occurred in postoperative period (2 plegia cases and 2 deep spastic paresis cases) due to severity of preoperative condition and postoperative complications. Neurological impairment was caused by late diagnosis and improper management. Correct indications for conservative or surgical treatment yield good prognosis if general preoperative status of a patient is fair.

[Results of treatment for severely slipped capital femoral epiphysis by biplanar wedge osteotomy of the femoral neck]. / Wyniki leczenia duzych mlodzienczych zluszczen glowy kosci udowej dwuplaszczyznowa klinowa osteotomia szyjki.

The results of treatment for severely slipped capital femoral epiphysis by biplanar wedge osteotomy of the femoral neck in 13 cases are presented. They were compared to the results quoted by both advocates and opponents of this method. The authors conclude that this method renders beneficial results but they depend greatly on surgical technique and experience.

[A case of spinal hemangioma uncommonly located within spinous processes and laminae of Th12]. / Przypadek naczyniaka kregoslupa o rzadkiej lokalizacji w wyrostku kolczystym i blaszkach luku kregu Th12.

Uncommonly located hemangioma within processus of spines and laminae of Th12 in 25 years old female is presented. Neurological deficits resulted from meningeal compression. After surgical resection en bloc and subsequent radiotherapy neurological symptoms resolved.

[K"ummell-Verneuille's disease]. / Choroba Kümmell-Verneuille'a.

Pathology, clinical symptoms, diagnosis and differentiation of Kümmell-Verneuille disease with other conditions of vertebral bodies are delineated on the basis of own experience and the literature. The reasons of missing this diagnosis or neglecting an adequate treatment are indicated specifically. In some cases the condition may lead to severe neurological sequels. Conservative methods of treatment are given as well as indications for surgical intervention.

[Our clinical experience with the diagnosis and treatment of Kummell-Verneuille disease]. / Nasze doswiadczenia kliniczne w rozpoznawa-niu i leczeniu choroby Kümmell-Verneuille'a.

Pathology and clinical symptoms in 10 patients with Kümmell-Verneuille disease treated in CMKP Orthopaedic Department are presented. Special attention is given to the course of the disease, natural history of vertebral body necrosis and serious neurological complications. Every phase of the disease is radiographically documented. The preferred treatment, both in early and late phase, is posterior fusion embracing adjacent vertebrae. In neurologically complicated cases anterior spinal decompression and perivertebral fusion is recommended.

[Results for surgical treatment of kyphoscoliosis complicated with spinal cord injury]. / Wyniki operacyjnego leczenia kifoskolioz powiklanych uszkodzeniem rdzenia.

Results of surgical treatment of kyphoscoliosis complicated with spinal cord injury are presented. There were 16 congenital kyphoscoliosis, 5 idiopathic ones and 4 in course of neurofibromatosis. Increased spasticity was present in 2 patients, spastic paresis in 12 and 11 patients were paraplegic. In 24 cases spinal decompression was performed, in 6 years old boy with spasticity the convex side of the curve was fused. Neurological symptoms ceased in 13 cases, marked improvement was achieved in 6 patients, partial recovery in 1 case, in 5 cases no improvement was accomplished. One patient died 6 weeks after operation due to heart attack. Analysis of results achieved indicates, that surgery in most of kyphoscoliosis complicated with spinal cord injury offers good prognosis.

[Results of surgical treatment for inveterate thoraco-lumbar and lumbar spine injuries with neurologic complications]. / Wyniki operacyjnego leczenia zastarzalych uszkodzen kregoslupa piersiowo-ledzwiowego i ledzwiowego powiklanych neurologicznie.

The method and results of surgical treatment for inveterate thoraco-lumbar spine injuries with neurological impairment in 31 patients are presented. All the patients were operated on. The mainstay of the procedure was anterior decompression from posterior-lateral approach. Symptoms abated or marked improvement occurred in more than half of the cases and partial recovery was noted in one fourth of them what confirms indications for surgery in these cases.

[Kyphoscoliosis: etiology, pathology, complications and treatment]. / Kifoskolioza: etiologia, patologia, powiklania i leczenie.

On the basis of the literature and authors' own experience etiology, natural history and neurological complications of kyphoscoliosis are presented. Diagnostics and spinal pathology depending on the type of kyphoscoliosis is discussed. Surgical methods of kyphoscoliosis treatment and their role in prevention of neurological complications are reviewed. Their historical evolution is shown. At present, if neurological complications exist, decompression of the spinal cord and stabilization of the spine is recommended.

[Degenerative spondylolisthesis]. / Kregozmyk zwyrodnieniowy.

Results of surgical treatment for degenerative spondylolisthesis in 31 patients are presented. Disabling lumbar and radicular pain not responding to conservative treatment was the indication for surgery in all cases. Twenty-six patients underwent neural decompression and segmental fusion; in 5 patients with no radicular symptoms fusion alone has been performed. In 15 patients with partially preserved intervertebral disc the fusion embraced the pedicle and processus transversus, in other 15 with damaged disc posterior fusion was done and in one case intervertebral fusion was performed. In 7 cases of posterior fusion a wire loop was used for internal stabilization of vertebrae. There were 28 good and fair results (91%) and in 3 patients no improvement was attained. The authors conclude surgical treatment according to the indications presented in this paper is the most beneficial mode of treatment for degenerative spondylolisthesis.

[The author's principles for treating small angle scoliosis in view of current concepts about scoliosis etiology and pathogenesis]. / Wlasne zasady leczenia skolioz niskostopniowych w swietle wspólczesnych pogladów na etiologie i patogeneze powstawania skolioz.

Hypothetical assumption, based on phylogenetic, anatomical and epidemiological studies as well as on clinical findings led the author to the conclusion, that regardless of an etiologic factor and the duration of its action the chief determinant for preserving the curve is the contracture of the short muscles and ligaments of the spine backed by scoliosis action of the long spinal muscles. Taking this into consideration the author has developed a method for small angle scolioses treatment by means of gravitational counteraction and removal of mainly ligamentous contracture of the spine. That can be accomplished by flexion-rotation exercises supplemented by "segmental gymnastics". The principles are validated by 30 years of clinical experience and advantageous results.

[Two cases of coexisting dysplasia fibrosa and mesenchymoma]. / Dwa przypadki równoczesnego wystepowania dysplazji wlóknistej kosci z mezenchymoma.

Two patients with dysplasia fibrosa who also had a tumor of mesenchymal origin are presented. One of them underwent one time resection of dysplasia fibrosa focus and the tumor, the other had the tumor resected 17 years after surgical resection of focus in the femur. The authors suggest an etiologic relationship between these two conditions based on mesenchymal changes--the occurrence never described previously. They also indicate efficacy of surgical treatment.

[Clinical value of the posterolateral approach, supplemented with pedicle excision of the arch, to the anterior wall of the spinal canal within the thoracolumbar (Th11-L1) and lumbar spine]. / Wartosc kliniczna dostepu tylno-bocznego, uzupelnionego pedikulotomia luku, do przedniej sciany kanalu w piersiowo-ledzwiowym (Th11-L1) i ledzwiowym odcinku kregoslupa.

UNLABELLED: The author validates clinically his own lateral approach to the lumbosacral (Th11-L1) and lumbar spine. In this approach an enlargement of the intervertebral foramen is achieved by the partial excision of adjacent pedicles or excision of one or several pedicles. The access to the anterior canal wall is gained in this manner. This surgical approach has been used in 48 patients with neurological injury (spinal cord, conus medullaris, cauda equina or the roots). An active tuberculosis was the causative factor in 12 cases, the sequelae of tuberculous infection in 10 cases, infection in one case, degenerative disc disease in 12 cases, osteochondrosis in 2 cases, nucleus pulposus prolapse into the root canal in 3 cases, developmental defect of the vertebrae in 2 cases, primary or metastatic tumors in 6 cases. These conditions resulted in plegia (3 cases), spastic paresis (3 cases), caudal paresis (5 cases), root paresis (12 cases) and root syndrome (24 cases). This approach provided possibility to recognize the pathology accurately and decompress the roots. Neurological results achieved were most advantageous since in 41 cases neurological symptoms subsided entirely, in 2 cases an improvement was noted, in 2 cases partial improvement and no improvement occurred in 3 cases only. IN CONCLUSION: this approach offers good visualization of the anterior part of the spinal canal and allows for efficient decompression rendering good clinical results.

[Complications of vertebral disc and spinal diseases after manipulation therapy]. / Powiklania choroby dyskowej i chorób kregoslupa po zabiegach kregarskich.

Complications caused by manipulation therapy in 3 cases of spine condition and 22 cases of vertebral disc disease observed in relatively short period of time are presented. In the first instance the patients were not diagnosed by physician. In the second one in all cases the nucleus pulposus protruded under the anterior ligament or into the spinal canal. It resulted in marked worsening of the patient's condition. The mechanism of disc damage has been determined intraoperatively. The authors conclude that manual therapy not preceded by precise diagnosis is highly hazardous.