The treatment of SL, especially in some cases, is mostly surgical. This lesion can be considered an extremely localised kyphosis (only two vertebrae) or a localized (sub-)luxation: at most hearetically pre-operative reduction should represent the first stage of the treatment, also because reduction makes further surgery easier and enables us to obtain the best results. After a glance at the various surgical techniques that have been used in the past, we describe our method of preoperative reduction in case of severe SL, an improvement of Scaglietti's original technique. According to the parameters taken into consideration, spondylolisthesis (SL) of the 4th and, above all, the 5th lumber vertebrae can be considered, especially in severe cases, as kyphosis or displacement (or even dislocation in the case of ptosis). In SL-kyphosis the antero posterior axes of the contiguous vertebral bodies are no longer parallel but tend to over-impose one to the other anteriorly forming an open posterior angle of varying degrees. It is an extremely short kyphosis (only two vertebrae) but from all points of view, even therapeutic, it reflects the characteristics of all types of vertebral kyphosis. SL-subluxation or SL-luxation (ptosis) is characterized by the respectively partial or total loss of normal alignment between the vertebrae involved. This can be explained by the fact that nearly all those who have dealt with the problem of treating SL, especially of L5, always ask themselves beforehand if it is possible and/or opportune to eliminate or improve the condition before surgery. In other words the question of reduction (pre or intraoperative, partial or total) of more or less severe L5 SL is always considered by all authors, even if their conclusions are often in disagreement.

Adolescent↗

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[Our method of treatment of idiopathic scoliosis].

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Adolescent↗

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[A new technic for the stabilization of internal tibial rotatory subluxation].

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Humans↗

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Infection therapy in cementless T.H.A.

Reimplantation (when possible) represents today the method of choice when dealing with and attempting to resolve cases of deep infection in total hip arthroplasty. In recent years we have, however, had the chance to treat some cases of infection in cementless arthroplasty (without loosening) by conservative treatment: surgical debridement and specific antibiotic therapy (2 cases), or medical therapy alone (1 case), both associated with immobilization in a plaster cast for 2-3 weeks. The long-term results proved to be quite encouraging: none of the 3 patients treated conservatively showed (after 5-6 years) clinical-radiographic signs of recurrence of the infection.

Adult↗

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Reimplantation or explantation in the treatment of septic prosthetic loosening.

Indications for the surgical treatment of septic loosening of hip arthroplasty vary depending on different parameters. Explantation is indicated when patients are elderly, in generally poor condition, when there are veterate infections, particularly if these were caused by gram negative bacteria, and when there is severe skeletal injury. Reimplantation is instead indicated in patients whose general conditions are good, and who are young and motivated.

Age Factors↗

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Failed back syndromes: opinions and personal experiences.

The authors consider poor results in lumbar disc surgery to be commonly caused by the following conditions: 1) recurrence of the hernia; 2) postoperative instability; 3) scarring entrapment of the spinal nerve roots; 4) coexisting local or general pathology; 5) arachnoiditis; 6) psychological causes and those where insurance is involved. In particular patients with insurance-related motivations or those affected with depressive syndromes are frequently observed among those submitted to lumbar surgery. The only indications for surgery include recurrence of disc herniation and postoperative instability. In any of the other situations further surgery often results in worsening of the patient's conditions, or it at any rate does not guarantee improvement in the conditions of the patients.

Humans↗

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The surgical treatment of spondylolisthesis.

The authors report the results obtained in 244 patients submitted to anterior interbody fusion. The method involves preoperative reduction in plaster (when necessary) and anterior surgical stabilization, facilitated by improvement in the anatomical and biomechanical conditions obtained with reduction. This method obtained excellent results in 85% of the cases, with fusion and absence of symptoms, and good results in 10% of the cases, with occasional symptoms and/or fibrous. Results were unsatisfactory in 5% of the cases because of residual radiculopathy (4 cases), non-union of the fusion (3 cases), retrograde ejaculation (2 cases), loosening of the graft (1 case) or unthreading of a screw (1 case). It is our opinion that anterior interbody fusion is the best surgical method for the stabilization of Meyerding grades III, IV and V spondylolisthesis. Posterolateral fusion is used to treat some cases with slippage equal to less than 25% (grade I) and cases where more than one level is involved.

Adolescent↗

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Total knee arthroplasty after proximal tibial osteotomy.

The cases of ten total knee arthroplasty after a proximal tibial osteotomy were compared with those of 50 primary total knee arthroplasty for osteoarthritis. The groups were matched according to age of patients, length of follow-up and type of prosthesis used. On the basis of HSS, an excellent or good result was obtained in 90% of patients who had had arthroplasty after osteotomy and in 94% of patients after a primary arthroplasty. Though some intraoperative difficulty may be encountered in a secondary prosthesis, osteotomy does not compromise a subsequent arthroplasty.

Aged↗