Secondary curve behaviour in Lenke IC class adolescent idiopathic scoliosis following video assisted thoracoscopic spinal fusion

Introduction. Ideally after selective thoracic fusion for Lenke Class IC (i.e. major thoracic / secondary lumbar) curves, the lumbar spine will spontaneously accommodate to the corrected position of the thoracic curve, thereby achieving a balanced spine, avoiding the need for fusion of lumbar spinal segments1. The purpose of this study was to evaluate the behaviour of the lumbar curve in Lenke IC class adolescent idiopathic scoliosis (AIS) following video-assisted thoracoscopic spinal fusion and instrumentation (VATS) of the major thoracic curve. Methods. A retrospective review of 22 consecutive patients with AIS who underwent VATS by a single surgeon was conducted. The results were compared to published literature examining the behaviour of the secondary lumbar curve where other surgical approaches were employed. Results. Twenty-two patients (all female) with AIS underwent VATS. All major thoracic curves were right convex. The average age at surgery was 14 years (range 10 to 22 years). On average 6.7 levels (6 to 8) were instrumented. The mean follow-up was 25.1 months (6 to 36). The pre-operative major thoracic Cobb angle mean was 53.8° (40° to 75°). The pre-operative secondary lumbar Cobb angle mean was 43.9° (34° to 55°). On bending radiographs, the secondary curve corrected to 11.3° (0° to 35°). The rib hump mean measurement was 15.0° (7° to 21°). At latest follow-up the major thoracic Cobb angle measured on average 27.2° (20° to 41°) (p<0.001 – univariate ANOVA) and the mean secondary lumbar curve was 27.3° (15° to 42°) (p<0.001). This represented an uninstrumented secondary curve correction factor of 37.8%. The mean rib hump measured was 6.5° (2° to 15°) (p<0.001). The results above were comparable to published series when open surgery was performed. Discussion. VATS is an effective method of correcting major thoracic curves with secondary lumbar curves. The behaviour of the secondary lumbar curve is consistent with published series when open surgery, both anterior and posterior, is performed.

Raman and infrared study of phyllosilicates containing heavy metals (Sb, Bi) : bismutoferrite and chapmanite.

The kaolinite-like phyllosilicate minerals bismutoferrite BiFe3+2Si2O8(OH) and chapmanite SbFe3+2Si2O8(OH) have been studied by Raman spectroscopy and complemented with infrared spectra. Tentatively interpreted spectra were related to their molecular structure. The antisymmetric and symmetric stretching vibrations of the Si-O-Si bridges,  SiOSi and  OSiO bending vibrations,  (Si-Oterminal)- stretching vibrations,  OH stretching vibrations of hydroxyl ions, and  OH bending vibrations were attributed to observed bands. Infrared bands 3289-3470 cm-1 and Raman bands 1590-1667 cm-1 were assigned to adsorbed water. O-H...O hydrogen bond lengths were calculated from the Raman and infrared spectra.

The role of secondary values in the selection process in organising

This study develops a model (i.e., secondary values selection process - 2VS) to describe how values shared by individuals (i.e., secondary values) contribute to the creation of meaning and interpretation in organisations. Elements of the model are identified through exploration of two bodies of literature (a) cultural approaches to organisational studies, and (b) theories of evolution. Incorporated within the model are observable elements that support analysis and evaluation of the 2VS. Outcomes of the study are (a) development of a more complete understanding of the Selection Process in organising and (b) creation of a mechanism for cultural analysis of organisational settings.