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Choosing the right operation for metastatic spinal tumours is often difficult, and depends on many factors, including life expectancy and the balance of the risk of surgery against the likelihood of improving quality of life. Several prognostic scores have been devised to help the clinician decide the most appropriate course of action, but there still remains controversy over how to choose the best option; more often the decision is influenced by habit, belief and subjective experience. The purpose of this article is to review the present systems available for classifying spinal metastases, how these classifications can be used to help surgical planning, discuss surgical outcomes, and make suggestions for future research. It is important for spinal surgeons to reach a consensus regarding the classification of spinal metastases and surgical strategies. The authors of this article constitute the Global Spine Tumour Study Group: an international group of spinal surgeons who are dedicated to studying the techniques and outcomes of surgery for spinal tumours, to build on the existing evidence base for the surgical treatment of spinal tumours. [ABSTRACT FROM AUTHOR]

In the study of pathophysiological mechanisms in growth abnormalities of the juvenile knee in arthritis an animal model in dogs was developed. Arthritis was induced by intra-articular injections of Carrageenan. Prominent growth changes were enlargement of the distal femoral epiphysis, patellar squaring and decreased endochondral and appositional growth of the distal femur. Generalized osteoporosis of the arthritic limb was present. The induced growth disturbances bear resemblance to the growth abnormalities in juvenile chronic arthritis and hemophilic arthropathy of the knee. [ABSTRACT FROM AUTHOR]

Tissue blood flow was measured by the tracer microsphere technique in the juxta-articular bones of the immature knee, knec joint capsule and skeletal muscles of the hind limbs after unilateral bone cannulation of the distal femoral epiphysis, surgical exploration of the popliteal vessels and unilateral isolated increase of venous outlet resistance in the distal femoral epiphysis during Halothane anaesthesia. Pressure registration was performed in a liquid-filled electromanometric pressure recording system. Significant regional differences in bone blood flow was found within the different bone compartments of both control and test limb. Bone cannulation resulted in insignificant hyperaemia in the distal femoral epiphysis. No changes of distribution pattern of bone blood flow followed the surgical procedure. Ligation of the medial genicular vein caused a three fold increase of venous outlet resistance measured after 5 min, while an insignificant decrease of arterial inlet resistance was calculated. After one hour a significant decrease of both arterial inlet resistance and venous outlet resistance was found. In addition evidence of a veno-arterial reflex mechanism causing a significant unilateral decrease of distal skeletal muscle blood flow was found. The results demonstrate the presence of both venous and arterial regulation, predominantly metabolic, of bone blood flow in the knee. [ABSTRACT FROM AUTHOR]