Relationship between the spino-pelvic parameters and the slip grade in isthmic spondylolisthesis

Purpose of the study Analysis of changes in the spino-pelvic alignment, depending on the slip grade in patients with low and high-grade isthmic slip. Materials and methods A group of 60 patients who had lumbar spine radiograms adequate to measure the spino-pelvic parameters selected from a series of 195 cases of isthmic spondylolisthesis. We analyzed the following spino-pelvic parameters: pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbosacral angle by Dubousset (LSA) and lumbar lordosis (LL). The ANOVA statistical test was used to examine whether there is a significant correlation between (1) the slip grade and the value of PI, PT, and LL, and the Pearson correlation was used to examine a correlation between (2) the size of PI and the value of other spino-pelvic parameters, (3) the value of LL and SS, (4) value of the LSA and LL, PI and PT. Results The greater the slip grade, the greater the value of PI, PT, and LL and lower LSA. Positive correlations have been found between PI and SS, PT and LL. There was also a positive correlation between LL and SS. Negative correlations were noted between LSA and LL, PI and PT. Conclusion The spino-pelvic alignment changes with the grade of isthmic spondylolisthesis, and the individual spino-pelvic parameters correlate together to form a causal chain in the development of isthmic spondylolisthesis

Companies regulatory liabilities resulting from workers employment and selected methods of their optimisation on the example of the Alfa company

Dokonano prezentacji poziomu oraz struktury zobowiązań publicznoprawnych firmy Alfa z tytułu zatrudnienia pracowników. Ukazano możliwości kształtowania tych zobowiązań celem ich optymalizacji.Tax and other regulatory burdens are a significant cost element in each company. In this situation managers natural react is to look for solutions allowing for legal decrease in the level of these burdens. Optimisation process of regulatory liabilities includes planning heading for decline of a liability level or time shift of payment moment. Management influences also on decrease in administration input connected with tax and tax-like settlements. Analyses carried out proved that regulatory liabilities have not only imposed endogenous value conditioned by company surrounding. Managers have possibilities to form value of these liabilities through skilful planning. However it needs knowledge on connections between particular economic events and laws on taxes included in appropriate law and regulations. A tax payer must analyse if particular solution is not possible to question by a responsible tax or insurance entity

The assessment of the usefulness of the i/t curve in the diagnosis of the carpal tunnel syndrome

Wyznaczanie krzywej i/t jest badaniem elektrodiagnostycznym pozwalającym ocenić stopień uszkodzenia nerwu obwodowego. Do badania stosuje się prąd stały o impulsach prostokątnych i trójkątnych. Czas trwania impulsów wynosi zazwyczaj 1000 ms. W pracy zbadano 88 chorych (70 kobiet i 18 mężczyzn) leczonych z powodu zespołu kanału nadgarstka (ZKN) w poradni przyszpitalnej i na oddziale neurochirurgicznym. U 19 chorych objawy miały charakter obustronny, tak więc łączna ilość wszystkich zbadanych przypadków wyniosła 107. Wiek chorych wyniósł średnio 54,4 lat. Ciężkość ZKN oceniono przy pomocy badania elektrodiagnostycznego. Grupa kontrolna obejmowała 31 osób: 15 kobiet i 16 mężczyzn, średnia wieku 23 lata, u których na podstawie badania klinicznego nie stwierdzono zaburzeń w funkcji nerwu pośrodkowego (objawów charakterystycznych dla ZKN). Krzywa i/t nie jest wystarczająco czułym i specyficznym badaniem, które może być wykorzystywane w diagnostyce pacjentów z ZKN. Nie występują istotne statystycznie różnice w kształcie krzywej w poszczególnych stopniach ciężkości ZKN oraz w grupie pacjentów zdrowych. Natomiast jakościowa ocena wartości progowej akomodacji oraz współczynnika akomodacji może posłużyć do różnicowania pacjentów z ciężkim nasileniem zespołu.Determination of the i/t curve is an electrodiagnostics method enabling diagnosis of the lesion of peripheral nerves. The method utilizes triangularly and rectangularly shaped direct current impulses, usually 1000 ms. In this study 88 patients were tested (70 women and 18 men) who were being treated due to carpal tunnel syndrome CTS at a hospital clinic and a neurosurgical ward. In 19 patients the symptoms were bilateral, hence the combined number of all tested cases was 107. The age of the patients was from 25 to 81, with the average equal 55. The severity of CTS was evaluated by means of electrodiagnostic testing. The control group included 31 persons: 15 females and 16 males (average 23 years), with no disorders of the function of the median nerve. It was stated that the i/t curve is not sufficiently sensitive and specific examination for the diagnosis of carpal tunnel syndrome. However, the qualitative assessment: threshold value of accommodation and accommodation coefficient can be used to differentiate the patients with severe carpal tunnel syndrome

Minimally invasive spine stabilisation with long implants

Originally aimed at treating degenerative syndromes of the lumbar spine, percutaneous minimally invasive posterior fixation is nowadays even more frequently used to treat some thoracolumbar fractures. According to the modern principles of saving segment of motion, a short implant (one level above and one level below the injured vertebra) is generally used to stabilise the injured spine. Although the authors generally use a short percutaneous fixation in treating thoracolumbar fractures with good results, they observed some cases in which the high fragmentation of the vertebral body and the presence of other associated diseases (co-morbidities) did not recommend the use of a short construct. The authors identified nine cases, in which a long implant (two levels above and two levels below the injured vertebra) was performed by a percutaneous minimally invasive approach. Seven patients (five males/two females) were affected by thoracolumbar fractures. T12 vertebra was involved in three cases, L1 in two cases, T10 and L2 in one case, respectively. Two fractures were classified as type A 3.1, two as A 3.2, two as A 3.3 and one as B 2.3, according to Magerl. In the present series, there were also two patients affected by a severe osteolysis of the spine (T9 and T12) due to tumoral localisation. All patients operated on with long instrumentation had a good outcome with prompt and uneventful clinical recovery. At the 1-year follow-up, all patients except one, who died 11 months after the operation, did not show any radiologic signs of mobilisation or failure of the implant. Based on the results of the present series, the long percutaneous fixation seems to represent an effective and safe system to treat particular cases of vertebral lesions. In conclusion, the authors believe that a long implant might be an alternative surgical method compared to more aggressive or demanding procedures, which in a few patients could represent an overtreatment