Hybrid Lumbar Fusion: A clinical and radiological review at 2 years

We report on our first 20 patients treated with hybrid lower lumbar stabilization, in which one or more segments were treated with caged interbody fusion by PLIF technique and one or more adjacent segments were stabilized using GRAF instrumentation.

The indications for interbody fusion included spondylolysis; previous failed disc surgery, and primary discopathy with positive discography and/or active modic signal on MRI.

The indication for flexible stabilization of adjacent segments was for disc degeneration on MRI scanning with or without evidence of posterior annular tear.

This was a prospective study with clinical evaluation using VAS pain scales and Oswestry disability score. All patients were reviewed by an independent consultant radiologist to assess integrity of the implant after two years and underwent CT scanning to assess progression of the caged fusion. There were no instances of failed fusion in this group and no cases of implant failure.

Myositis Ossificans of the Hand

Extraskeletal ossification may occur in muscle and other soft tissue, The phenomenon may be classified as follows: (1) progressive Myositis ossificans, (2) traumatic localized Myositis ossificans, and (3) nontraumatic localized Myositis ossificans. The literature suggests that 75% of the localized forms occur as a result of trauma. We report a case of non traumatic myositis ossificans which involved the hypothenar region of the hand.