Objective To analyze the influence of the Risser sign on the sagittal compensatory mode of the spine in idiopathic thoracic scoliosis after anterior spinal fusion.Methods Between June 2002 and November 2006,43 adolescent idiopathic scoliosis(AIS)patients(Lenke 1)undergone anterior correction with a minimum 2 years follow-up were included in this study.The patients were divided into three groups according to the Risser sign:group A(Risser 0),group B(Risser 1-3),and group C(Risser 4-5).The preoperative,postoperative and follow-up sagittal profile were evaluated by the following radiological parameters measured on the lateral radiograph,including the thoracic kyphosis,the lumbar lordosis,the thoracolumbar junction kyphosis,the distal junctional kyphosis,and the sagittal vertical axis.Results In group A,the thoracolumbar junction kyphosis significantly changed from-1.7° preoperative to 6.6° at the final follow-up,with an average increase of 8.3°.Similarly,in group B,the thoracolumbar junction kyphosis changed from -7.3° before surgery to 0.6° at the final follow-up,with an average variation of 7.9°.No obvious change of the thoracolumbar junction kyphosis was observed in group C.At the final follow-up,the average thoracic kyphosis in three groups was 21.2°,18.4° and 14.7°,respectively.No significance of the variation of the thoracic kyphosis was observed in the three groups,however,in group A and B,the thoracic kyphosis showed an ascending trend during the follow-up without significant statistical difference,in addition; the ratio of the thoracic kyphosis increased in group A was higher compared with group B and C.Conclusion For AIS patients with low Risser sign,the increased thoracic kyphosis,and the thoracolumbar junction kyphosis may be ascribed to the decompensation of thoracolumbar region caused by the reconstruction of sagittal alignment due to the continued growth of posterior elements of the thoracic spine.

OBJECTIVE: To explore the clinical effects of using custom-made tumor prosthesis replacement to treat malignant tumor located in the distal femur or proximal tibia. METHODS: A retrospective study of 29 cases malignant tumors around knee treated surgically from June 2001 to October 2008. In the study there were 19 males and 10 females, aging from 17 to 65 years, with an average of 38.5 years. The location of tumors was at distal femur in 22 cases and 7 cases at proximal tibia. After the tumor was extensively resected or radically resected, custom-made tumor prosthesis replacement was performed for reconstruction, simultaneously, neoadjuvant chemotherapy and radioactive-therapy were used in treating the tumor according the pathology. RESULTS: All patients were followed-up for 18-84 months, with average follow-up period of 54.2 months. The 3 year survival rate was 79.8%, and the 5 year survival rate was 63%. As for the complications, prosthesis breakage occurred in 2 patients, aseptic loosening in 1 patients, 2 had a recurrence of the soft tissue tumor for which the diseased limb amputation was performed. The mean MSTS score showed excellent limb function in 15 patients, good in 8 patients, fair in 5 patients and poor in 1 patient. The overall excellent and good function was obtained in 79% of the patients. No superficial or deep infection occurred. Two patients suffered common peroneal nerve injury, but were cured by symptomatic treatments. CONCLUSION: Application of tumor prosthesis can give a satisfactory functional outcome, which is an effect method in limb salvage treatment of malignant tumor around the knee.