An unusual case of congenital scoliosis associated with rib agenesis in the upper part of the concavity treated by VEPTR vertebra to vertebra

Background contextRib agenesis in congenital scoliosis is rarely encountered, and its disposal in the application area of the proximal vertical expandable prosthetic titanium rib (VEPTR) module is a challenge to the orthopedic surgeon.PurposeTo present a case in which known treatment methods in early-onset scoliosis were not possible to apply.Study designCase report.MethodsA patient aged 1 year and 10 months, presenting a congenital scoliosis with the following characteristics: left T3 hemisegmented hemivertebra, T5–T6–T7 hemivertebral segment, T9, T10 trapezoidal vertebrae, right side I–IV rib agenesis with T1–T2–T4 hemivertebral hypoplasia (T3 agenesis) and bilateral XIIth rib agenesis, and V–VI and VII–VIII–IX fused ribs on the right side. We applied a standard VEPTR in a new construct, vertebra to vertebra.ResultsThe VEPTR vertebra to vertebra proved to be an efficient and stabile construct after 1.5 years of follow-up and three device distractions in a row. The curve corrected from 100 to 58 Cobb degrees.ConclusionsWe believe that the vertebra-to-vertebra construct with eventual modifications may be a solution in the treatment of early-onset scoliosis needing surgery, which associate rib agenesis in the area where the proximal module has to be applied.     

Osteogenesis imperfecta: diagnosis and treatment

Osteogenesis imperfecta is a heritable disorder characterized by extremely fragile bones, blue sclerae, dentinogenesis imperfecta, hearing loss, and scoliosis. In 1979, Sillence classified the condition into four types based on genetic and clinical criteria. Three more classifications have subsequently been added. Diagnosis of osteogenesis imperfecta may be done prenatally (in severe cases), clinically, radiographically, or via biochemical or genetic examination. Medical treatment consists of bisphosphonate use, even in patients younger than age 2 years. Surgical treatment consists of internal splinting of long bones. Research is currently being done on the use of smart intramedullary rods (ie, composed of nitinol shape-memory alloy) for correction of bone deformity and on the use of bone marrow transplantation to increase osteoblast density, thereby reducing fracture frequency.     

Determination of methanol concentration by GC-MS in a fatal case poisoning

Due to the consumption of alcoholic beverages with methanol content above the admitted limit, a woman from Bac?u died at the Bac?u County Hospital after 9 hours of hospitalization. MATERIALS AND METHODS: For the toxicological examination blood, liver, bile, stomach, intestine and kidney samples were analyzed in order to establish the concentration of methanol. Determination of methanol was carried out by gas chromatography coupled with mass spectrometry (GC-MS), analyzing the distillates obtained from blood and organs. We used an Agilent Technologies 7890 A gas chromatograph coupled to an Agilent Technologies 7683 C spectrometer. Helium was employed as mobile phase and a Phenomenex Zebron ZW-Plus polar column represented the stationary phase. Spectra acquisition mode: SIM, mass range followed: 15-500 atomic mass units, interpretation of the obtained results: Agilent Technologies ChemStation software. RESULTS: After peak integration on the chromatograms, the following values of methanol concentration were obtained: 1.720 g per thousand in blood, 0.795 g per thousand in liver, 2.661 g per thousand in bile, 2.287 g per thousand in stomach, 1.639 g per thousand in intestine and 1.590 g per thousand in kidney; the results have proved a large quantity of ingested methanol. They have also highlighted the absorption and distribution pattern of the methanol within the body.