Introduction Crankshaft phenomenon is determined as a loss of three-dimensional correction of the scoliosis curve, which occurs after posterior fusion in children who have not completely finished skeletal growth. Dubousset named this phenomenon when he noticed that the entire spine and torso gradually turn and deform anterior spine, which continues to grow and rake around the axis of the fusion mass. This is mostly seen in infantile and juvenile idiopathic scoliosis, however this also occur in adolescents who are immature at the time of the last fusion. Aim To analyze this phenomenon in adolescents who have not finished skeletal growth and were operated for idiopathic scoliosis. Material and Methods This retrospective–prospective study analyzed 48 randomly selected adolescents operated for idiopathic scoliosis in Clinic for Orthopaedic and Traumatology in Tuzla between 1996 and 2011. Patients operated only with a posterior stabilization and fusion were divided into two groups. One group consisted of adolescents with intensive growth (12 years for girls and 14 years for boys) and another group consisted of adolescents at final stage of skeletal growth (14 years for girls and 16 years for boys). We measured Cobb angle at standard X-rays performed in an upright posture immediately after the surgery and at the latest X-rays done at the end of skeletal growth at the age of 18 years. Results Increasing Cobb angle was noted in 53% of studied patients. In group A higher values of Cobb angle noted in 69.56% examinees and in 36% in group B. When we analyzed both groups Cobb angle increased from preoperative 19.6 degrees to postoperative 22 degrees (2.4 degrees—12.2%) (r = 0.98), In group A preoperative Cobb angle increased from preoperative 20.6% degrees to postoperative 24 degrees (3.4 degrees—16.22%) (r = 0.97), while in group B from 18.60 to 20 degrees (1.4 degrees—7.52%) (r = 0.98). Conclusion Postoperative deformity progression of anterior column in adolescents operated for idiopathic scoliosis could be seen even if the stable fusion achieved. The risk for progression is higher in younger patients.

Abstract OBJECTIVE: Anomalies of vertebrobasilar vessels arise as early embryonal developmental deteriorations. The majority of them concern the position, origin and shape of the basilar artery. Therefore the present study was carried out to find out the variations in position and shape of the basilar artery using Magnetic Resonance Imaging and CT Angiography. MATHERIAL AND METHODS: The study included 130 consecutive patients, adults of both sexes, treated in UKC Tuzla. Patients were divided into two groups. In one group (100) were patients without aneurysm in the vertebrobasilar tree, and in the second group (30) patients with aneurysm. RESULTS: Three types of variations in the shape of basilar artery were recorded: those with arched course, S-shaped course, and the straight course type. All the three types are approximately of the same percentage prevalence in the group of subjects without aneurysm in the vertebral-basilar tree, as well as in the group with aneurysm. Basilar artery at 89.33% of respondents was located in medial or in paramedial position. CONCLUSION: Attention is drawn to the practical importance of such variations as a possible source of diagnostic errors during cerebral arteriography. We highlight the morphological aspects of the basilar artery, the knowledge of which would help neurosurgeons safely diagnose, as well as plan and execute vascular bypass and shunting procedures for the treatment of stenosis, aneurysms and arteriovenous malformations.

ABSTRACT Introduction: The morphological anatomy of the posterior circulation is very complex and variable. Aims of this research were to document the morphological anatomy of the posterior circulation along with variations in the Bosnian population, in patients with or without aneurysm. Measurements of the outer diameters of the vertebral artery, basilar artery and posterior cerebral artery were taken. The second aim was to determine the possible relationship between diameters of the area with subsequent aneurysm formation. Material and Methods: The study involved 60 consecutive patients, adults of both sexes, treated in the UKC Tuzla.The patients were divided into two groups. One group consisted of the patients without aneurysm of basilar artery, and the other group of patients with aneurysm. All the 60 patients were treated by means of MRI angiography. Results: The mean diameter of the vertebral artery was 2,43 mm; 3.61 mm on the right and 2,83 mm; 3,94 mm on the left. The diameter of the basilar artery varied from 3, 8 mm; 3, 43 mm. The diameter of the posterior cerebral arteries 2, 5 mm; 2,52 mm on the right and 2,46 mm; 2,62 mm on the left. Conclusions: We have documented the various morphometry variations as well as the differences of the anatomy in this area in Bosnian population as compared to the medicine literature.

Objective. To describe the intrahepatic bile duct transposition (anatomical variation occurring in intrahepatic ducts) and to determine the frequency of this variation. Material and Methods. The researches were performed randomly on 100 livers of adults, both sexes. Main research methods were anatomical macrodissection. As a criterion for determination of variations in some parts of bile tree, we used the classification of Segmentatio hepatis according to Couinaud (1957) according to Terminologia Anatomica, Thieme Stuugart: Federative Committee on Anatomical Terminology, 1988. Results. Intrahepatic transposition of bile ducts was found in two cases (2%), out of total examined cases (100): right-left transposition (right segmental bile duct, originating from the segment VIII, joins the left liver duct-ductus hepaticus sinister) and left-right intrahepatic transposition (left segmental bile duct originating from the segment IV ends in right liver duct-ductus hepaticus dexter). Conclusion. Safety and success in liver transplantation to great extent depends on knowledge of anatomy and some common embryological anomalies in bile tree. Variations in bile tree were found in 24–43% of cases, out of which 1–22% are the variations of intrahepatic bile ducts. Therefore, good knowledge on ductal anatomy enables good planning, safe performance of therapeutic and operative procedures, and decreases the risk of intraoperative and postoperative complications.