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  • 1
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    German Medical Science; Düsseldorf, Köln
    In:  68. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 90. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 45. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20041019-20041023; Berlin; DOC04dguE6-1604 /20041019/
    Publication Date: 2004-10-20
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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    German Medical Science; Düsseldorf, Köln
    In:  67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 44. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20031111-20031116; Berlin; DOC03dguO21-2 /20031111/
    Publication Date: 2003-11-11
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 44. Tagung des Berufsverbandes der Fachärzte für Orthopädie; 20031111-20031116; Berlin; DOC03dguO8-4 /20031111/
    Publication Date: 2003-11-11
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
    ISSN: 0942-0940
    Keywords: Spinal cord compression ; metastatic tumour ; operation ; operative stabilization ; results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Fourty-three cases with metastatic spinal cord compression were reviewed post-operatively to clarify the usefulness of the procedures concerning restoration of neurological function, and pain relief. Only patients with pathological spinal instability and neurological sequelae were included. Posterior decompression and stabilization was performed in all but six patients. All but four patients (91%) reported decrease of pain symptoms. Amelioration of neurological function was achieved in 58%. Re-establishment of walking ability was obtained in 57%. Post-surgery life expectancy averaged 11 months. In patients with widespread metastatic disease and/or multi-level instability of the spine restriction to palliative dorsal procedures is sensible. Post-operative ancillary treatment is necessary.
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  • 5
    ISSN: 1437-2320
    Keywords: Anterior instrumentation ; CDH ; CDI ; Operative therapy ; Spondylodiscitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In a study the results recorded in 34 surgically treated patients with specific or unspecific spondylodiscitis after dorsoventral one-stage instrumentation with CDI and anterior grafting (group 1) were compared with those obtained in a group of 38 patients treated with anterior CDH instrumentation in combination with anterior grafting (group 2). The mean observation periods were 48.4 (19–82) months in group 1 and 29.0 (8–54) months in group 2. In both groups the infection healed after fusion without a secondary operation. In group 1 the mean values for blood loss, operating time, length of hospital stay and fusion length (3.5 segments) were significant higher than those in group 2; in particular, the fusion length was shorter (1.3 segments) in group 2. Only 8 patients in group 1 were treated with postoperative external support. The mean preoperative segmental angle of 18.2° (group 1) was corrected by a mean of 11.9°, and the reposition loss during follow-up amounted to an average of 2.7°. Group 2 showed a mean preoperative segmental deformity angle of 13.4°, which was corrected by 11.6°, and the loss of reposition was 2.9° on average. Even in florid spondylodiscitis a short-range anterior fusion of the affected spinal segment can be performed with a primarystable implant, avoiding a second operation without an increased risk of infection-related dislocation. In the authors' own experience a secondary dorsal operation can be avoided except in the case segment L-5/S-1, the fast mobilization without external support allows a up-to-date treatment in this severe spinal disease.
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Neurosurgical review 22 (1999), S. 102-106 
    ISSN: 1437-2320
    Keywords: Key words Lumbar spinal stenosis ; Long-term results ; Decompression ; Instrumented fusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of the study was to evaluate the long-term outcome of various surgical procedures for lumbar spinal stenosis. Operations were performed on 117 consecutive patients for lumbar spinal stenosis between 1987 and 1992. Pre- and intraoperative data were recorded in a standardized manner. Three treatment groups were distinguished: group I consisting of 39 patients submitted to undercutting decompression; group II, 51 patients, submitted to laminectomy and foraminal decompression alone; and group III, 27 patients, who underwent foraminal decompression and laminectomy with instrumented fusion. Eight years (5–10 years) after surgery a questionnaire was mailed to the patients containing the outcome scales according to Greenough and Fraser [6] and Turner et al. [22] together with questions about residual pain, necessity of treatment and satisfaction with the operative outcome. A total of 72 questionnaires (61.6%) gave enough information for analysis. After a mean follow-up of 8 years, walking capacity had increased significantly in all groups (P〈0.001). Compared to preoperative values, pain had decreased significantly in all groups (P〈0.01). In group I 36% had good-to-excellent outcomes, and 30.8% and 23.8% in groups II and III (P〉0.05). Forty percent of group I patients were unsatisfied with the result, compared to 38.4% and 33.3% in the other groups (P〉0.05). Overall, 25 of 72 patients (34.7%) had severe constant back and/or leg pain requiring daily administration of analgesics. We conclude that the long-term outcome of decompressive surgery of the lumbar spinal canal, without and with instrumented fusion, is less favourable than was previously reported.
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  • 7
    ISSN: 0942-0940
    Keywords: Keywords: Prosthetic lumbar nucleus; artificial disc; biomechanical investigation.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  The aim of this study is to determine the significance of an artificial nucleus implant for lumbar discs (PDN device) with special regard to the biomechanical properties of the spinal motion segment.  From 11 human cadavers the lumbar segment L2/L3 was harvested, the lamina and the muscles were removed with care to preserve the anterior and posterior longitudinal ligaments. The segments were fixed on a special testing device mounted in universal testing machine (Zwick, Ulm-Germany). Physiological load with maximum of 7 Nm was applied in flexion/extension, right and left sidebending and right and left torsion. The movement of the measuring point (center of L2) was registered along three axes (sagittal, frontal and vertical axis). Three cycles of measurement were performed in all specimens: a) the intact segment, b) segment after nucleotomy, c) segment with 2 PDN devices.  There was a statisticaly significant (p〈0.05) increase in segmental mobility in all directions after nucleotomy with an increased mobility of the segment between 38 and 100 percent.  After introduction of two PDN implants there was a restoration of segmental mobility for all movement-directions with no statistically significant difference compared with the intact situation before nucleotomy.
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  • 8
    ISSN: 1432-5195
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Le but de cette étude est d’évaluer les effects des ondes de choc de basse énergie sur les douleurs persistantes de l’épiconcyle afin de préciser leur utilisation en orthopédie. On a divisé 50 patients en deux groupes selon le nombre des ondes de choc appliquées. Le groupe n° I qui a re*u trois fois 100 impulsions à 0.08 mJ/mm 2 montrait significativement des meilleurs résultats après trois et douze semaines que le groupe n° II qui a re*u trois fois 10 impulsions à 0.08 mJ/mm 2 . Globalement nous avons trouvés des résultats bons et excellents chez 56% des patients du groupe n° I comparé avec 20% chez des patients du groupe n° II.
    Notes: Summary. Fifty patients who suffered from persistent tennis elbow for more than 12 months, and were referred for surgical treatment, were assigned at random to 2 groups of low-energy extracorporal shock wave therapy. Group I received a total of 3000 impulses of 0.08 mJ/mm 2 ; group II (controls) 30 impulses of 0.08 mJ/mm 2 . Follow up was after 3 and 12 weeks. We found no significant differences between the 2 groups before treatment, there was but significant relief of pain and improvement of function in group I with good or excellent outcome in 56% at the last evaluation.
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  • 9
    ISSN: 1432-2129
    Keywords: Schlüsselwörter Extrakorporale Stoßwellentherapie ; Epicondylopathia humeri radialis ; Key words Extracorporal shock-wave application ; Tendopathy ; Lateral elbow ; Review of literature
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Aim: This review article focuses on a possible pain-alleviating effect of shock-wave application in persistent lateral epicondylopathy of the elbow and compares the effects with data on other non-operative and operative procedures. Methods: Patients who suffered from chronic tennis elbow for more than 12 months and were therefore referred for a surgical procedure were assigned at random to two groups of low-energy shock-wave therapy. Group I received a total of 3000 (3×1000) impulses of 0.08 mJ/mm2, while group II (control group) received a total of 30 (3×10) impulses of 0.08 mJ/mm2. Follow-up examinations were carried out after 3, 6, and 24 and 52 weeks. Results: There was a significant improvement of pain and function in group I, with a good or excellent outcome in 52% of cases compared to 6% in group II at the last evaluation. Conclusion: Extracorporeal shock-wave application has a dose-dependent pain-relieving effect on chronic tendopathy of the lateral elbow.
    Notes: Zusammenfassung Fragestellung: Seit Beginn der 90er Jahre wurde in der Orthopädischen Universitätsklinik Mainz überprüft, bei welchen Krankheitsbildern die niederenergetische extrakorporale Stoßwellentherapie sinnvoll eingesetzt werden kann. Methode: In einer prospektiv-randomierten Studie wurde die Wirksamkeit der 3maligen Applikation von 1000 vs. 10 Impulsen niedriger Energieflußdichte bei chronischer Epicondylopathia humeri radialis überprüft. Ergebnisse: Sehr gute oder gute Ergebnisse lagen nach einem Follow-up von 12 Monaten bei 26 von 50 Patienten der Behandlungsgruppe vor, aber lediglich bei 3 der Kontrollgruppe. Schlußfolgerungen: Zusammenfassend läßt sich sagen, daß die Methode bei entsprechender restriktiver Indikationsstellung aus der klinischen Erprobung in den Praxisalltag entlassen werden kann.
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    European spine journal 3 (1994), S. 214-218 
    ISSN: 1432-0932
    Keywords: Discogenic paresis ; Lumbar discectomy ; Prognostic criteria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This discourse is aimed at elucidating prognostic criteria for the assessment of the course of a paresis in the case of lumbar disc herniation. Fourhundred and fifty patients were examined who had been operated on for lumbar disc herniation at the Orthopaedic University Clinic Mainz between 1986 and 1991. Of these, 240 showed radicular paralytic symptoms. They were examined prior to the operation, immediately afterwards and 1 year after the operation. The influence of the degree of intensity of the paresis, the time elapsed since the occurrence and other factors like nerve root affected, intraoperative findings, age, sex and weight of the patient were registered. It is obvious that the degree of intensity of a paresis is a good prognostic criterion for the assessment of the postoperative course. A paresis classified as grade III or IV receded in more than 70% of the cases within 6 months. For a paresis of grade 11, the recovery rate was 40%. In the case of a total paresis, no complete neurological recovery was registered. The period of time which had elapsed since the occurrence of the paresis, the weight of the patient, the nerve root affected and other factors did not show any significant influence. As a criterion for an emergency or postponed operation on a herniated disc, the duration of paralytic symptoms should therefore be attributed less importance than the progression.
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