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Biomedical subjects

D Stoltze

Publications and source records attributed to D Stoltze.

17 recordsLinked to original sources

[Correction of posttraumatic deformities. Principles and methods].

The reason for inadequate results after the treatment of spinal lesions may be due to the misinterpretation of the type of lesion thus leading to incorrect therapy. Frequently the bio-functional construction principles of the spine are ignored and biomechanically based reconstruction of the spine is not done. Unsuitable approaches and fusion techniques may result in insufficient stabilisation with predictable failure. In both the first surgery and the salvage procedure, the principles of the load-sharing system as well as the posterior tension band principle must be respected. These principles and the surgery techniques are demonstrated in individual examples. Special attention is drawn to the impact of segmental deformities on the general statics of the spine. Frequently, residual deformities with the typical clinical picture lead to decompensation and the reduction of efficiency only after ten to fifteen years.

Adolescent↗

[The radiotherapy of heterotopic ossifications in paraplegics. The preliminary results].

BACKGROUND/AIM: Mobilisation of patients with paraplegia is frequently associated with acute inflammatory processes of soft tissues and muscles in the neighbourhood of joints, where subsequently heterotopic bone formation develops. Rehabilitation is then seriously compromised. For this clinical situation, no local therapeutic options exist so far except extensive resection. To evaluate if radiotherapy early in the course of the disease prevents heterotopic bone formation or if--in case of already manifest ossification and consecutive resection--recurrence can be avoided. PATIENTS AND METHODS: In 20 patients with paralysis, 25 regions were irradiated with (mostly) 10 Gy in single fractions of 2 to 2.5 Gy using 8 MV photons. In 15 patients radiotherapy was performed as a primary treatment in the status of myositis; 7 patients were treated after (subtotal) resection of already manifest ossifications (2 patients were treated twice, primarily and postoperatively). RESULTS: In a minimum follow-up of 12 weeks, none of the 20 irradiated patients showed any progression of the developing or already manifest ossification; thus mobilisation and rehabilitation could be carried out as desired. No side effects occurred. CONCLUSION: The preliminary results of the present study suggest that radiotherapy is an effective local treatment with minimal side effects for the prevention of heterotopic bone formation in patients with paraplegia. Treatment should be started early in the course of the disease. Further evaluation in a prospective study seems desirable.

Adult↗

[High-grade transverse syndrome caused by echinococcus cysts].

In this report we present the case of a 16-year-old patient, born in Macedonia, who complained of abdominal and back pain and developed paraparesis. On admission to hospital, he showed a paraplegic syndrome, the level of sensation being T7, together with high-grade paraparesis of the lower extremities and spasticity and urinary incontinence. The protein content of the CSF was raised to 183 mg/dl. CT and MRI of the thoracic spine showed cystic lesions at the level of the 6th and 7th thoracic vertebrae, in the paravertebral area and in the 7th rib on both sides. The antibody titer of Echinococcus in the serum was positive. To treat this problem, corporectomy of the 6th to 8th thoracic vertebrae was performed, the area being bridged by a corticospongoid pelvic bone graft and with instrumental support of the 5th to 9th thoracic vertebrae. Histological examination revealed multilocular Echinococcus lesions. Under long-term treatment with mebendazole, the neurological deficits decreased in the postoperative phase.

Adolescent↗

[Computer tomography for rare soft tissue tumours of the extremities (author's transl)].

Five patients with undiagnosed soft tissue masses in the extremities were examined and in two a pathological diagnosis could be made. One was an extensive, invasive fibroma (desmoid) 22 cm long which could be followed from the thigh almost into the pelvis. It was sharply demarkated form the surrounding muscles and of higher density. The second case was a 12 cm long cavernous haemangioma in the semi-membranosus muscle. This was originally hypo-dense, but showed marked increase in its density after the administration of contrast.

Adolescent↗