[Orthopedic surgery methods for the alleviation of pain].
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Biomedical subjects
Publications and source records attributed to F Brussatis.
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A computer-controlled electromyography (EMG) System has been developed for the kinesiologic examination of orthopedic patients. A major objective in the design of the system was its convenient operation in the daily clinical routine. The EMG signals are transduced by specially constructed electrode-preamplifier units and filtered and further amplified in a cable distribution box fixed to the subject's belt or back. The amplified signals are transmitted to the stationary signal conditioning, display, and recording units by an easily tractable trailing cable guided in a ceiling rail. The test gait sequence is performed on a level walkway 14 m in length. A functional partition into periodically recurring gait is achieved either by foot-floor contact sensors or by optional goniometric measurements in the lower extremity. Patient safety is provided by an opto-coupling interface. The EMG signals are displayed on specially constructed large screen oscilloscopes for convenient real-time monitoring by the examiner. An analog recording is carried out by a multi-channel strip chart recorder. The digital recording and processing of the EMG signals and the control of the analog recording unit are implemented by an on-line system. This paper describes the main constructional features of the system and its components, discusses the basic problems involved in the digital recording and processing of EMG signals, and gives an outline of the digital processing mode employed so far in our electromyographical examination of orthopedic patients with various gait disorders.
A measuring carriage system has been developed in our biomedical motion-analysis laboratory for the continuous optoelectronic measurement of angular coordinates or point coordinates in the sagittal plane of a walking patient. The carriage is automatically driven on a guide rail in parallel with the advancing test subject along a level walkway 14 m in length. The carriage propulsion is effected by a servomotor which is controlled by an object-tracking optoelectronic position-feedback control system. The paper describes the constructional principles of the system and gives a basic analysis of its feedback-control behavior.
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The article describes a few guiding points for indicating the need for a knee-joint endoprosthesis, basing on experience with 253 cases, followed up for 2--48 months. Following the application of prostheses according to Walldius-Debeyre and Guepar, several complications were seen which we tried to reduce by introducing four prostheses of different sizes, since the choice of the implantates could be adapted to the prevailing anatomical conditions. A hinged-joint prosthesis of the St. George type is indicated in cases of most severe axial deviation, severe flexion contraction, extensive loss of bone substance, and instability of the ligaments. Sheeban's prosthesis is indicated in severe damage involving both compartments, limited frontal axial deviation, and flexion contraction of not more than 25 degrees with intact lateral ligaments. In younger patients with rheumatoid arthritis we implant the Geomedic prosthesis. If only one knee-joint compartment is involved, and after the possibility of readjustment osteotomy has been excluded, we consider a sliding prosthesis to be the prosthesis of choice.
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In case ischias-type pain persists or recurs following surgical removal of lumbar disk prolapses, it will be necessary to carefully weigh against one another as possible causes: disk prolapse recidivation, epidural or intradural cicatrization, and pseudoradicular pain in myotendinoses. Postoperative diskitis or spondylitis must also be considered as a possible cause.
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Report on a case, wrongly interpreted for a long time. The diagnostic difficulties in a slowly developing spinal cord syndrome in Paget's disease are discussed. The cord may be damaged in this disease in various ways. Here it was increasing mechanical compression by bone bulging into the spinal canal. Decompression laminectomy gives usually good results provided it is done early enough.
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