Biomedical subjects

H Zippel

Publications and source records attributed to H Zippel.

78 records · Page 5Linked to original sources

PubMedDate not supplied

[Surgical treatment of infantile and juvenile scoliosis--a retrospective analysis of 21 patients].

PROBLEM: We carried out a retrospective analysis of 21 patients with infantile or juvenile scoliosis (9 boys, 12 girls) who underwent surgical treatment between 1985 and 1997. 13 patients underwent primary dorsal instrumentation without fusion (growing-rod group). In contrast, 8 patients received already in this young age an instrumented spondylodesis (fusion-group). PATIENTS AND METHODS: The initial examination was performed at an age of 6 years (median; range 29 years), and first surgery was performed at an age of 8 years (median, range 310 years). The patients have been followed-up clinically and radiologically at an age of 16 years (median; range 1021 years). RESULTS: The preoperative measurement showed no significant differences between both groups (thoracic Cobb angle 77 degrees versus 66 degrees [median], lumbar Cobb angle 40 degrees versus 51 degrees [median]). At follow-up we measured significantly better results in the fusion-group than in the growing-rod group (thoracic Cobb angle 24 degrees versus 60 degrees [median; p < 0.01]), lumbar Cobb angle 21 degrees versus 34 degrees [median, p < 0.05]). The fusion-group also showed significantly better results with respect to the parameters (median values given): duration of hospital stay (14 versus 150 days), number of operations per patient (2 versus 3) and number of complications (0 versus 26). CONCLUSION: Based on the results of this small patient group we no longer see an indication to treat infantile and juvenile scoliosis by dorsal instrumentation without fusion. In contrast, we find the principle of short instrumented anterior fusion to be more promising.

Adolescent↗

PubMedDate not supplied

[Use of peridural catheters in the treatment of postoperative pain after spinal instrumentated fusion--an experience report].

AIM: In a prospective randomized clinical study we investigated in a group of 20 patients after spinal instrumentation surgery the analgesic efficacy and the safety of epidural analgesia. Intraoperatively an epidural catheter was placed by the orthopedic surgeons for postoperative pain control. METHOD: For epidural catheter analgesia a mixture of the local anesthetic ropivacaine and the opioid sufentanil was used with an initial bolus, followed by a continuous infusion and the possibility of patient-controlled bolus administration (PCEA). Pain-scores (VAS) were measured pre- and postoperatively at rest, and during active mobilization maneuvers like turning around in bed and standing. The neurological status, side effects, and complications were evaluated. RESULTS: Mean pain-scores (VAS) were 3.8 pre-operatively at rest, after initiation of epidural analgesia 0.3 at rest, 1.6 at turning around in bed and 0.8 at standing (6.8 pre-operatively). Transient sensible or motoric deficits, due to the local anesthetics' effect, occurred in 8 respectively in 3 of the patients. Drug-induced typical side-effects were pruritus, nausea and emesis. No cardiopulmonary complications happened. CONCLUSION: The epidural lumbal analgesia is an effective and safe method to control postoperative pain after spinal instrumentation surgery. Precondition is the knowledge about the safe and standardized technique of intraoperative catheter placement by the orthopedic surgeon, the choice of the appropriate analgesic drugs and a good cooperation between the departments of anesthesiology and orthopedic surgery and nursing staff.

Adult↗

PubMedDate not supplied

[Early postoperative functional differences between total knee arthroplasties supplied with mobile-bearing platform or fixed-bearing system--an analysis of gait pattern].

AIM: The goal of this study was to analyze differences of gait patterns among patients with total knee arthroplasty supplied with mobile-bearing platform in contrast to patients supplied with fixed-bearing knee systems. METHOD: For that reason 17 patients with mobile-bearing knee systems and two groups of 15 patients each with fixed-bearing knee systems have been examined clinically, radiologically, and by means of gait analysis up to 6 months postoperatively. Additionally 20 knee-healthy control subjects have been gait-analyzed for comparison. RESULTS: There existed no different developments of gait characteristics between the groups of patients in the preoperative status. After the operation an increase of the ground reaction force of the operated leg was observed in all groups. The functional range of motion in the operated knee joint improved among patients postoperatively. Besides, in the group with the mobile-bearing knee a significantly stronger flection of the operated leg during the stance phase under load could be proven. Between the groups of patients the average values of the respective radiological alignments did not exhibit statistically significant differences. No severe complications have been observed. CONCLUSION: For the group of patients with fixed-bearing knee course samples have been registered, which approximate the reference values of healthy control subjects more strongly. The entire course sample is characterized by an increased range of motion of the opposite side and the adjacent joints. The parameters measurable in the gait analysis point to a better biomechanical situation after implantation of the mobile-bearing system.

Adult↗

PubMedDate not supplied

[An alternative treatment strategy in lumbar intervertebral disk damage using an SB Charité modular type intervertebral disk endoprosthesis].

At the Department of Orthopedics, Humboldt University School of Medicine, Charité Hospital, the three-piece disk endoprosthesis SB Charité of the modular type, which works according to the low-friction principle, has been developed combining the advantages of a beneficial effect on the patient's complaints by simultaneous distraction in the vertebral segment, and of achieving movement within the physiological range. So far, this disk endoprosthesis consisting of two cover plates made of implantat steel or titanium sheet, which are fixed without cement, as well as a moveable polyethylene sliding core being vertically adjustable, has been implanted in sixteen patients. The therapeutic results show that it is possible with this method to replace the nucleus pulposus, thus providing, in addition to conventional nucleotomy and segment fusion, another therapeutic alternative for lumbar disk lesions.

Adult↗

PubMedDate not supplied

[Lumbar segmental spondylodesis--isolated ventral or combined dorsoventral? A comparison of results].

Indications for intercorporal fusion are progressive spondylolisthesis in children and adolescents, painful segmental instability in adults (spondylolisthesis, post-discectomy-syndrome, failed-back-syndrome). From 1980-86 152 isolated anterior intercorporal fusions had been realized, and in 1987/88 we carried out 79 combined anterior-posterior fusions. The rate of pseudarthrosis has been 25% with isolated anterior fusion and on the contrary 9% with combined fusion. With combined fusion the rate of complications did not increase, but the objective and subjective results became better. The postoperative period became more convenient, the stay in hospital and the consolidation of fusion were shorter. The reposition of spondylolisthesis was durable and the spine channel was accessible. We consider the instrumented fusion to be a complex reconstructive operation with high chances of success.

Adolescent↗

PubMedDate not supplied

[Experiences with external fixation of the cervical spine in the halo-yoke system].

The Halo-Yoke-System allows an external fixation, reposition and immobilisation of the cervical spine. Indications for application of application of Halo-Yoke exist in conservative or operative treatment of acute traumatic lesions and protection of results after surgical treatment in cases of instability of different etiology (tumour, spondylitis, rheumatoid arthritis, congenital deformities). The experience basing on 28 own cases is reported.

Cervical Vertebrae↗