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J P Giehl

Publications and source records attributed to J P Giehl.

10 recordsLinked to original sources
PubMed2001

A surprising cause of paresis following scoliosis correction.

Paralysis following scoliosis correction is a catastrophic situation. We report an unusual metabolic cause of neurological deficit after anterior thoracic release. A 15-year-old female developed proximal leg paralysis 1 day after surgery. Investigations disclosed severe serum hypokalaemia (2.8 mmol/l). After intravenous potassium substitution the neurological status completely normalized within a few hours. We assume that the condition was a manifestation of hypokalaemic paralysis since no further abnormalities could be disclosed. Spinal surgeons should bear in mind hypokalaemia as a benign and easily correctable cause of paresis following surgical scoliosis correction.

Adolescent↗
PubMed1993

Kinematics of the Zielke procedure (VDS) in scoliosis. Intraoperative measurements.

The Zielke correction technique (VDS) has two parts, derotation and ventral convex-side compression. Both were studied by measurements made during and after the operation. Ventral derotation always creates lordosis. Lordosis can be maintained during compression by insertion of intervertebral bone blocks, or kyphosis created by omitting them.

Biomechanical Phenomena↗
PubMed1992

Correction of the sagittal plane in idiopathic scoliosis using the Zielke procedure (VDS).

This paper reports a retrospective review of 91 patients with idiopathic thoracic scoliosis corrected by Zielke VDS instrumentation. The results were analysed to demonstrate the correction in all three planes. Satisfactory correction was obtained, and was particularly good in the sagittal and horizontal planes. There were no disadvantages from the thoracotomy.

Adolescent↗
PubMed1991

Stabilization of the lumbosacral spine in postlaminectomy syndromes. Technique and 2-year results.

A 2-year follow-up study is presented using transpedicular stabilization with USIS (Universal Spinal Instrumentation System) and dorsoventral fusion for failed back syndrome. Eighty-four % excellent and good results at 3 to 6 months have decreased to 56% at 1 to 2 years. Complications are few if the anatomic landmarks are respected. Many psychological and social factors also modify the final outcome of salvage surgical procedures. Only the relief of pain determined our subjective evaluation by the patient himself, without regard to sensory or motor deficiencies.

Adult↗
PubMed1990

[The natural history of scoliosis].

Adequate treatment of scoliosis requires from the managing doctor a detailed knowledge about the natural history of the disease for correct indication of the various possibilities for treatment and favourable influence of the spontaneous history. Essential prognostic factors of idiopathic scoliotic forms and congenital or neuromuscular scolioses will be demonstrated.

Adolescent↗
PubMed1990

[Surgical scoliosis therapy using VDS and Harrington instrumentation (ventral derotation spondylodesis)].

The VDS-method in accordance to Zielke and the Harrington-distraction-spondylodesis are proved as methods for correction of scoliosis lasting for decades, which late results are world-wide analysed and published. The both diametrical corrective principles and the fundamental different operative techniques settle their different indications, which doubtless depend on the experience of the surgeon. Both methods complete each other in operative spectrum of the spinal surgeon. A careful study of the bending properties and the general situation is the supposition for adequate differential indication, which details and results are reported.

Adolescent↗
PubMed1989

[Zielke ventral derotation spondylodesis].

There are several procedures in the operative treatment of scoliosis. Zielke-instrumentation has proven to be a safe and effective method for many years. Biomechanics, the operative technique, indications and complications are presented as well as long-term results after 5-10 years. VDS really proves a superior correction of all the three dimensions of a curve, major complications are very rare. Special regard is given to rotation correction, the cosmetic improvement and to the behavior of compensatory curves: a full correction is not an ideal result.

Adolescent↗
PubMedDate not supplied

[The course of inflammatory mediators after elective orthopedic interventions].

PURPOSE OF THE STUDY: The aim of the study was to characterize the changes of C-reactive protein, erythrocyte sedimentation rate, white blood count and body temperature by serial measurements after different types of uncomplicated orthopedic surgery. METHODS: The uncomplicated course of 180 patients after elective total hip and knee arthroplasties, ventral and dorsal spinal fusions and diagnostic knee and shoulder arthroscopies were analyzed. RESULTS: The maximal CRP-values were recorded on the second or third day after operation. The peak levels correlated with the extent of the procedures and reached 1.28-17.71 mg/dl. The ESR increased to maximal rates five to six days after surgery and remained elevated during the 14 days of the investigation period. WBC and body temperature showed a slow and uncharacteristic increase followed by a slow and irregular decrease. CONCLUSION: Awareness of the typical pattern of CRP, ESR, WBC and body temperature may help to evaluate the early postoperative course. The CRP is a sensitive marker. ESR, WBC and body temperature are less costly but a poor diagnostic aid for the early detection of postoperative complications especially infections.

Acute-Phase Reaction↗
PubMedDate not supplied

Metastatic spine disease in renal cell carcinoma--indication and results of surgery.

Metastatic spine disease is frequent in renal cell carcinoma and 50% of osseous metastases are already found at the time of primary diagnosis. Therefore patient mobility and quality of life are threatened early in the course of disease. Surgery is able to relieve pain and to regain or to preserve mobility. Indication and technique of surgery (anterior decompression, vertebral replacement and transpedicular fixation) are explained and treatment results of eleven cases are reported. All patients with paraparesis or cord compression preoperatively were mobile when leaving our hospital after surgery. There were no severe complications, especially no neurological deteriorations or deaths. Postoperative survival time was ten months approximately in cases with multiple osseous lesions and it was several years in cases with solitary metastases. Mobility was preserved for most of the survival time. In conclusion, restabilisation of the spine proved to be a worthwhile treatment option in well-selected cases suffering from malignant spinal involvement.

Adult↗