Biomedical subjects

Richard P Schlenk

Publications and source records attributed to Richard P Schlenk.

5 recordsLinked to original sources

PubMed2007

Multiple level discectomy and fusion.

The ventrolateral approach for surgical decompression of the cervical spine is widely used and well known to most spinal surgeons. Because compression of the spinal cord and nerve roots usually occurs ventral to the spinal cord, and the spinal cord does not tolerate traction, this approach allows safe and direct decompression of most compressive pathology. This article reviews the indications, diagnostic evaluation, and technique for multiple level discectomy and fusion. It further addresses the advantages and disadvantages of this technique compared with alternate surgical procedures.

Cervical Vertebrae↗

PubMed2003

The biomechanics of iatrogenic spinal destabilization and implant failure.

Revision spinal surgery is usually indicated in cases of persistent or recurrent symptoms related to neural compression, spinal deformity, or construct failure. An understanding of fundamental biomechanical principles of both spinal decompression and reconstructive strategies is essential to avoid unnecessary subsequent spinal operations.

Biomechanical Phenomena↗

PubMed2003

Surgery for postarthrodesis adjacent-cervical segment degeneration.

Anterior cervical decompression and fusion has gained popularity because of its applicability to a variety of cervical spine disorders. The authors of long-term follow-up studies have demonstrated the development of degenerative changes in segments adjacent to fusion. So-called adjacent-segment disease causes symptomatic deterioration in up to 25% of the patients who have undergone anterior cervical decompression and fusion for cervical spondylotic myelopathy. The causes of this condition are debated in the literature. The authors provide a review of the available literature on the pathogenesis, prevention, and treatment of postarthrodesis adjacent-segment degenerative disease.

Aged↗

PubMed2003

Biomechanics of spinal deformity.

The correction of spinal deformity may be achieved by a variety of methods, each of which has advantages and disadvantages. The goals of spinal deformity surgery include reasonable correction of the curvature, prevention of further deformation, improvement of sagittal and coronal balance, optimization of cosmetic issues, and restoration/preservation of function. The failure to consider all these factors appropriately may result in a suboptimal outcome. Understanding fundamental biomechanical principles involved in the formation, progression, and treatment of spinal deformities is essential in the clinical decision-making process.

Anthropometry↗

PubMed2002

Persistent iliac crest donor site pain: independent outcome assessment.

OBJECTIVE: This study objectively defines the incidence of donor site pain in an independent outcome analysis. In addition, this study identifies the significant discrepancies that are observed when independent outcome assessment results are compared with the incidences determined by review of the operating surgeon's documented findings. METHODS: A review of patients who underwent iliac bone graft harvesting by a single neurosurgeon was conducted. The presence of iliac crest donor site pain, at a time remote from surgery, as determined by specific questioning and recorded in the neurosurgeon's written evaluation was compared with independent assessment findings obtained in structured telephone questionnaire interviews. During a 4-year period, 105 patients met the inclusion criteria. Both the operating surgeon' and independent interviewer's follow-up evaluations were completed for all study patients. Pain was classified into three categories, i.e., no pain, acceptable pain, or unacceptable pain. Patients were also asked to assess the severity of their donor site pain by using a visual analog scale. Statistical analyses comparing the incidences of iliac crest donor site pain in the operating surgeon's evaluations and the independent assessments were performed. RESULTS: When evaluated at a time remote from surgery, the true incidence of iliac crest donor site pain after graft harvest procedures (34%) was significantly greater than previously appreciated by the neurosurgeon (8%). Although occasional or mild pain was observed for 31% of patients, only 3% of all patients experienced unacceptable pain. CONCLUSION: Independent outcome assessment values should be provided to patients in preoperative discussions regarding donor site morbidity. Objective outcome analysis, based on independent observations, is crucial for the most accurate interpretation of perceptions of iliac crest donor site pain.

Adolescent↗