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Biomedical subjects

U Bötel

Publications and source records attributed to U Bötel.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Spondylodiscitis with spinal and radicular involvement. Limits of conservative treatment].

During 1988 to 1992 18 patients with spondylodiscitis and neurological deficits were treated in our clinic. Tuberculous spondylodiscitis was diagnosed in 4 patients and 14 suffered from non specific spondylodiscitis. The mean age was 59 years (range 25-77). 16 (89%) of the patients had risk factors like diabetes mellitus, genitourinary tract infection, respiratory tract infection, rheumatism, intervertebral disc operation and old spine fracture. MR-tomography revealed the most valuable diagnostic method. 14 patients with progressive spinal cord compression, and root lesions because of gross vertebral damage and epidural abscess underwent operative removal of the focus with intercorporal spondylodesis. Postoperative neurological examination revealed improvement in 7 and no changes in the other 7 patients. In 4 patients with non specific spondylodicitis and radicular deficits conservative treatment was performed and spontaneous interbody fusion without persisting neurological complaints occurred.

Abscess↗
PubMed1993

[Unusual site of heterotopic ossification in the area of a laparotomy scar].

We report on a patient with spinal cord injury and an unusual localization of heterotopic ossification (HO) in the area of a laparotomy scar, with a large quantity of foreign bodies from residual suture material. This makes it obvious that extraskeletal cells can differentiate for osteogenesis. However, neither the mechanism of the induction process of HO nor the stimulating agents are precisely known. It must be stressed, however, that the occurrence of HO can be influenced by foreign bodies in the presence of favourable microenvironmental conditions.

Abdominal Injuries↗
PubMed1992

Heterotopic ossification after spinal cord injury. Epidemiology and risk factors.

From 1981 to 1986 we treated 413 patients for acute spinal-cord injuries. We reviewed 356 patients followed for a minimum of two years of whom 71 (20%) developed heterotopic ossification around one or more joints. Heterotopic ossification occurred more often in male patients (23%) than in female (10%), and was most frequent in the 20- to 30-year age group. It was also more common after injuries of the lower cervical or thoracic spine than after those of the lumbar spine. Patients with severe neurological deficits (Frankel grades A and B) showed significantly more heterotopic ossification but there was no correlation with the number or severity of associated head and limb injuries. Serum calcium levels did not change significantly in either group for 30 weeks after injury, but the erythrocyte sedimentation rate and the alkaline phosphatase level were significantly increased at six weeks in patients with heterotopic ossification.

Age Factors↗
PubMed1992

[Classification and surgical indications in spinal injuries].

A simple and precise classification of vertebral injuries is the key to correct treatment, depending on the differentiation of temporary or permanent instability. This aim is met by a classification presented by Magerl, Harms, Gertzbein et al. It is based on three main types according to the pathomechanics consisting of several subgroups with morphological aspects. In the neurological field, indications for surgical treatment are absolute after a free interval or rapid rising of the level of lesion. In vertebral injuries operative indications are found in possibly permanent instabilities or kyphotic deformities. Some indications depend on the patient himself, especially age and psychosis.

Humans↗
PubMed1991

[Dorsal fixation of the thoracic and lumbar spine with grooved plates in combination with the Universal Spine Instrumentation System. A short stretch, angle-stable alternative].

In the Department of Surgery in the University Hospital "Bergmannsheil" in Bochum, 67 patients with unstable injuries of the thoracic and lumbar spine were analyzed in a retrospective study. The sagittal correction loss was greatest about 6 months after dorsal stabilization--6 degrees on the average--after stabilization with a plate alone. The correction loss after stabilization with plates combined with the Universal Spine Instrumentation System (USIS), which was developed for ventral derotational spondylodesis or after implantation of an internal fixation device, however, amounted to 3 degrees on the average. The clinical results show that by combining the plate and USIS the injuries can be stabilized for short stretches and without correction loss. The main advantage of this combination over internal fixation is the smaller amount of metal used, which means the soft tissue in loss compromised and there is a possibility of fitting the implant more directly. In 10 patients (15%) the implants broke at the place of maximum shear stress between 4 and 8 months postoperatively after consolidation of the fracture and without spoiling the result. This occurred equally often with all types of implants. Efficient use of the three systems is discussed with regard to the different pathomechanical modes of injury. A causative scheme of treatment is presented.

Adolescent↗
PubMed1988

Intermittent catheterisation versus percutaneous suprapubic cystostomy in the early management of traumatic spinal cord lesions.

Spinal injury patients initially treated by intermittent catheterisation (IUC) and those who received a fine-bore suprapubic catheter (SPC) have been reviewed. The results show that fine-bore suprapubic catheterisation seems to be superior to intermittent catheterisation because the rate of urinary tract infections is significantly lower in the SPC-group (50%) than in the IUC-patients (71.9%), and the first infecting organisms in the SPC-group differ from those in the IUC-group and are much more easily treated by antibiotic therapy.

Adolescent↗
PubMed1988

[Decubitus ulcer in paraplegic patients--a comparative clinico-pathologic study].

331 pressure sores of 141 patients with paraplegia were investigated histologically, the results were partly correlated with the roentgenological features. The level of the spinal cord lesion was the segment Th12-L1 in 45%, the decubital ulcers were mostly localized above the os ischiadicum (64%). A pseudocancerosis was diagnosed in 14.2%, one time a cancer in a sacral decubitus has been found. The inflammation was limited to the soft tissue in 56.9%, in 28.5% a chronic osteomyelitis of different severity had developed. In 73.6% of the patients with a histologically proven osteomyelitis this osteomyelitis could be diagnosed roentgenologically too. The high amount and severity of the dermal and bony lesions justifies the radical surgical therapy of the pressure sores, which is practised today. Our investigations of chronic pressure sores did not point out new aspects of aetiology of pathogenesis--this is only possible by experimental models.

Adolescent↗
PubMed1985

[Standard operative technic in fresh fractures of the thoracic and lumbar vertebrae].

Undesirable sequelae of spinal column injuries are chronic instabilities and decompensated axis shifts. If a poor functional result can be expected after the initiation of conservative treatment, indication for surgery should be considered as early as possible. The authors describe a surgical technique which can be employed both in emergencies and electively on account of its standardization; it consists of dorsal repositioning manoeuvres that result in short-distance fusioning of the spinal column to achieve stable functioning. However, repositioning via the dorsal approach can be effected with maximum success only if it is done within the first 10 to 14 days.

Bone Transplantation↗
PubMed1984

[The spine].

Spinal injuries must be divided into stable and unstable lesions. Stable fractures are treated functionally, in unstable cases a decision must be made whether conventional treatment will be satisfactory. Severe kyphosis or chronic instability must be avoided. Open reduction and spinal fusion are recommended very early, if conventional therapy is not successful. Surgical risks are minimized by technical standards.

Fractures, Open↗
PubMed1982

[Experiences in the treatment of decubital ulcers with synthetic skin grafting (author's transl)].

Pressure sores have always been, and still are, a serious threat to health and life of patients paralysed by a transverse lesion of the cord; hence, intensive-care treatment is essential. The most important basic measure is a consequential relief of the damage caused by pressure; success is achieved with synthetic skin grafting using polyurethane foam for the conditioning of wound areas prior to final surgery. Extended pressure sores are particularly suitable for treatment with synthetic skin graft, whereas this principle is unsuitable in skin defects with many "pockets" and cavities. On account of its microporous surface which is impervious to bacteria while offering the possibility of gas exchange, polyurethane foam is also used to protect wounds against superinfection.

Artificial Organs↗
PubMed1981

[Rehabilitation of patients suffering from para- and tetraplegia (author's transl)].

The rehabilitation of paralysed patients may not be postponed to the urgent primary treatment, but has to begin at the onset of disability. This can be done in special centers. An early mobilisation is the first aim, for which operative stabilization may also be indicated. A high standard of self-help in daily life activities must be obtained in tetraplegics. Wheelchair-sports is of utmost importance for improving power and ability. Clinical rehabilitation is aimed at preparing the patient for social reintegration and vocational training.

Communication Devices for People with Disabilities↗