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Biomedical subjects

W Seelig

Publications and source records attributed to W Seelig.

7 recordsLinked to original sources
PubMed1992

Repair of lumbar spondylolysis with a hook-screw.

A hook-screw has been devised to link the vertebral arch and superior articular process across the defect of a spondylolysis. This method of direct repair overcomes the difficulty of fixation in dysplasia of the arch and avoids crossing the defect with a screw. Compression and a bone graft are applied to the defect to obtain union. This procedure has been used in 33 patients followed for an average period of 3.5 years, and has given satisfactory relief of back pain in 79% and radiographic fusion in 73%, with better results in patients under 20 years of age. Associated degeneration and instability of the disc spaces should be assessed before operation by magnetic resonance imaging so that a standard intervertebral fusion can be used if indicated rather than this direct approach to the lysis. The technical problems encountered and the recent addition of a compression spring to the hook-screw are described.

Adolescent↗
PubMed1992

Arthroscopy of the shoulder joint.

Arthroscopy is without doubt the most comprehensive procedure for shoulder lesions, providing even better inspection of the interior of the joint than conventional open procedures. In 174 diagnostic arthroscopies, it proved more reliable than the computed tomography scan, ultrasound, or arthrography. The results of ultrasonography proved disappointing despite the enthusiastic reports on this technique, probably due to imperfections of equipment and lack of expertise rather than any inherent defect in the method. Arthrography seems to have a high incidence of false results. Though an invasive method requiring anesthesia, arthroscopy offers many diagnostic advantages such as an assessment of the role of the long biceps tendon and glenohumeral ligaments in recurrent or ordinary dislocation and the recognition of rotator cuff lesions not detectable at arthrography. It is also possible to assess the nature of shoulder instability and so to plan the appropriate operative procedure. A major advantage of arthroscopy is the possibility of carrying out treatment in the same session, though many of the suggested procedures are very demanding in terms of technical skill and time; the complication rate is often excessive. It is therefore best to restrict operative arthroscopy to simpler procedures such as irrigation in joint infections, the trimming of infolded flaps of labrum or stubs of biceps tendon, and the removal of loose bodies, where results are excellent. Arthroscopic repair of the rotator cuff or stapling of the labrum are more questionable regarding successes, complications, and recurrence. The equipment for arthroscopic operations needs improvement. Perhaps the major advantage of arthroscopic diagnosis is that it directs open procedures to the essential, thus minimizing operative trauma.

Adult↗
PubMed1989

[Perioperative risks and problems in total hip joint replacement].

In a population of 689 patients with primary total hip arthroplasties, perioperative problems and complications were investigated. A preoperative cardiovascular disease was found in 32%, obesity in 18% of the patients. The death-rate was 0.43% in a population of patients, two thirds of whom was older than 60 years, one third even older than 70 years. The importance in preoperative evaluation of health and in treatment of various diseases is emphasized. Postoperative management is crucial to reduce thromboembolisms, urinary retention and infections.

Aged↗
PubMed1989

[Revision arthroplasty of the hip joint with autologous and homologous cancellous bone].

On revision arthroplasty a substantial loss of bone stock is frequently encountered. To anchor the new prosthesis many different additional technical appliances, e.g. supporting rings, wire meshes and fixation screws, are suggested. However, filling of all the bone cavities by cement will lead to further peripheral defects of bone stock, worsening the situation if renewed loosening occurs. Such loosening must be expected since additional bone is damaged by the implants and the large amount of cement. Therefore, it is increasingly recognized that biologic reconstruction of the deficient acetabulum and femoral shaft by bone grafting should be the goal in revision arthroplasty, in order to restore the bone-implant interface to the site of a primary arthroplasty. Autologous bone graft is harvested from the outer iliac wing as a bone paste most easily by use of an acetabular reamer. As an additional approach is needed and the amount is not always sufficient, often homologous bone is used in solid cortico-cancellous blocks or as a bone paste ground by a bone mill. The bone banking procedure is described. At the acetabulum the grafting technique depends on whether there is a contained or non-contained defect. The cup has to be brought to the anatomical position and should be supported at several sites by the original iliac bone and not only by the graft. At the shaft, osteotomy of the greater trochanter can be avoided by a lateral transgluteal approach in the vast majority of cases (90 out of 95 cases). If still possible, a short stem is preferred to an extra-long one. Follow-up examination of 164 patients at 46 months (min. 24, max. 78 months) after cup revision showed that 8 re-revisions had been performed in the meantime: in 6 cases renewed loosening or infection had been treated by implantation of a new component; in 2 cases a Girdlestone procedure was the final outcome.

Acetabulum↗
PubMedDate not supplied

[Pain following operations of the lumbar spine. The "failed back surgery syndrome"].

This is a follow up study of 61 patients with a 'failed back surgery syndrome' (FBSS). The mean follow up time is 5.4 years after the first operation on the lumbar spine. The diagnosis before the first operation was in 35 patients an entrapment disease (disc herniation or stenosis of the spinal canal), in 25 patients a segmental instability and once a deformity. The reason for the development of a 'failed back surgery syndrome' was in 18% a perioperative complication, in 24% a late unhappy consequence of the operation, in 40% an assessment- or treatment error. In 18% we were not able to figure out any reason for the failure. The correlating diagnosis were: postoperative infections 3, hematoma 1, disc herniation or instability on a second level 12, a second disc herniation at the same level 3, scarring or arachnoiditis 2, instability 18, lateral spinal stenosis 10. We emphasize the importance to distinguish between a clinical relevant and irrelevant diagnosis and to use special tests for this differentiation.

Adolescent↗