Abstract:
:Background Anterior cervical corpectomy and fusion (ACCF) has become a standard procedure for patients with spondylotic myelopathy due to multisegmental stenosis of the cervical canal. Beside the fusion technique using autogenous bone grafts, synthetic cages have been increasingly used in recent years. Published information on the clinical and radiological results of different cage materials for ACCF is still limited. The study presented here is the largest series to date reporting clinical and radiological outcomes and complication rates after one- to three-level ACCF using structural polyetheretherketone (PEEK) or titanium cages augmented by anterior plate-screw osteosynthesis. Materials and Methods Retrospective comparative study on 126 patients after cage ACCF using modular PEEK (n = 101) or distractable titanium (n = 25) cages with a minimum follow-up of 6 months. The numbers of hardware failures and implant-related surgical revisions were determined. The rate of subsidence and fusion and the course of lordotic alignment (segmental and regional Cobb's angles) were analysed. Neck Disability Index (NDI) and European Myelopathy Score (EMS) were assessed. Results Significantly greater number of screw and cage complications were detected in the titanium cage group (36 vs. 7.9 % and 64 vs. 36.6 %, respectively). Non-significant trend to a higher rate of implant related revision rate in the titanium cage group (16 vs. 2.97 %). Significantly greater rate of grade I or II fusion in the PEEK cage group after 6 months (82 vs. 52 %). NDI, EMS and lordotic alignment improved significantly in both groups. There were neither significant differences between the two groups nor significant correlations between these clinico-radiological parameters and the cage material. Partial correlations performed with control of parameters showing inhomogenous distribution (patient age, fusion distance, rate of multilevel corpectomy and the rate of intraoperative segmental overdistraction) showed no significant correlations for any of the clinical or radiological outcome parameters and the complications or revisions to the cage material. Conclusion Cages are a safe and effective alternative to autogenous bone graft for ACCF. A significant improvement in clinical and radiological parameters can be achieved with both titanium and PEEK implants. Significant differences between the two cage material groups or significant correlations of clinico-radiological outcome and cage material were not proven. Moreover there is no evidence in the literature for clinical advantages of one special cage material, to date. Therefore further prospective randomised evaluation of different fusion techniques in ACCF is still necessary.
journal_name
Z Orthop Unfalljournal_title
Zeitschrift fur Orthopadie und Unfallchirurgieauthors
Schulz C,Mauer UM,Mathieu Rdoi
10.1055/s-0042-118717subject
Has Abstractpub_date
2017-04-01 00:00:00pages
201-208issue
2eissn
1864-6697issn
1864-6743journal_volume
155pub_type
杂志文章abstract:BACKGROUND:The Surgical Safety Checklist (SSC) was introduced by the World Health Organization (WHO) in 2008 in order to analyse and reduce perioperative surgical morbidity. Preoperative estimation of the expected surgery time (EST) by the surgeon is an integral part of the SSC. OBJECTIVE:The aim of the present study ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-101416
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:In the late 1960s, the helicopter emergency medical service (HEMS) was established in Germany because of an increasing number of severe injuries in traffic accidents. To get a doctor quickly on scene was the initial intention, rather than transporting the patient. Today, rescue helicopters cover the entire f...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545801
更新日期:2015-08-01 00:00:00
abstract:AIM:Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder arising from synovial cells of the tendon sheets and joint capsules. The potential value of external beam radiation therapy in the interdisciplinary management of PVNS is demonstrated by a comprehensive literature review on the clinical use of...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0030-1250687
更新日期:2011-12-01 00:00:00
abstract::Aims and Indications A paralabral ganglion cyst of the shoulder can cause neuropathy of the inferior branches of the suprascapular nerve. This can lead to atrophy of the infraspinatus muscle. Arthroscopic decompression of the cyst in combination with repair of the associated labrum tear appears to be an effective trea...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-100628
更新日期:2017-02-01 00:00:00
abstract:PURPOSE:Every day several million people are seeking for answers to medical problems via the internet. In particular parents, whose children are affected by systemic diseases, orthopaedic defective positions, anomalies or deformities, use the internet to increase their knowledge. Concerning this situation there is a la...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1185898
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Displaced midshaft clavicular fractures are often treated operatively. The most common way of treatment is plating. Elastic stable intramedullary nailing (ESIN) is an alternative, but seldom used. Studies showed comparable or even better results for intramedullary nailing than for plating in simple 2- or 3-f...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1383206
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:The developments towards a combined specialty of orthopaedic and trauma surgery requires not only the consolidation and revision of the postgraduate education training programme but also the development of a catalogue of learning objectives as a uniform basis for undergraduate medical training in the new spe...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038899
更新日期:2008-07-01 00:00:00
abstract::The reasons for delayed fracture healing or non-union formation are multifactorial. Mechanical factors are well known to influence the process of fracture healing. However, there is a lack of knowledge about the biological conditions that have to be achieved for adequate bone healing. Treatment of non-unions is still ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1546146
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:In Germany there are 5000 to 7000 new cases of atraumatic avascular necrosis of the femoral head in adults per year. It occurs mostly in middle age. An increased frequency of idiopathic cases can be observed. Chemotherapy, corticoids and kidney transplants are frequently associated with the disease. In most ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1545903
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate long-term clinical and radiological results as well as survival rates of the NexGen® CR posterior cruciate retaining prosthesis. PATIENTS AND METHODS:We evaluated a consecutive series of 761 total knee replacements performed on 716 patients from 1999 to 2001 at our ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-0035-1546040
更新日期:2015-10-01 00:00:00
abstract:AIM:The point of time for total knee arthroplasty has a significant importance due to limited implant survival rate. To what extent the preoperative stage of physical and psychological function limitation, which is increasing with the progression of the osteoarthritis, has an influence on the early functional outcome a...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038463
更新日期:2008-05-01 00:00:00
abstract::The ideal treatment for massive rotator cuff tears is influenced by the morphology and chronicity of the tear, tissue quality, the degree of concomitant osteoarthritis, and patient-specific factors. Traditionally, massive rotator cuff tears have wrongly been equated with irreparable tears. A variety of improvements in...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1558056
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The outcome of orthopaedic surgery such as total hip replacement (THR) or total knee replacement (TKR) is commonly given by the change in mean scores on patient-reported outcome measures (Prom's). This may give the impression that all enrolled patients have experienced an improvement. But the Swedish hip reg...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1328531
更新日期:2013-06-01 00:00:00
abstract:AIM:The aim of this study was to compare the different diagnostic features (symptoms, physical examination, radiographic features and intraoperative findings) of osteoarthritis of the knee before total joint replacement and consequently relate them with each other. METHOD:Patients with primary osteoarthritis of the kn...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2007-965550
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Realisation of a major operation of tumours/metastases in the backbone is in many cases not possible, above all in older multimorbid patients with higher OP risks. So it is important to proceed here so minimally invasive as possible, but at least actually to reduce above all pain for the patient and the dang...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1382936
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The use of information technology (IT) in health care has continuously increased. This includes software solutions for digitalisation, data storage and innovative approaches in diagnostics. The facilitation of the access to specific information, even by the patient, has changed daily clinical work. Patients ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-116941
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:The Morel-Lavallée lesion is one of the concomitant soft tissue lesions of pelvic fractures. Its role in spine fractures and its treatment in combination with osteosynthesis of pelvic or spine fractures have not yet been determined. The aim of this study was to analyse the best diagnostic and treatment optio...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/a-0596-8018
更新日期:2018-10-01 00:00:00
abstract:AIM:The Internet provides additional and nearly endless health-related information material for the patient. On the other hand, previous studies reported on the lack of quality for health-related websites, especially for message boards. A direct analysis of treatment recommendations from message board members and spine...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1250525
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The treatment of cartilage defects has seen a shift from replacement to regeneration in the last few years. The rationale behind this development is the improvement in the quality-of-care for the growing segment of young patients who are prone to arthroplasty complications because of their specific character...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0031-1298387
更新日期:2012-06-01 00:00:00
abstract::During the last years, the prosthetic replacement in upper limb amputees has undergone different developments. The use of new nerve surgical concepts improved the control strategies tremendously, especially for high-level amputees. Technological innovation in the field of pattern recognition enables the control of mul...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-108910
更新日期:2016-08-01 00:00:00
abstract:AIM:Whole body spiral CT scans have become a routine method in the radiological imaging of severely injured patients in emergency rooms of an increasing number of hospitals. The routine use of CT scans is, however, still discussed controversially, especially with regard to its use in children. This is mainly due to the...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-989438
更新日期:2008-01-01 00:00:00
abstract::Injuries to the lateral ankle ligaments are the most common sports injuries. Determination of their severity and exclusion of relevant accompanying injuries requires a subtle clinical and a focussed radiological assessment. Treatment is non-operative and functional in the majority of cases. Consequent application of o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1280258
更新日期:2011-10-01 00:00:00
abstract::Anterior dynamic scoliosis correction is an innovative non-fusion option in the treatment of patients with severe adolescent scoliosis. Growth modulation and sometimes intraoperative curve correction is achieved by convex insertion of segmental screws and a flexible polyethylene cord. The present review analyses and d...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0983-1265
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to perform a cross-cultural adaption of the KOOS into Chinese and to evaluate its psychometric properties in patients with anterior cruciate ligament reconstruction (ACL reconstruction) in mainland China. DESIGN:A cross-sectional study. SETTING:Patients completed the Chinese versio...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0621-9504
更新日期:2019-02-01 00:00:00
abstract::The present refresher article highlights the current role of pedicled flaps in the reconstruction of complex wounds at the lower extremity. Due to the increasing standardization and ongoing improvements in microsurgery and in view of the fact that local tissue limitation and elevated rates of wound healing disorders r...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-124091
更新日期:2019-02-01 00:00:00
abstract::Venous thromboembolism (VTE) is a common, sometimes even fatal though preventable complication after surgical interventions, especially in orthopaedic surgery. The risk can be reduced by more than 50 % by mechanical means and different anticoagulant drugs. However, only few patients receive adequate treatment. Medicam...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1186018
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:The residency program for a specialist in orthopedics and trauma surgery is facing fundamental changes based on an initiative originating from the working group "medical training" of the German Medical Association (GMA). A survey indicated that 50 % of all trainees are dissatisfied with their current situati...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0033-1345672
更新日期:2013-04-01 00:00:00
abstract:INTRODUCTION:The mechanical properties of acrylic bone cements are an important factor in determining an efficient load transmission between prosthesis and bone to guarantee the long-term stability in cemented hip arthroplasty. MATERIAL AND METHODS:Palacos and Refobacin Palacos specimens from 21 aseptically loosened f...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-989324
更新日期:2008-01-01 00:00:00
abstract::Periprosthetic fractures are a challenging problem in view of the demographic development and the increasing number of implanted prostheses. Most of these fractures occur postoperatively after a period of two to four years after implantation of a total knee arthroplasty. They are usually caused by traumata, implantati...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1315398
更新日期:2012-10-01 00:00:00
abstract:AIM:Problems with the patellofemoral joint are still one of the most common difficulties after total knee arthroplasty. One of the main reasons for these problems seems to be the rotatory malposition of the femoral component. We examined the rotation of the femoral component and the symmetry of the flexion gap of knee ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240587
更新日期:2011-12-01 00:00:00