Abstract:
:Background: The perception of back pain subjective is hard for physicians to measure. For this reason, questionnaires are an important instrument to evaluate the pain 1. The main point of this study was to verify differentiation of pain symptoms in patients with different pain mechanisms. The most important parameter was the PainDetect questionnaire, which can differentiate between nociceptive and neuropathic pain. Additional parameters were measured before and after surgery to characterise pain symptoms in detail. Material and Methods: We selected patients with diagnosed vertebral compression fracture, herniated disc or with spinal cord compression. To characterise the preoperative condition on admittance, we collected the data from the physical examination, as well as clinical data, including X-ray, CT and MRI. To characterise the pain, we used the painDetect questionnaire, the Oswestry Index questionnaire (ODI) and the visual analogue scale (VAS). Depending on the diagnosis, patients were treated by surgery (radiofrequency kyphoplasty, nucleotomy, spondylodesis). At 2 to 3 days and 6 months after surgery, we repeated the questionnaire and compared the results with those before the operation. Data on patient satisfaction and adverse events were also collected. Results: This study included 62 patients with vertebral compression fracture (group 1: VBF, 89 % female, mean age 71 years) and 77 patients with herniated disc or spinal cord compression (group 2: non-VBF, 55 % female, mean age 53 years). There was no difference between both groups in preoperative pain intensity (acute, maximum, average): median ordinal scale 0 to 10; group 1: 6, 8, 7; group 2: 6, 9, 7. The total score in the painDetect questionnaire differed significantly between the two groups (median group 1 = 9, group 2 = 17; effect size r = 0.5; p = 0.000). The existence of neuropathic pain was presumed (> 90 %) in 3 % of the patients in group 1 and in 13 % of patients it was not excluded. In contrast, in group 2 it was presumed (> 90 %) in 43 % of patients and in 30 % of patients it could not be excluded. Patients with vertebral compression fracture had greater pain intensity (VAS 71) than patients from group 2 (VAS 53). There was no difference in the total score of the Oswestry questionnaire between the two groups (56 % vs. 58 %). Pain intensity was significantly reduced in both groups after the operations. Six months postoperatively, pain intensity (median ordinal scale 0 to 10; acute, maximum, average) was 2, 5, 3 in group 1 and 2, 4, 2 in group 2. Moreover, the final scores of the painDetect questionnaires were significantly lower in both groups after the operations (4 in both groups). The median score of the ODI was reduced in both groups, with an effect size of 0.6. 98 % of the patients in group 1 and 94 % in group 2 were satisfied with the outcome of the operation. Conclusion: The preoperative pain characteristics of patients with vertebral compression fracture is different from those of patients with herniated disc or with spinal cord compression. 43 % of patients in group 2 exhibited a neuropathic pain component and in 30 % this could not be excluded. In contrast, in group 1 only 3 % of the patients exhibited a neuropathic pain component. Postoperatively, pain symptoms were significant reduced in both groups, so that the risk of chronic pain was considerably less.
journal_name
Z Orthop Unfalljournal_title
Zeitschrift fur Orthopadie und Unfallchirurgieauthors
Lee YJ,Koch EM,Breidebach JB,Bornemann R,Wirtz DC,Pflugmacher Rdoi
10.1055/s-0042-108063subject
Has Abstractpub_date
2016-12-01 00:00:00pages
571-577issue
6eissn
1864-6697issn
1864-6743journal_volume
154pub_type
杂志文章abstract:AIM:The objective of this systematic review and meta-analysis is to obtain information about risks and associated factors for knee symptoms and the progression of osteoarthritis in idiopathic bone marrow lesion (BML). MATERIALS AND METHODS:The primary search on 31. 12. 2013 included the databases PubMed, EMBASE, Web o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,meta分析,评审
doi:10.1055/s-0042-101560
更新日期:2016-08-01 00:00:00
abstract::A young woman had subcutaneous bleeding at the retinaculum of the left knee after minor trauma. A small vein was attached to the scar and repeatedly ruptured after several other small traumas. Conservative therapy had no impact on the genesis of the bleeding. Having gone through severe bleeding situations with massive...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1240786
更新日期:2010-09-01 00:00:00
abstract::Surgical principles for treatment of full-thickness cartilage defects of the knee include bone marrow stimulation techniques (i.e. arthroscopic microfracturing) and transplantation techniques (i.e. autologous chondrocyte implantation and osteochondral transplantation). On the basis of increasing scientific evidence, i...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 共识发展会议,杂志文章,评审
doi:10.1055/a-0591-6457
更新日期:2018-10-01 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::Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unst...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-111594
更新日期:2017-10-01 00:00:00
abstract:AIM:The aims of this review were to discuss the different mechanisms of biocorrosion of orthopaedic metal implants in the human body, as well as the effects of the released metal ions on bone metabolism and the immune system in regard to their involvement in the pathophysiological mechanisms of aseptic loosening and me...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1250108
更新日期:2010-08-01 00:00:00
abstract::Background Medical curricula require an increasing amount of integrated clinical practical skills education. German medical faculties are increasingly implementing the OSCE (objective structured clinical examination) to test students' practical as well as communication skills. Teaching and assessment tools for practic...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0043-109022
更新日期:2017-08-01 00:00:00
abstract::Tibial plateau fractures are complex articular injuries, especially if caused by high energy. For adequate treatment a decidedly clinical and radiographic diagnostic is required. The three-column-concept has proven as excellent surgical planningstool in this complex trauma. By (1) precisely considering the specific ch...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-116779
更新日期:2017-06-01 00:00:00
abstract::Tuberculosis constitutes an important clinical entity with 90 million new infections worldwide during the last decade. 10 % of these infections affect osseous structures based on haematogenous spread. Therefore, tuberculous spondylodiscitis remains a major illness in orthopaedics which needs to be considered in cases ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1039246
更新日期:2009-03-01 00:00:00
abstract:AIMS:The combination of a distal tibia fracture with an additional upper ankle joint injury is a challenge. Apart from various implants the intraoperative problem is the handling of these two injuries with appropriate reduction and retention. The existing and further developing soft tissue damage has to be taken into c...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1039265
更新日期:2009-05-01 00:00:00
abstract::Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,实务指引,评审
doi:10.1055/s-0042-116330
更新日期:2017-02-01 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 OF THE STUDY:Maintaining segmental motion is one of the most reported theoretical advantages of total disc replacement (TDR). Several inlay sizes are available for reconstruction of the physiological disc height. The influence of the implant height on the range of motion (ROM) was investigated in a biomechanical st...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038400
更新日期:2008-07-01 00:00:00
abstract:INTRODUCTION:The treatment of juvenile proximal humerus fractures is based on the extent of the deformity. The standard diagnosis with X-ray images in 2 directions is error-prone and can lead to a suboptimal treatment. The aim of this study was to evaluate if ultrasound imaging can improve the measurement of the deform...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1055/s-0032-1328193
更新日期:2013-02-01 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: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::Objective Development of a preparation technique for hamstring tendons to ensure a maximum of intraoperative flexibility during individualised cruciate ligament surgery. Indications Primary ACL- and PCL-reconstruction as well as cases of later revision. Method Three- or five-stranded grafts can be obtained with the us...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-119899
更新日期:2017-12-01 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::Soft-tissue management is essential for the outcome in total knee arthroplasty. In combination with osseous resections and component positioning, correction of the underlying ligamentous dysbalance should yield a stable joint throughout the flexion arc. Different "philosophies" with regard to technique, timing and tac...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-965688
更新日期:2007-09-01 00:00:00
abstract:AIM:This retrospective monocentre study investigates long-term results of the cementless parabolic-shaped HI threaded cup. MATERIAL AND METHODS:678 threaded cups made of titanium were implanted into 641 patients from November 1991 to May 1995. Mean age was 67 years, 65 % female, 35 % male. From December 2005 until Oct...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0029-1185434
更新日期:2009-03-01 00:00:00
abstract::Background MRSA represents a considerable health threat to orthopaedic patients. Throughout the last decade, livestock-associated MRSA emerged increasingly in livestock all over Europe. LA-MRSA broke the species barrier, colonizing and causing infections in humans. Nevertheless, to date there are no studies concerning...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-103457
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The design and the surgical technique of the Silent Micro Hip™ are different compared to other hip stems due to a conical shape for fixation within the metaphyseal femur. The purpose of the present study was to evaluate hip joint biomechanics of the Silent Micro Hip™ in comparison to other implants. Implant-...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0033-1350862
更新日期:2013-10-01 00:00:00
abstract:AIM:Inter- and intraobserver reliability and learning curve using Graf's ultrasonographic hip examination were assessed. MATERIAL AND METHODS:189 participants of the basic, advanced and final courses on hip ultrasound using the Graf method (DEGUM) were asked to answer a questionnaire and to measure 34 normal and patho...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038477
更新日期:2008-09-01 00:00:00
abstract:INTRODUCTION:Arbitration offices ("Schlichtungsstellen") in Germany are expert panels for the extrajudicial resolution of malpractice claims. The performance of arbitration panel proceedings ("Schlichtungsverfahren") is based on the German medical and insurance jurisdiction. In Germany, and in the United States likewis...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1250487
更新日期:2010-12-01 00:00:00
abstract:AIM:Navigated implantation of the cup and stem components enables additional parameters to be recorded for joint reconstruction. The results and reproducibility of the implant position were studied in a consecutive series of implantations with femoral transmitter (femoral C-clamp) close to the hip joint. METHOD:107 co...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2007-965650
更新日期:2007-09-01 00:00:00
abstract:AIM:The aim of this prospective clinical trial was to analyse the ventral fusion rate following circumferential fusion for degenerative spine disease using a radiolucent carbon fibre cage (Brantigan, Fa. DePuy-Acromed) loaded with either autogeneous bone graft (iliac crest) or with the tricalcium phosphate Cerasorb wit...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-2007-965252
更新日期:2007-07-01 00:00:00
abstract::In recent years, increasing concern has been raised regarding potential systemic toxicity of metals released from arthroplasty implants. A lack of valid metal thresholds for human (organ) toxicity and the prospect of multi-decade survival of modern hip and knee replacements pose special challenges. Indeed, evidence of...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1187-1751
更新日期:2020-10-01 00:00:00
abstract::Background: Placing transpedicular screws in the cervical spine is a special challenge for spine surgeons, due to the anatomical features of this part of the spine. During the last 15 years, computer-aided navigation systems have been developed to facilitate this procedure and to make it safer for patients. One option...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-105957
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Postarthroscopic glenohumeral chondrolysis (PAGCL) is a rare complication of shoulder arthroscopy. PAGCL describes a chondrolysis in the shoulder joint after arthroscopy mostly affecting younger patients. The process leading to chondrolysis is not known yet. MATERIAL AND METHODS:The case report describes a ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0030-1270919
更新日期:2011-12-01 00:00:00
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 infor...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-118717
更新日期:2017-04-01 00:00:00