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 danger of other fractures and deformations and to improve thereby the quality of life. The modern method of the percutaneous cavity coblation by plasma field has been known for a short time and has been used by us for 5.5 years successfully. The aim of this work is to present the specific features of the methodology, problems, OP technology, results of the treatment of more than 218 patients with spine tumours/metastases. PATIENTS/MATERIAL AND METHODS:Old and young patients with spinal tumours (painful large haemangiomas) and metastases were treated. The Cavity SpineWand device (ArthroCare) provides a space in the tumour by patented coblation technology (coblation = controlled ablation, based on plasma-provided high-frequency energy) and can be used with additional procedures such as, for example, cement injection for vertebral stabilisation - kypho-/vertebroplasty. Access to the backbone occurs percutaneously and transpedicularly, in some cases extrapedicularly. By the removal of tumour tissue not only space for the cement replenishment is achieved, but also complete destruction/vaporisation of the tumour cells. Recurrence risk, fracture danger and compression of the neural structures are clearly reduced thereby. RESULTS:Within the 5.5 years (03/2008-09/2013) we treated 218 patients (144 f., 74 m., age 31-92 years) with spinal tumours and backbone metastases with this method. In 59 cases it was carried out in addition to dorsal percutaneous instrumentation and erection. RESULTS of clinical and radiological evaluations were assessed at 2 and 14 days as well as at 3, 6, 12, 24, 36, 48 and 60 months post-surgery (but not for control with all patients on account of the shorter method application time). A clear pain reduction and with it satisfaction and quality of life improvement were seen for all patients. In several cases treatment was combined with chemotherapy or radiotherapy by which also tumour cell growth or recurrence could be clearly diminished. Patients could be mobilised quickly after surgery, blood loss was minimal, further oncological treatment could be initiated immediately. Especially for haemangiomas in one or several levels with massive bleeding tendency and danger of cement embolism, these risk factors were clearly minimised by ablation and coagulating the tumour vessels. COMPLICATIONS:in 29 cases with especially large osteolytic defects slight cement escape was observed paravertebrally (forwards, lateral and in the intervertebral disc field), without clinical relevance, an intervention was not necessary. 65 patients (43 f., 22 m.) died due to tumour intoxication. CONCLUSION:The percutaneous cavity coblation method for the treatment of tumours and metastases in the spine represents a sure, minimally invasive procedure for patients as demonstrated by short-term and long-term results. Due to the percutaneous, minimally invasive access, the OP risks, especially blood loss and OP times are clearly low and shorter. This new method is as yet only available in a few medical centres in Germany as well as in other countries but at the moment it is being used successfully and from our point of view has a promising future.
journal_name
Z Orthop Unfalljournal_title
Zeitschrift fur Orthopadie und Unfallchirurgieauthors
Dabravolski D,Lahm A,Kasch R,Merk Hdoi
10.1055/s-0034-1382936subject
Has Abstractpub_date
2014-10-01 00:00:00pages
489-97issue
5eissn
1864-6697issn
1864-6743journal_volume
152pub_type
杂志文章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 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::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
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更新日期:2011-10-01 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
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abstract:BACKGROUND:The Mayo Elbow Performance Score is a clinical assessment to rate the performance of the elbow from a medical and/or therapeutic perspective. It is simple and efficient to operate and therefore frequently used in research as well as in clinics. However, an adequate translation of the MEPS into the German lan...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-0974-3836
更新日期:2020-10-01 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
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abstract:BACKGROUND:Currently, short cementless femoral stems are alternative implants to treat osteoarthritis in young patients with sufficient bone quality in order to get a more proximal load transfer. The purpose of the present study was to biomechanically compare joint reconstructions resulting from implantations of a shor...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1396230
更新日期:2015-02-01 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:INTRODUCTION:Infantile idiopathic scoliosis (IIS) is a rare orthopaedic condition. Braces and casts are popular options in the treatment of IIS but there is a paucity of studies commenting on the outcome of non-operative treatment. The purpose of this study was to analyse failure and success after non-operative treatme...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0031-1280330
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Brace treatment prevents the progression of scoliosis and reduces surgical treatment rates. However, the efficacy of brace treatment varies depending on the patient's age, gender, curve magnitude and type, structure of the curve, and patient compliance at the beginning of treatment. METHODS:Between January ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1269-0000
更新日期:2020-11-24 00:00:00
abstract::The present paper gives an overview of the different types of short stem total hip replacements. There is a pronounced inhomogeneity of the nomenclature in clinical practice as well as in regard to the scientific literature. Examples include neck preserving implants, meta-, epi- or metadiaphyseal fixed implants, micro...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/a-0808-5115
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to estimate the influence of concomitant diseases and the cooperation of patients on the duration of rehabilitation after femoral neck fractures. MATERIAL AND METHOD:This study reviewed 493 patients with dislocated femoral neck fracture treated with hip endoprostheses. RESULTS:T...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1039160
更新日期:2009-01-01 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::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::Bone sarcomas are extremely rare representing approximately 0.2% among all cancer types. Due to the rarity of these tumors both the patients and the physicians can overlook or misinterpret the first often unspecific symptoms of these tumors (pain, limping and swelling). Therefore, radiographic examination (X-ray and/o...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-117905
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::Financial pressure on hospitals has been a major issue in the health care system of the past years and the financial situation is often what decides about the future of the hospitals. Therefore today the economic feasibility of patient treatment in hospitals is more important than ever before. After the degradation of...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0034-1368472
更新日期:2014-06-01 00:00:00
abstract::Ochronosis is a manifestation of the rare disease alkaptonuria. The most common presentations include pain in the lumbar spine region starting during the 3rd decade, spreading over the large joints. There exists no curative therapy for the disease at the moment. In the long-term the patients will be dependent on total...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1039225
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abstract::Lateral epicondylitis is a common disease in orthopaedic practice. Although the majority of cases do not become chronic, patients who do not respond to the initial treatment may suffer from pain in the long term and effective treatment is challenging. The off-label use of botulinum toxin is one of the common potential...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
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journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
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journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-116683
更新日期:2017-04-01 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
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: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: 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::Acute compartment syndrome of the lower leg following computer navigated primary total knee arthroplasty is rare but potentially devastating. This could be triggered by a setting of the bicortical tibial navigation pin. It is essential to take care during the operation, and to implement close post-operative control, e...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/a-1295-0249
更新日期:2020-12-17 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::The primary objective of osteomyelitis treatment is disinfection. Therapies can be protracted and expensive. The basic approach is to use radical debridement with antibiotics. However, radical debridement often results in major osseous defects, so it may be necessary to restore bone structures. Several different thera...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-100737
更新日期:2016-04-01 00:00:00
abstract:INTRODUCTION:Trauma or infectious diseases can cause destruction of the epiphyseal region of the knee with premature partial bridging of the physis and deviation of length and axis. There is only little information about tumorous lesions as pathogenetic factor for these deviations. We have been searching for an approac...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038999
更新日期:2008-11-01 00:00:00
abstract:AIM:An assessment of the reproducibility of the acetabular index on the basis of anteroposterior radiographs of the pelvis was performed in order to rule out residual dysplasia of the hip in the second year of life. METHOD:51 consecutive patients (41 girls, 10 boys) with congenital dysplasia of the hip (35 bilateral, ...
journal_title:Zeitschrift fur Orthopadie und Unfallchirurgie
pub_type: 杂志文章
doi:10.1055/s-2008-1038321
更新日期:2008-03-01 00:00:00