Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · Mar 2002
[Calculation of 3-D deformity in scoliosis by MRI of the total spine in two perpendicular reconstructed planes].
Scoliosis is a spinal deformity that is more complex and does not exist in one plane only. There have been many attempts to analyse three-dimensional spinal deformity, however, these procedures necessitate higher radiation doses. ⋯ Our method enables us to determine the real angle of scoliosis and to avoid techniques with any radiation risk for the patient.
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Z Orthop Ihre Grenzgeb · Mar 2002
[Technique and results of monosegmental transpedicular subtraction osteotomy in patients with ankylosing spondylitis and fixed kyphotic deformity of the spine].
The posterior extension osteotomy leads to a lengthening of the anterior column, which is associated with neurological complications and the risk of injuring retroperitoneal structures. Especially in high-grade syndesmophytosis the results are dissatisfactory. In this study we report on the results of an alternative procedure named the transpedicular subtraction osteotomy. ⋯ With the transpedicular subtraction osteotomy fixed kyphotic deformities of the spine in patients with ankylosing spondylitis can be corrected produce safely. The level of osteotomy is discussed and should depend upon the apex of kyphosis.
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Z Orthop Ihre Grenzgeb · Mar 2002
[Epiduroscopic diagnosis and treatment of epidural adhesions in chronic back pain syndrome of patients with previous surgical treatment: first results of 31 interventions].
Scars in the epidural space play an important role in the chronic lumbar pain syndrome of patients with previous surgical treatment. The results of surgical resection are frequently unsatisfactory. Discrepancies to imaging diagnostics are conspicuous. These are known from experience with endoscopic operations. Minimal adhesions may promote pain. Epiduroscopy is available for visualization of the epidural space. The objective of this study was to examine its possibilities in patients with previous surgical treatment. ⋯ Epiduroscopy offers a novel view of this compartment. Minimal adhesions which are not visible in imaging ean promote pain. They can be partially diagnosed and treated by epiduroscopy. There are still marked limitations to epiduroscopy due to technical problems. These must be minimized.
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Complaints in orthopaedics that are not sufficiently explainable can be caused (partly) by psychosomatic disorders. A manual psychosomatic disorders for legal assessment in orthopaedics will be supplied. ⋯ When composing legal assessments in orthopaedics, especially on pain, the knowledge of psychosomatic (co)morbidity is necessary for meeting the different causes of the complaints. Under awareness of possible psychosomatic disorders, additional psychosomatic legal assessments can be recommended and understood as well.