Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · Mar 2005
Comparative Study[Minimally-invasive computer-assisted fluoroscopic navigation for kyphoplasty].
The transpedicular placement of a hollow needle into vertebral bodies for kyphoplasty requires utmost accuracy and thereby permanent multiplanar X-ray control. Facing the increasing number of vertebral compression fractures, the aim of this work was the implementation of computer-assistance to optimise the issue. Prior to clinical implementation, experimental trials were undertaken to analyse the quality-improving options of the technique. ⋯ In challenging cases of deteriorated anatomy and difficult radiomorphologic orientation, especially of the lower thoracic spine, the CAOS-procedure succeeds in finding the optimal pedicular approach to the vertebral body, helps to avoid collateral damage and minimises the overall risk of the procedure. High accuracy and reduced radiation exposure justify the clinical use of fluoroscopic navigation for transpedicular instrumentation.
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Z Orthop Ihre Grenzgeb · Mar 2005
Comparative Study[Surgical therapy of unspecific and specific Spondylodiscitis].
The aim of this study was to evaluate the clinical and radiological results of surgical treatment of thoracic and lumbar vertebral osteomyelitis by means of one-stage extrafocal posterior stabilisation, anterior debridement, and anterior column reconstruction. ⋯ One-stage extrafocal posterior stabilisation combined with anterior debridement and anterior column reconstruction with bone grafts or titanium cages is a safe and effective strategy for patients with vertebral osteomyelitis in need of surgery. Titanium cages have proven to be biomechanically advantageous, especially in cases of extensive destruction and are not associated with higher rates of persistence or recurrence of infection compared to autologous bone grafts.
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Z Orthop Ihre Grenzgeb · Mar 2005
Randomized Controlled Trial Clinical Trial[Influence of local anesthesia and energy level on the clinical outcome of extracorporeal shock wave-treatment of chronic plantar fasciitis].
The efficacy of low energy extracorporeal shock wave treatment (ESWT) for chronic plantar fasciitis is discussed controversially. It is unclear whether the simultaneous application of local anesthesia (LA) interferes with clinical outcome. ⋯ At 6 weeks success rates after low-energy ESWT with local anesthesia were significantly lower than after identical low-energy ESWT without local anesthesia. Higher energy levels could not balance the disadvantage of this effect. LA significantly influenced the clinical results after low energy ESWT in a negative way. Blinding patients by LA in ESWT studies must therefore be considered a systematic error in study design.
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Z Orthop Ihre Grenzgeb · Mar 2005
Clinical Trial[The potential for training of proprioceptive and coordinative parameters in patients with chronic ankle instability].
This study was aimed at assessing the outcome of physical therapy based on both subjective patient's satisfaction and objective measurement of peroneal reaction time in patients with chronic ankle instability. ⋯ Measurement of PRT can be used as a helpful diagnostic parameter, as a parameter for quality control and for verification of therapy results. Specific physiotherapy leads to good clinical results and increased PRT.