Zeitschrift für Orthopädie und ihre Grenzgebiete
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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.
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Z Orthop Ihre Grenzgeb · Sep 2001
Clinical Trial[Experiences with calcitonin treatment of patients with type I complex regional pain syndrome (CRPS I--Sudeck disease)].
PURPOSE/METHODS/PATIENTS: Calcitonin is a common treatment in patients suffering from Complex Regional Pain Syndrome Type 1 (CRPS I), although its effects are being controversially discussed. In a prospective study of 24 patients with CRPS I of the upper limb, we examined the tolerance of daily doses of 0.5 mg human calcitonin administered subcutaneously over 8 weeks. To assess the benefit of this therapy, the patients were clinically examined every second week. The results were compared to a consecutive group of 25 CRPS 1 patients who received only analgetics and physiotherapy. ⋯ The therapy with calcitonin has the burden of numerous unpleasant side-effects and causes only a slight therapeutic improvement. Thus, calcitonin must only be prescribed with reservations for patients suffering from CRPS I.