Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · Mar 1989
Review[Pain and the spine. A review. 1. On the pathophysiology of radicular pain syndromes. Current concepts explaining pain in nerve entrapment syndromes].
The problems of nociception and the development of pain in radicular syndromes of the spine may be summarized as follows: 1. The anatomic complex nerve root/dorsal ganglion is a key structure in the pain physiology of disk prolapse and spinal stenosis. 2. ⋯ The change in membrane properties in the nociceptive pathways of nerve roots is one of the preconditions for perception of pain. As the authors' remark indicate, a better understanding of the pathophysiology of pain will lead to a more differentiated therapeutic approach.
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Z Orthop Ihre Grenzgeb · Jul 1987
Case Reports[Pseudomeningocele following lumbar intervertebral disk surgery].
Pseudomeningoceles have been observed several times after closed traumatic injuries of the cervical plexus resulting in avulsion of the nerve roots. Following lumbar puncture or lumbar disc operation meningoceles are seldom occurring events. ⋯ Since that time about 50 cases have been reviewed by the literature (10, 11). In this paper we report another case of an iatrogenic pseudomeningocele developed following surgical treatment for herniated lumbar disc attempting to outline their clinical and radiological findings.
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Z Orthop Ihre Grenzgeb · Mar 1987
[Percutaneous lumbar facet denervation. Indications and significance in chronic backache].
The lumber facet joints have been established as a source of low back pain which may radiate to the leg. Because there are no reliable clinical signs which confirm the diagnosis injections of an anaesthetic agent into the joints are necessary. Therapeutically a percutaneous radiofrequency destruction of the medial branches of lumbar dorsal rami may relieve such pain. Success rate, however, is depending on a careful selection of patients.
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Presented is a procedure for the correction of the juvenile kyphosis and the kyphotic false posture upon spondylitis ankylopoietica. Upon spine dissects the extraction and outbreak force of screws and screw pairs dorsally brought into the vertebral body were measured. It has been showed that the pedicle screws tolerate very high extraction forces upon sagittal and right-angle stress as well. The correction of the juvenile kyphosis upon rigid kyphosis and the correction by lordosing the thoraco-lumbar transition upon patients with a spondylitis ankylopoietica is clinically possible with good results.
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Orthopedic surgery on the distal lower extremities can be performed with conduction anesthesia of the sciatic nerve at the popliteal fossa, supplemented by blocking of the femoral nerve with ischemia or partial deprivation of blood supply. The technique of this method of anesthesia is described. It has proved its value in patients with high anesthesia risk as well as in out-patients.