Zeitschrift für Orthopädie und ihre Grenzgebiete
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Z Orthop Ihre Grenzgeb · May 2005
Clinical Trial[What questions are appropriate for predicting the risk of chronic disease in patients suffering from acute low back pain?].
The objective of the study was to develop a brief questionnaire to determine the risk of chronification for patients suffering from lumbar (low) back pain who are consulting a physician for the first or second time. ⋯ Based on these questions, it was possible to predict the chronification of back pain with a probability of 78.05 %. A corresponding questionnaire and an evaluative table were developed.
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Z Orthop Ihre Grenzgeb · May 2005
Review Comparative Study[How can I assess the back pain status in my patients? The Mainz chronic disease staging method and its prognostic value].
Chronification of pain is not just a simple matter of duration, although many publications still pretend that this is so. Chronification is more a spread of pain on the physical level, on duration and even more on the psychological and social levels. We present different models to explain this process. ⋯ Results of different inquiries have shown the correlation between chronicity of pain and measurements of quality of life and effectiveness of medical treatment. Also the MPSS has a prognostic value about the effect of further treatment. To get a differentiated view on the results of examinations and treatment outcome, an evaluation of the chronification process of the patient's pain is a necessity.
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Z Orthop Ihre Grenzgeb · May 2005
[epiDRB--a new minimally invasive concept for referencing in the field of computer-assisted orthopaedic surgery].
Optoelectronic navigation for computer-assisted orthopaedic surgery (CAOS) is based on a firm connection of bone with passive reflectors or active light-emitting diodes in a specific three-dimensional pattern. Even a so-called "minimally-invasive" dynamic reference base (DRB) requires fixation with screws or clamps via incision of the skin. Consequently an originally percutaneous intervention would unnecessarily be extended to an open procedure. Thus, computer-assisted navigation is rarely applied. Due to their tree-like design most DRB's interfere with the surgeon's actions and therefore are at permanent risk to be accidentally dislocated. Accordingly, the optic communication between the camera and the operative site may repeatedly be interrupted. The aim of the research was the development of a less bulky, more comfortable, stable and safely trackable device that can be fixed truly percutaneously. ⋯ With the newly developed epiDRB computer-assisted navigation becomes easier and safer to handle even in punctures and other percutaneous procedures at the spine as much as at the extremities without an unproportionate amount of additional trauma. Due to the special design referencing of more than one vertebral body is possible at one time, thus decreasing radiation exposure and increasing efficiency.
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Z Orthop Ihre Grenzgeb · May 2005
[What do we know about the symptoms of back pain? Epidemiological results on prevalence, incidence, progression and risk factors].
This paper provides an overview of epidemiological findings concerning the prevalence and incidence of back pain, the underlying risk factors and health care utilization due to back pain. ⋯ Back pain belongs to the major individual and societal health problems in Germany. While extensive epidemiological evidence exists for the prevalence of back pain, its severity, course and associated risk factors, little systematic knowledge is available about the medical treatment of back pain.
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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.