Retrospective patient outcome evaluation after semi-rigid stabilization without fusion for degenerative lumbar instability

Postero-lateral fusion by means of rod-and-screws/hooks constructs is still the gold standard in the treatment of lumbar degenerative spinal diseases. However, fusion remains fraught with a high risk of adjacent levels degeneration, sometimes leading to suboptimal clinical outcomes. Dynamic stabilization is supposed to compensate for disadvantages associated with rigid fusion. Preliminary results of spinal stabilization by means of dynamic devices show encouraging results. Therefore, the aim of the present study is to retrospectively evaluate the overall long term outcome and the condition of the adjacent discs to fused segments in an active population of 33 patients with back pain associated with lumbar instability, who underwent postero-lateral dynamic stabilization by means of a dynamic rod-and-screws construct, without fusion. The mean follow-up was 45 months. Clinical and radiological data, pain, function, return to work rate and patient satisfaction index were recorded to assess the overall patient outcome. The results show a very low rate of post-operative complications. No spontaneous fusion was noted in any patient. Pain, both lumbar and radicular, was totally relieved in most of the patients and the functional results were good or excellent in 76% of patients. Most of the patients resumed their previous activities; the return to previous work rate was 87.5%. Ninety-four percent of the patients were fully satisfied with the results. The preservation of both instrumented levels and the adjacent ones was observed in 90% of patients. Although the present series is rather limited in number, the results of the study are encouraging and in agreement with most findings in the literature. As the results are sustained at a mid and long term, the authors believe that the stabilization without fusion by means of semi-rigid/dynamic systems is an interesting alternative to classical fusion as long as the indications are strictly defined.     

Das Dilatationsverhalten von Polyesterprothesen

In a prospective, randomized multicenter trial, 175 patients with abdominal aortic aneurysms were treated by conventional operation. Two types of polyester prostheses (Gelsoft Plus, Vascute Terumo Corp., Hamburg, Germany or Microvel, Boston Scientific, Ratingen, Germany) were selected randomly for implantation. Diameters ranged from 14 to 20 mm. The diameters of the grafts were measured by ultrasound postoperatively, as well as 6, 12, and 24 months after operation. Local and systemic complications were recorded. Dilation of the main body of the “Gelsoft plus” prosthesis was 19% within the first 12 months and 30% for the Microvel prosthesis. Extreme dilation was not observed. Thus, vascular prostheses must be chosen small enough and the dilation of 20–30% should be considered. The most frequent complication was incisional hernia (32%).     

Methodik der fortlaufenden Kreislaufanalyse am Hunde

Zusammenfassung Es wird ein für die fortlaufende Blutdruckschreibung an der Karotisschlinge des Hundes entwickeltes Gerät hoher Empfindlichkeit beschrieben, welches bei entlasteter Gefäßwand die Blutdruckänderungen mit automatisch richtiger Wiedergabe der Amplitude durch ein optisches Glasplattenmanometer zur Aufschrift bringt. Die Steuerung des Manometers erfolgt durch eine sich selbsttätig entlastende Membran.Mit 7 Abbildungen     

Von der Entstehung und Beobachtung der Schatteneffekte bei der Skiaskopie

Ohne ZusammenfassungMit 13 Textabbildungen.     

Chirurgische Behandlung benigner Läsionen und Strikturen der Gallenwege

Benign strictures of the biliary ducts are treated surgically in 90% of cases. Usually they are caused by trauma to the choledochous duct during gallbladder operations. Younger patients are frequently affected and, particularly if the strictures go untreated, can suffer from secondary complications such as cholangitis or secondary biliary cirrhosis with the serious dangers of portal hypertension and even hepatic failure and death. Although immediate treatment by end-to-end anastomosis has sometimes been described, this method is reasonable only for smooth cuts to the choledochous duct. Good long-term results have been achieved in 86% of cases with Roux-en-Y hepaticojejunostomy. In general, the best way to avoid complications is the all-important surgical maxim of correct indication for the primary operation. The best course is to limit the decision for surgery to symptomatic gallstones.     

Ärztliche Gesichtspunkte bei der Wiedereinrichtung des Unfallkrankenhauses Straßburg im Jahre 1940

Ohne Zusammenfassung     

Ueber die Ursachen der Erythropsie

Ohne Zusammenfassung     

Besprechungen

Ohne Zusammenfassung     

Untersuchungen über die pathologische Histologie,Pathogenese und postmortale Diagnose der seuchenhaften Gehirn-Rückenmarksentzündung (Bornaschen Krankheit) des Pferdes. Ein Beitrag zur vergleichenden Pathologie des Zentralnervensystems

Ohne Zusammenfassung