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D Adelt
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ABSTRACT: The safety and effectiveness of the Coflex implant has been confirmed in a large retrospective data analysis. Further studies investigated the long-term clinical outcome up to 12 years and evaluated all associated complications showing a strong safety record. Prospective studies oversee only a small patient population at this point and exhibit scientific shortcomings. A large prospective, randomized, concurrently controlled multicenter trial is underway collecting data in seven spine centers in Germany. A similar study is being performed in the USA with a different control group regulated by the Food and Drug Administration (FDA). A differential indication is the stabilization of an adjacent segment next (above) to a fusion. Stabilization of a functional spinal unit after nucleotomy is not promoted by the author.
Der Orthopäde 06/2010; 39(6):595-601. · 0.51 Impact Factor
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ABSTRACT: Lumbar fusion is practicable by combined operations with dorso-ventral combined procedures. The indication is advisable following degenerative, inflammative, neoplastic processes and fractures of the spine. We operated 125 patients with combined procedures in 10 years. Beside dorsal instrumentation an intervention at the spinal canal is mostly necessary, only in 9 patients we preferred first the ventral part for the correction of a deformity. According to our experience the advantage for delayed dorso-ventral procedure is the preoperative blood donation, perioperative ferrum substitution and intraoperative cell saver system. In contrast to 1 combined procedure, most patients with 2 operations during the same hospital stay do not need homologous blood, the addition of time for 2 delayed procedures is shorter than for a single operation with intraoperative patient turn round in anesthesia, the convalescence was better, complications were seldom and hospital stay shorter. This comes out very clear in the group of lumbar degeneration in high age, who otherwise were bedridden for a long time following frequent complications.
Unfallchirurgie 09/1995; 21(4):167-74.
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ABSTRACT: Durch Operationsverfahren mit Kombination dorsaler und ventraler Eingriffe ist die Fusion lumbaler Bewegungssegmente möglich.
Die Indikation ist in der Orthopädie und Traumatologie aufgrund degenerativer, entzündlicher und neoplastischer Prozesse sowie
Frakturen gegeben, wenn sowohl der dorsale als auch der ventrale Wirbelsäulenabschnitt betroffen sind. In einem Zehn-Jahres-Abschnitt
wurden 125 Patienten durch kombinierte Verfahren versorgt. Nach dorsaler, meist transpedikulärer Instrumentierung erfolgte
der Eingriff am Spinalkanal zur Dekompression; nur bei neun Patienten wurde bei ausgeprägten Wirbelkörperdeformitäten zur
Korrektur der ventrale Teil vorgezogen. Unsere Erfahrung zeigt, daß sich bei präoperativer Eigenblutspende, zwischenzeitlicher
Eisensubstitution und intraoperativer Blutrückführung ein zeitlich verzögertes dorsoventrales Vorgehen als vorteilhaft erweist.
Gegenüber der einzeitigen Operation kann häufiger auf Fremdblutgaben verzichtet werden; die addierte Operationszeit von zwei
Eingriffen war kürzer als bei einzeitigem Vorgehen mit intraoperativer Patientenumlagerung in Narkose. Die Rekonvaleszenz
war günstiger, und der stationäre Aufenthalt kürzer, besonders deutlich bei den Patienten mit degenerativen Erkrankungen in
hohem Lebensalter, die sonst lange Liegezeiten mit hoher Komplikationsrate aufweisen.
Lumbar fusion is practicable by combined operations with dorso-ventral combined procedures. The indication is advisible following
degenerative, inflammative, neoplastic processes and fractures of the spine. We operated 125 patients with combined procedures
in 10 years. Beside dorsal instrumentation an intervention at the spinal canal is mostly necessary, only in 9 patients we
prefered first the ventral part for the correction of a deformity. According to our experience the advantage for delayed dorso-ventral
procedure is the preoperative blood donation, perioperative ferrum substitution and intraoperative cell saver system. In contrast
to 1 combined procedure, most patients with 2 operations during the same hospital stay do not need homologeous blood, the
addition of time for 2 delayed procedures is shorter than for a single operation with intraoperative patient turn round in
anesthesia, the convalescence was better, complications were seldom and hospital stay shorter. This comes out very clear in
the group of lumbar degeneration in high age, who otherwise were bedridden for a long time following frequent complications.
European Journal of Trauma 04/1995; 21(4):167-174.
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Neurosurgical Review 02/1989; 12 Suppl 1:412-5. · 2.04 Impact Factor
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ABSTRACT: Creatine-Kinase-BB (CK-BB) is a brain specific enzyme, with a prognostic value for the patient's outcome after head-injury. We have investigated 76 brain injured patients and attempted to show a correlation of the concentrations of CK-BB and the Glasgow-Outcome-Scale (GOS). Patients with a CK-BB concentration of more than 50 ng/ml died. Patients, who had a CK-BB concentration less than 25 ng/ml showed only minimal neurological deficits. Intracerebral contusions and acute subdural haematomas showed the highest CK-BB concentration, indicating a high degree of braintissue-damage. CK-BB seems to have no correlation with the age of patients. Normalisation of elevated CK-BB levels do not correlate with recovery from neurological deficit.
Acta Neurochirurgica 02/1989; 101(3-4):117-20. · 1.52 Impact Factor
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ABSTRACT: Four patients with intracerebral vascular malformations underwent preoperative butylcyanoacrylate embolization via a calibrated leak catheter, in order to reduce the risks of surgery alone. In three cases the malformation was removed without causing neurological deficits. One patient died later from recurrent bleeding.
Journal of Neurology 08/1988; 235(6):355-8. · 3.47 Impact Factor
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ABSTRACT: If blood supply to the brain hemisphere is disturbed following closure of internal homolateral carotid artery tumors of the skull base with involvement of this artery should not be operated on radically. The authors describe the electrophysiological monitoring of cortical evoked somato-sensory potentials. If there is no alteration of the evoked potentials after preliminary reversible blockade of the internal carotid artery this vessel can be definitely closed using a detachable balloon. Thereafter the whole tumor including the carotid artery can be removed. The authors describe a case of juvenile angiofibroma operated on in this way. The combined interventional-neuroradiological and surgical management widens the range of skull base surgery.
Laryngologie, Rhinologie, Otologie 08/1986; 65(7):406-9.
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ABSTRACT: In 43 patients with arterio-venous malformations and one patient with a cavernous haemangioma, whose angiomas were completely removed by the same Surgeon, pre- and postoperative angiograms were reviewed and the clinical results documented in a follow-up study. Mortality rate (7%) and severe disability (7%) are significantly lower than in untreated patients. A poor outcome strongly depends on the number of feeding arteries, on localization (midline) and size.
Acta Neurochirurgica 02/1985; 76(1-2):45-9. · 1.52 Impact Factor
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ABSTRACT: Some vertebro-basilar aneurysm may not be treatable at a reasonable risk by direct clipping. A possible alternative is transvascular obliteration, using the means of modern interventional neuroradiology in combination with neurophysiological monitoring. These possibilities and related difficulties are outlined and discussed and the example of two cases with different types of vertebrobasilar aneurysms (top of the basilar artery and basilar trunk aneurysm) which have been treated by balloon embolization.
Acta Neurochirurgica 02/1985; 78(3-4):136-41. · 1.52 Impact Factor
