Christian Morgenstern

Christian Morgenstern
Centro Medico Teknon · Morgenstern Institute of Spine

Medical Doctor (Dr. med.), PhD in Biomedical Engineering, Diplom-Ingenieur

About

37
Publications
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460
Citations

Publications

Publications (37)
Article
Objective Aim of this study was to evaluate the efficacy in reducing post-operative pain and opioid analgesia of a novel inter-disciplinary strategy combining pre-operative Thoraco-Lumbar Interfascial Plane (TLIP) block and percutaneous/endoscopic TLIF surgery. Secondary aims were to determine the time to first postoperative ambulation and hospital...
Article
Full-text available
Invited reply to the letter to the editor by McNally et al., 2021
Article
Background: Open spine surgery usually requires post-operative analgesia with narcotics. The Thoraco-Lumbar Interfascial Plain (TLIP) block is a novel, ultrasound-guided local anesthesia technique that targets the sensory component of the dorsal rami of the thoracolumbar nerves. Study Design: Prospective, non-randomized sequential case series stud...
Article
BACKGROUND CONTEXT Open lumbar spine fusion surgery usually requires opioid analgesia for several weeks during the postoperative recovery period. Recently, a facet-sparing, full percutaneous transforaminal lumbar interbody fusion (TLIF) has been introduced that uses an endoscopic cannula for placement of an interbody cage in combination with percut...
Article
Full-text available
Background: Synovial fluid culture is the standard investigation for the preoperative diagnosis of periprosthetic joint infection (PJI). However, the culture has limited sensitivity and requires several days until result. We evaluated the value of isothermal microcalorimetry for real-time diagnosis of PJI based on heat produced by microbial growth...
Article
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Background The performance of multiplex PCR (mPCR) for detection of antimicrobial resistance from clinical isolates is unknown. We assessed the ability of mPCR to analyse resistance genes directly from clinical samples. Patients with orthopedic infections were prospectively included. Phenotypical and genotypical resistance was evaluated in clinical...
Article
Study design: This was a prospective, multicenter, consecutive case series' study. Objective: The objective of this study was to evaluate a novel facet-sparing, percutaneous transforaminal lumbar interbody fusion (pTLIF) technique consisting of percutaneous insertion of an expandable interbody cage through an endoscopic cannula with the trans-Ka...
Article
Full-text available
Introduction: We evaluated the feasibility of a full percutaneous approach with an expandable interbody cage and an interspinous spacer for a segmental stabilization of the anterior and posterior columns of the lumbar spine, respectively, with local anesthesia. Methods: Patients were prospectively included between 2012 and 2018 in this single-cent...
Article
Objective To prospectively evaluate automated multiplex PCR and isothermal microcalorimetry tests for rapid and accurate diagnosis of septic arthritis. Methods Patients with acute arthritis were prospectively included from October 2014 to September 2015. In synovial fluid (SF), leukocyte count and differential, culture, PCR, and microcalorimetry w...
Article
BACKGROUND CONTEXT Interbody fusion by open discectomy is the usual treatment for degenerative disc disease but requires a relatively long recovery period. The transforaminal posterolateral approach is a well-known standard in endoscopic spine surgery that allows direct access to the disk with progressive tissue dilation, avoiding tissue and bone d...
Article
Full-text available
Objectives The objective of this study was to develop a test for the rapid (within 25 minutes) intraoperative detection of bacteria from synovial fluid to diagnose periprosthetic joint infection (PJI). Methods The 16s rDNA test combines a polymerase chain reaction (PCR) for amplification of 16s rDNA with a lateral flow immunoassay in one fully aut...
Article
Introduction: Bone healing disturbance following fracture fixation represents a continuing challenge. We evaluated a novel fully automated polymerase chain reaction (PCR) assay using sonication fluid from retrieved orthopedic hardware to diagnose infection. Patients and methods: In this prospective diagnostic cohort study, explanted orthopedic h...
Chapter
The standard treatment for degenerative disk disease is interbody fusion by open discectomy. However, this technique requires open tissue dissection with the disadvantages of higher risk of infection, blood loss and a relatively long recovery period.
Article
Introduction Analysis of joint aspirate is the standard preoperative investigation for diagnosis of periprosthetic joint infection (PJI). We compared the diagnostic performance of culture and multiplex polymerase chain reaction (PCR) of synovial fluid for diagnosis of PJI. Patients and Methods Patients in whom aspiration of the prosthetic hip or k...
Article
Kniegelenksverletzungen und Überlastungsschäden im Nachwuchsleistungssport nehmen deutlich zu. Hierbei spielen vordere Kreuzbandrupturen und der vordere Knieschmerz eine große Rolle. Verletzungen und Überlastungsschäden entstehen überwiegend, wenn die die Bewegung stabilisierenden Strukturen die zusätzlich auftretenden Kräfte nicht kompensieren kön...
Article
Full-text available
Background: Interbody fusion by open discectomy is the usual treatment for degenerative disk disease but requires a relatively long recovery period. The transforaminal posterolateral approach is a well-known standard in endoscopic spine surgery that allows direct access to the disk with progressive tissue dilation. The aim of this study was to ass...
Chapter
Study Design. Prospective study. Objective. The purpose of this study was to assess the clinical outcome of three endoscopic lumbar disc techniques: selective endoscopic discectomy (SED), intracanal transforaminal endoscopy (ITE), and an interlaminar endoscopy (ILE). Summary of Background Data. A number of percutaneous endoscopic procedures for lum...
Article
Full-text available
Study objectives: The clear discrimination of central and obstructive hypopneas is highly relevant to avoid misinterpretation and inappropriate treatment of complicated breathing patterns. Esophageal manometry is the accepted standard for the differentiation of the phenotypes of sleep apnea. However, it is limited in its use due to poor acceptance...
Chapter
This chapter discusses endoscopically assisted transforaminal percutaneous lumbar interbody fusion. Degenerative disc disease (DDD) is associated with diminished disc height and painful symptomatology. The usual treatment is highly invasive lumbar interbody fusion (transforaminal lumbar interbody fusion [TLIF], posterior lumbar interbody fusion [PL...
Article
Background: The identification of obstructive and central hypopneas is considered challenging in clinical practice. Presently, obstructive and central hypopneas are usually not differentiated or scores lack reliability due to the technical limitations of standard polysomnography. Esophageal pressure measurement is the gold-standard for identifying...
Article
Measurement of upper airway resistance is of interest in sleep disordered breathing to estimate upper airway patency. Resistance is calculated with the airflow and respiratory effort signals. However, there is no consensus on a standard for upper airway resistance measurement. This study proposes a new benchmarking method to objectively compare dif...
Article
Full-text available
Hydrogels are water-insoluble hydrophilic polymers used in a wide range of medical products such as, drug delivery, tissue replacement, heart surgery, gynaecology, ophthalmology, plastic surgery and orthopaedic surgery. These polymers exhibit low toxicity, reduced tissue adherence, and are highly biocompatible. A class of hydrogels, hydrolysed poly...
Article
Clinical series of patients with degenerative disk disease undergoing an endoscopic posterolateral transforaminal procedure that used a reaming foraminoplasty technique to enlarge the foramen coupled with insertion of the B-Twin expandable spacer. This retrospective analysis of 107 consecutive patients sought to assess the outcome of this surgical...
Article
Full-text available
The automatic differentiation of obstructive and central respiratory events is a major challenge in the diagnosis of sleep-disordered breathing. Esophageal pressure (Pes) measurement is the gold-standard method to identify these events. This study presents a new classifier that automatically differentiates obstructive and central hypopneas with the...
Article
Full-text available
The differentiation of obstructive and central respiratory events is a major challenge in the diagnosis of sleep disordered breathing. Esophageal pressure (Pes) measurement is the gold-standard method to identify these events but its invasiveness deters its usage in clinical routine. Flattening patterns appear in the airflow signal during episodes...
Article
New techniques for automatic invasive and noninvasive identification of inspiratory flow limitation (IFL) are presented. Data were collected from 11 patients with full nocturnal polysomnography and gold-standard esophageal pressure (Pes) measurement. A total of 38,782 breaths were extracted and automatically analyzed. An exponential model is propos...
Article
Full-text available
The differentiation between obstructive and central respiratory events is one of the most recurrent tasks in the diagnosis of sleep disordered breathing. Esophageal pressure measurement is the gold-standard method to assess respiratory effort and identify these events. But as its invasiveness discourages its use in clinical routine, non-invasisve s...
Article
Detection of inspiratory flow limitation (IFL) is being recognized of increasing importance in order to diagnose pathologies related to sleep disordered breathing. Currently, IFL is usually identified with the help of invasive esophageal pressure measurement, still considered the gold-standard reference to assess respiratory effort. But the invasiv...
Article
Assessing incidence and severity of inspiratory flow limitation (IFL) is of importance for patients suffering of sleep disordered breathing (SDB) in order to diagnose a spectrum of different pathologies. In this study a new exponential equation is proposed to characterize the pressure/flow relationship of IFL and non-IFL breaths. Classical and alte...
Article
Full-text available
We sought to construct a general methodology for objectively quantifying the learning curve associated with any surgical technique and to determine the number of cases needed to achieve a success rate of 90% for the technique of transforaminal endoscopic lumbar discectomy. To our knowledge, no other studies have observed the learning curve of endos...
Chapter
Full-text available
We present a component-based system for object detection and identification. From a set of training images of a given object we extract a large number of components which are clustered based on the similarity of their image features and their locations within the object image. The cluster centers build an initial set of component templates from whi...
Article
Full-text available
We present a component-based approach for recognizing objectsunder large pose changes. From a set of training images of a givenobject we extract a large number of components which are clusteredbased on the similarity of their image features and their locations withinthe object image. The cluster centers build an initial set of componenttemplates fr...
Article
Full-text available
The goal of this work was the evaluation of various spectral estimation methods with regard to their suitability for classifying EEG data. A test environment was implemented in which the algorithms are optimized and evaluated using various artificial and real EEG data. The methods are based on autoregressive approaches, as well as from FFT, wavelet...
Conference Paper
Telemedicine is gaining more and more momentum as a new approach for patients' surveillance at their home to encourage public safety. One of the most important physiological parameters to be monitored is the electrical activity of the heart. This paper presents a new microcontroller-based system, in which patients can be monitored 24 hours-a-day in...

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Projects

Projects (3)
Archived project
Since 2005 we have developed a new lumbar access system and an expandable interbody cage to be inserted via Kambin's triangle with local anesthesia (awake surgery) and a skin incision of only 1 cm based upon our experience with endoscopic surgery.
Archived project
To evaluate samples of synovial fluid obtained by joint aspirations of patients with suspected periprosthetic joint infection (PJI). In this project, one of the biggest bio-databases of synovial fluid samples in Europe was established at the Charité clinic in Berlin, Germany. The samples were analyzed with the newest available technology to improve the diagnosis and therapy of PJI.
Project
This projects shows our articles on lumbar endoscopic spine surgery.