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| 2. |
- Heyde, Christoph-E., et al.
(author)
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C1 Lateral Mass Screw Fixation
- 2019
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In: Koller H., Robinson Y. (eds) Cervical Spine Surgery: Standard and Advanced Techniques.. - Cham, Schweiz : Springer. - 9783319934310
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Book chapter (peer-reviewed)abstract
- C1 lateral mass screws according to Goel and Harms represent a safe and stable stabilization of the atlas within posterior constructs. Those constructs avoiding transarticular C1-C2 screws allow for different reduction manoeuvers after screw insertion. By preoperative planning, the course of the vertebral artery has to be visualized to avoid potentially disastrous injuries. Proper subperiosteal preparation is necessary to avoid copious bleeding from the venous plexus below the C1 arch. Under lateral visualization, screws can be placed in the C1 lateral mass without the necessity of sacrificing the C2 root. C1 screws should converge about 10–20°, and bicortical screw placement is preferred.
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| 3. |
- Heyde, Christoph E, et al.
(author)
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Fatale komplexe HWS-Verletzung bei M. Bechterew nach Sturz mit dem Rennrad
- 2007
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In: Sportverletzung, Sportschaden. - : Georg Thieme Verlag KG. - 0932-0555 .- 1439-1236. ; 21:3, s. 148-151
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Journal article (peer-reviewed)abstract
- Patienten mit ankylosierender Spondylitis sind durch die Kyphose, die Einsteifung und den häufig osteoporotischen Knochen der Wirbelsäule im Rahmen von Stürzen für Verletzungen der Halswirbelsäule besonders prädestiniert. Dabei besteht ein überdurchschnittlich hohes Risiko für neurologische Komplikationen. Vorgestellt wird ein Patient mit M. Bechterew, der bei einem Sturz mit dem Rennrad eine komplexe HWS-Verletzung erlitt. Trotz umgehender operativer Versorgung kam es im weiteren Verlauf zum Tod des Patienten durch einen schweren hypoxischen Hirnschaden. Vor dem Hintergrund dieses fatalen Verlaufes sollen die Empfehlungen zur sportlichen Betätigung bei M. Bechterew und die sich daraus für die veränderte Wirbelsäule ergebenden Gefahren diskutiert werden.
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| 5. |
- Heyde, Christoph-E, et al.
(author)
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Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis.
- 2008
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In: Patient safety in surgery. - : Springer Science and Business Media LLC. - 1754-9493. ; 2
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Research review (peer-reviewed)abstract
- Patients with ankylosing spondylitis are at significant risk for sustaining cervical spine injuries following trauma predisposed by kyphosis, stiffness and osteoporotic bone quality of the spine. The risk of sustaining neurological deficits in this patient population is higher than average. The present review article provides an outline on the specific injury patterns in the cervical spine, diagnostic algorithms and specific treatment modalities dictated by the underlying disease in patients with ankylosing spondylitis. An emphasis is placed on the risks and complication patterns in the treatment of these rare, but challenging injuries.
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| 6. |
- Heyde, Christoph-E., et al.
(author)
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Ätiologie und Pathogenese der Spondylodiszitis
- 2017
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In: Die Wirbelsäule. - Stuttgart : Georg Thieme Verlag KG. - 2509-8241 .- 2509-825X. ; 01:04, s. 237-244
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Journal article (peer-reviewed)abstract
- Die Häufigkeit der unspezifischen „pyogenen“ und der verschiedenen Formen der spezifischen Spondylodiszitiden nimmt zu. Die Gründe dafür sind vielfältig. Diese Erkrankungen sind auch heute noch mit einer relevanten Morbidität und Mortalität vergesellschaftet. Die Diagnose erfolgt aufgrund der unspezifischen klinischen Manifestation häufig verzögert. Die Kenntnis der Epidemiologie, der Ätiologie und der Pathogenese der verschiedenen Formen der Spondylodiszitis kann die frühzeitige Diagnose und damit den Beginn der Therapie als auch die Therapie an sich erleichtern. In diesem Artikel werden deshalb epidemiologische Daten und wesentliche Aspekte der Ätiologie und Pathogenese der unspezifischen pyogenen Spondylodiszitis sowie der verschiedenen Formen der spezifischen Spondylodiszitis bei Tuberkulose, bei Brucellose und bei Pilzinfektionen diskutiert.
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| 7. |
- Przkora, René, et al.
(author)
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Operative treatment of unstable odontoid fractures in the geriatric population
- 2006
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In: Topics in Spinal Cord Injury Rehabilitation. - 1082-0744 .- 1945-5763. ; 12:2, s. 12-19
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Journal article (peer-reviewed)abstract
- Background: Odontoid fractures, often in combination with C1 fractures, are a common fracture of the cervical spine in geriatric patients. The optimal treatment of this fracture in this patient population is often controversial. We report the surgical outcome of unstable type II odontoid fractures in the elderly. Method: 8 patients (median age, 80.5 years; range, 72-93) with unstable type II odontoid fractures according to the Anderson and d'Alonzo classification were included in this prospective study. 2 patients sustained a C1 fracture (1 had an unstable type III fracture according to the Gehweiler classification, and 1 had a stable type III fracture). There were no neurological complications. All patients were classified as ASA class III. 7 patients were treated with anterior odontoid double-screw compression osteosynthesis followed by a firm neck support for 6 weeks. 1 patient with an unstable C1 and C2 fracture was treated with an occipital cervical (C2) fusion in combination with a C1-C2 fusion according to Magerl technique. Follow-up was 18 months. Results: No deaths occurred during the study period. All patients demonstrated fracture healing at followup. Median length of hospital stay was 31.4 days (range, 16-64). Preexisting comorbidities complicated final outcome in 2 patients, both of whom received a temporary tracheostomy for respiratory failure. Conclusion: Type II odontoid fracture healing can occur predictably with anterior double-screw compression osteosynthesis. The outcome in this patient population may be complicated by preexisting medical comorbidities.
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| 8. |
- Robinson, Yohan, 1977, et al.
(author)
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Complications and safety aspects of kyphoplasty for osteoporotic vertebral fractures: a prospective follow-up study in 102 consecutive patients.
- 2008
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In: Patient safety in surgery. - : Springer Science and Business Media LLC. - 1754-9493. ; 2
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Journal article (peer-reviewed)abstract
- Kyphoplasty represents an established minimal-invasive method for correction and augmentation of osteoporotic vertebral fractures. Reliable data on perioperative and postoperative complications are lacking in the literature. The present study was designed to evaluate the incidence and patterns of perioperative complications in order to determine the safety of this procedure for patients undergoing kyphoplasty.We prospectively enrolled 102 consecutive patients (82 women and 20 men; mean age 69) with 135 operatively treated fractured vertebrae who underwent a kyphoplasty between January 2004 to June 2006. Clinical and radiological follow-up was performed for up 6 months after surgery.Preoperative pain levels, as determined by the visual analogous scale (VAS) were 7.5 +/- 1.3. Postoperative pain levels were significantly reduced at day 1 after surgery (VAS 2.3 +/- 2.2) and at 6-month follow-up (VAS 1.4 +/- 0.9). Fresh vertebral fractures at adjacent levels were detected radiographically in 8 patients within 6 months. Two patients had a loss of reduction with subsequent sintering of the operated vertebrae and secondary spinal stenosis. Accidental cement extravasation was detected in 7 patients in the intraoperative radiographs. One patient developed a postoperative infected spondylitis at the operated level, which was treated by anterior corporectomy and 360 degrees fusion. Another patient developed a superficial wound infection which required surgical revision. Postoperative bleeding resulting in a subcutaneous haematoma evacuation was seen in one patient.The data from the present study imply that percutaneous kyphoplasty can be associated with severe intra- and postoperative complications. This minimal-invasive surgical procedure should therefore be performed exclusively by spine surgeons who have the capability of managing perioperative complications.
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| 9. |
- Robinson, Yohan, 1977-, et al.
(author)
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Diagnostik und Therapie der thorakalen Spondylodiszitis
- 2007
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In: Manuelle Medizin. - : Springer Science and Business Media LLC. - 0025-2514 .- 1433-0466. ; 45, s. 17-20
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Journal article (peer-reviewed)abstract
- Due to the increase in patients with multiple co-morbidities and immigration from developing countries the incidence of thoracic spondylodiscitis has not decreased. The diagnosis of thoracic spondylodiscitis is based on clinical findings, laboratory diagnostics and radiological imaging, including X-ray and MRI. Surgical therapy includes radical debridement, correction of deformity and adequate stabilisation, even though the use of titanium implants is discussed controversially. Additionally antibiotic therapy according to the resistance spectrum is necessary. Early diagnosis and therapy enable healing without severe complications.
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| 10. |
- Robinson, Yohan, 1977, et al.
(author)
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Evidence supporting the use of bone morphogenetic proteins for spinal fusion surgery.
- 2008
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In: Expert review of medical devices. - : Informa UK Limited. - 1743-4440 .- 1745-2422. ; 5:1, s. 75-84
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Research review (peer-reviewed)abstract
- Bone morphogenetic proteins (BMPs) are capable of promoting bone healing and even induce de novo osteogenesis. Their clinical application in spinal fusion surgery has recently increased in popularity. This is especially true for the use of BMPs in combination with artificial bone substitutes that have the capability to replace autologous bone graft, which can be associated with severe harvesting complications. This review will examine the use of BMP-2 and BMP-7 as commercially available products that have proven their osteoinductive capacity in spinal fusion. We will perform an overview of the literature for scientific evidence supporting the use of these new technologies. Despite their high osteoinductive potency, the use of BMPs does not replace proper surgical stabilization in spinal fusion. Safety issues with BMPs are osteoclast activation, postoperative swelling and hyperostosis. Despite these issues, manufacturers continue to expend more effort concerning proper application, dosage and carriers for these devices for spinal fusion, both presently and in the future.
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