Publications by authors named "Klaus John Schnake"
Article Synopsis
- The study evaluated the reliability of the AO Spine-DGOU Osteoporotic Fracture classification system using a cross-sectional survey with 23 trauma experts rating 33 cases at two different times.
- The calculated kappa statistics indicated moderate inter-rater agreement and substantial intra-rater reproducibility, suggesting that while raters differed slightly, individual consistency was high.
- The findings highlight the importance of training in improving the reliability of the classification system for identifying fracture patterns and guiding treatment.
Purpose: The goal of this systematic review is to offer a detailed summary of the present status of robotic-assisted surgery for adult spinal deformity.
Methods: This review is based on articles systematically searched in PubMed, Medline, and Web of Science Core Collection databases on robotic-assisted surgery for adult spinal deformity. Differences in the precision of pedicle screw placement, duration of surgery, and incidence of complications between robotic-assisted surgery and the conventional open surgery were considered.
[Cervical Spine Injuries].
Z Orthop Unfall
August 2024
Article Synopsis
- About one-third of cervical spine injuries happen in the upper section, specifically between the base of the skull (occiput) and the second cervical vertebra, with 70% of injuries occurring at this location.
- Types of injuries in this area include atlas fractures, occipital condyle fractures, and injuries to ligaments associated with the upper cervical spine.
- Treatment options range from conservative therapy for stable injuries to surgical intervention for unstable cases, with the article covering details on injury frequency, diagnosis, classification, and standard treatment methods.
Article Synopsis
- This narrative review discusses the rising prevalence of osteoporosis in an aging population and its impact on spinal surgery outcomes, particularly concerning implant failure and reoperation rates.
- It summarizes the effects of decreased bone mineral density (BMD) on spinal biomechanics and outlines multidisciplinary strategies to prevent complications in osteoporotic patients.
- The conclusions emphasize the importance of tailored preoperative evaluations and adherence to surgical principles to enhance implant stability and reduce complication rates in patients with low BMD.
Article Synopsis
- Osteoporotic vertebral compression fractures (OVCF) are increasingly common in older adults and can lead to significant economic costs, with surgical treatment often involving high complication rates.
- A systematic review of 739 studies yielded 15 relevant studies involving 15,515 patients, identifying both non-adjustable (like age over 90 and male gender) and adjustable risk factors (such as kidney and liver function) affecting clinical outcomes.
- The study emphasizes the need for preoperative assessments of risk factors and suggests interdisciplinary collaboration, particularly with geriatricians, to improve surgical results for elderly patients with OVCF.
Study Design: Multicenter prospective cohort study.
Objective: The study aims to validate the recently developed OF score for treatment decisions in patients with osteoporotic vertebral compression fractures (OVCF).
Methods: This is a prospective multicenter cohort study (EOFTT) in 17 spine centers.
Article Synopsis
- The study involved analyzing surgical strategies and outcomes for patients with osteoporotic thoracolumbar fractures classified as OF 5 within a larger multicenter cohort of 518 patients.
- Out of 19 patients assessed, different surgical methods were utilized, with no major surgical complications but a 45% occurrence of general postoperative complications reported.
- Results indicated significant improvements in patients' functional outcomes and quality of life at an average follow-up of 20 weeks, highlighting surgical stabilization as an effective treatment despite the associated complication rate.
Article Synopsis
- The study is a systematic review and expert consensus focused on managing odontoid fractures in elderly patients, highlighting the high complication rates associated with both surgical and non-surgical treatments.
- Recommendations were developed through collaboration among experts from the German Orthopaedic and Trauma Society, incorporating new literature on the topic.
- Key conclusions emphasize that CT scans are the diagnostic standard, non-surgical options are viable for certain fracture types, and surgical methods, particularly posterior stabilization for osteoporotic fractures, are recommended with careful consideration for very old patients.
Study Design: Systematic review.
Objective: The aim of this study was to conduct a systematic overview of the pathogenesis and the treatment options of combined odontoid and atlas fractures in geriatric patients.
Methods: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science databases for articles published until February 2021 dealing with combination fractures of C1 and C2 in geriatric patients.
Article Synopsis
- This study aimed to analyze treatment strategies for osteoporotic thoracolumbar OF 4 fractures, assessing complications and clinical outcomes in 518 patients.
- Out of these, 152 patients with OF 4 fractures were evaluated, with the most common treatment being short-segment posterior stabilization, revealing varying outcomes based on age and treatment type.
- The findings suggest that conservative treatment is effective for moderate symptoms, while hybrid stabilization showed better results, indicating that cement augmentation is a good alternative for specific patients.
Article Synopsis
- Multidisciplinary consensus recommendations for managing spinal involvement in multiple myeloma (MM) were developed by experts from various medical fields in Germany.
- The aim is to deliver a thorough diagnostic and treatment approach for thoracolumbar vertebral fractures in MM patients, reviewing current strategies and literature.
- Treatment decisions should involve a team of specialists, focusing on improving patient quality of life while considering risks and the patient's overall condition and preferences.
Study Design: prospective, observational.
Background: Wound drainage's indwelling duration and general use are the centre of ongoing discussion. The aim of our prospective observational study was to evaluate the total drainage volume postoperatively and its course after lumbar interbody fusion surgeries to define an ideal point in time for drainage removal.
Reduction and treatment of complications can be achieved through improvement of treatment options, complication management, and the abilities to remedy complications, and through the minimization of errors, respectively. Human-medical error represents an inappropriate treatment, for instance, not administered carefully, correctly or in a timely manner. It can cover all areas of physician-related and medical activities with regard to prophylaxis, diagnosis, selection of treatment modalities, and post-operative care.
View Article and Find Full Text PDFPurpose: The considered benefit of surgical drain use after spinal surgery is to prevent local accumulation of a haematoma by decompressing the closed space in the approach of the surgical site. In this context, the aim of the present systematic review was to prove the benefit of the routine use of closed-suction drains.
Methods: We conducted a comprehensive systematic review of the literature according to the Preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist and algorithm.
Background: Osteoporotic vertebral fractures (OVFs) have become increasingly common, and previous nonrandomized and randomized controlled trials (RCTs) have compared the effects of cement augmentation versus nonoperative management on the clinical outcome. This meta-analysis focuses on RCTs and the calculated differences between cement augmentation techniques and nonsurgical management in outcome (e.g.
View Article and Find Full Text PDFPurpose: The aim of this systematically review is to detect differences between fractures located at the mid-thoracic spine compared to fractures of the thoracolumbar junction (TLJ) and the lumbar spine in osteoporotic vertebral body fractures.
Methods: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications regarding osteoporotic fractures of the thoracolumbar spine with respect to the fracture location. Differences in prevalence, cause of fracture, fracture healing, and outcomes between the mid-thoracic spine and the TLJ and the lumbar spine were considered.
Objective: Optimal management of A3 and A4 cervical spine fractures, as defined by the AO Spine Subaxial Injury Classification System, remains controversial. The objectives of this study were to determine whether significant management variations exist with respect to 1) fracture location across the upper, middle, and lower subaxial cervical spine and 2) geographic region, experience, or specialty.
Methods: A survey was internationally distributed to 272 AO Spine members across six geographic regions (North America, South America, Europe, Africa, Asia, and the Middle East).
Purpose: The aim of this study was to assess therapeutic strategies of inpatients with osteoporotic thoracolumbar fractures (OTF) in Germany.
Methods: Prospective multi-center study including 16 German-speaking trauma centers over a period of 7 months. All inpatients with OTF were included.
Study Design: Retrospective cohort study.
Objectives: The OF classification is a new classification for osteoporotic vertebral fractures. The aim of this study was to clarify the relationship between preoperative OF subgroups and the postoperative outcome after kyphoplasty in patients with such fractures.
Purpose: This study aimed to compare clinical results and fusion rates of uncoated polyetheretherketone (PEEK) cages with titanium-coated PEEK cages in posterior lumbar interbody fusion (PLIF) surgery.
Methods: A prospective randomised study including 60 patients with one- or two-segment lumbar degenerative diseases. Patients received either titanium-coated PEEK cages (group A) or uncoated PEEK cages (group B).
Article Synopsis
- Minimally invasive stabilization techniques for thoracolumbar osteoporotic fractures are effective treatment options, especially for neurologically intact patients.
- The OF classification helps determine the best surgical approach depending on fracture type and condition severity.
- Though generally safe, some procedures may carry a higher risk of complications, especially in more invasive cases or severe osteoporosis.
Article Synopsis
- * The review aims to explore literature on acute traumatic thoracic vertebral fractures in patients who have normal bone quality, emphasizing the importance of using CT scans for accurate diagnosis.
- * Patients with thoracic spine fractures often have additional thoracic injuries like sternal fractures, which increase fracture instability; thus, long segment stabilization is recommended for unstable mid and upper thoracic fractures.