Fracture care using percutaneously applied titanium mesh cages (OsseoFix®) for unstable osteoporotic thoracolumbar burst fractures is able to reduce cement-associated complications--results after 12 months.

Background: Despite the known demographic shift with expected doubled rate of vertebral body fractures by the year 2050, a standardized treatment concept for traumatic and osteoporotic incomplete burst fracture of the truncal spine does not exist. This study aims to determine whether minimally invasive fracture care for incomplete osteoporotic thoracolumbar burst fractures using intravertebral expandable titanium mesh cages is a suitable procedure and may provide improved safety in terms of cement-associated complications in comparison to kyphoplasty procedure.

Methods: In 2011/2012, 15 patients (10 women, 5 men; mean age 77) with 15 incomplete osteoporotic thoracolumbar burst fractures (T10 to L4) were stabilized using intravertebral expandable titanium mesh cages (OsseoFix®) as part of a prospective study.

Single-stage epidural catheter lavage with posterior spondylodesis in lumbar pyogenic spondylodiscitis with multilevel epidural abscess formation.

Background: Despite significant advances in the conservative management of pyogenic spondylodiscitis, consecutive instability, deformity, and/or neurologic compromise demands a prompt surgical intervention. However, in rare cases involving additional multilevel epidural abscess formation, the appropriate surgical strategy remains controversial. In this retrospective cohort analyses, we evaluated the efficacy of a single-stage posterior approach with the addition of a one-time multilevel epidural lavage via the surgically exposed interlaminar fenestration of the infected segment.

Percutaneous Stabilization System Osseofix® for Treatment of Osteoporotic Vertebral Compression Fractures - Clinical and Radiological Results after 12 Months.

Study Design: A prospective consecutive cohort study (follow-up study).

Objective: Our study investigated whether implantation of an expandable titanium mesh cage (Osseofix®) is a successful and safe minimally invasive therapy for osteoporotic vertebral compression fractures (VCF). Our experiences, clinical and radiological findings after 12 months follow-up are presented.

Disc volume reduction with percutaneous nucleoplasty in an animal model.

Study Design: We assessed volume following nucleoplasty disc decompression in lower lumbar spines from cadaveric pigs using 7.1Tesla magnetic resonance imaging (MRI).

Purpose: To investigate coblation-induced volume reductions as a possible mechanism underlying nucleoplasty.

Percutaneous disc decompression with nucleoplasty-volumetry of the nucleus pulposus using ultrahigh-field MRI.

Purpose: To evaluate changes in nucleus pulposus volume as a potential parameter for the effects of disc decompression.

Methods: Fifty-two discs (T8 to L1) were extracted from 26 pigs and separated into thoracic (T8 to T11) and thoracolumbar discs (T12 to L1). The discs were imaged using 7.

Marginal contribution of UKS- versus TKA in varus arthritis of the knee.

Background: In recent years, decisions regarding the treatment of individual patients have increasingly been affected by economic considerations. The G-DRG system reimburses sledge endoprosthetic implantations at a much lower rate than surface replacements and at significantly different cost weights (CW). Therefore, when only G-DRG payments are considered, TKA produces higher gains.

Analysis of IL-17(+) cells in facet joints of patients with spondyloarthritis suggests that the innate immune pathway might be of greater relevance than the Th17-mediated adaptive immune response.

Introduction: In this study, we analysed the number of IL-17(+) cells in facet joints, in the peripheral blood (PB) and synovial fluid (SF) of spondyloarthritis (SpA) patients and compared these results with those of patients with other rheumatic diseases and controls.

Methods: Immunohistochemical analysis of IL-17(+) cells was performed in facet joints of 33 ankylosing spondylitis (AS) patients and compared with data from 20 osteoarthritis (OA) patients. The frequency of IL-17(+)CD4(+) T cells in PB and SF of SpA patients (PB n = 30, SF n = 11), rheumatoid arthritis (RA) patients (PB n = 14, SF n = 7), OA patients (PB n = 10) and healthy controls (PB n = 12) was analysed after stimulation with Staphylococcus aureus Enterotoxin B and phorbol 12-myristate 13-acetate/ionomycin and quantified by flow cytometry.

Immunohistochemical analysis of osteoblasts in zygapophyseal joints of patients with ankylosing spondylitis reveal repair mechanisms similar to osteoarthritis.

Objective: New bone formation of the spine is a typical feature of ankylosing spondylitis (AS). It is unknown whether new bone formation is part of a physiological repair process or a unique pathological entity of the disease.

Methods: We analyzed zygapophyseal joints from patients with AS and osteoarthritis (OA) undergoing spinal surgery for rigid hyperkyphosis (AS) or radiculopathy caused by severe OA.

Successful treatment of spondylodiscitis using titanium cages: a 3-year follow-up of 22 consecutive patients.

Background And Purpose: The use of metal implants in large defects caused by spinal infection to support the anterior column is controversial, and relatively few results have been published to date. Despite the fact that there is bacterial adhesion to metal implants, the strong immunity of the highly vascularized spine because of rich muscle covering is unique. This possibly allows the use of metal implants, which have the advantage of high stability and reduced loss of correction.

Reconstruction of large defects in vertebral osteomyelitis with expandable titanium cages.

The purpose of this study was to investigate the outcome of expandable titanium cage implantation in large defects caused by acute vertebral osteomyelitis. Twenty-five patients with acute single or multilevel spondylodiscitis were treated after radical débridement and posterior instrumentation with an anterior expandable titanium cage and bone grafting. Clinical, laboratory and radiological follow-up continued for 36 months.

Pitfalls and complications in the treatment of cervical spine fractures in patients with ankylosing spondylitis.

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.

Loads on a telemeterized vertebral body replacement measured in two patients.

Study Design: The loads acting on a vertebral body replacement (VBR) were measured in vivo.

Objective: To measure the implant loads for different activities within the first 6 months after surgery.

Summary Of Background Data: Mathematical models exist for predicting spinal loads for various activities.

Complications and safety aspects of kyphoplasty for osteoporotic vertebral fractures: a prospective follow-up study in 102 consecutive patients.

Background: 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.

Postoperative multisegmental lumbar discitis treated by staged ventrodorsoventral intervention.

Background: Postoperative spinal infections are relatively rare. They can become life-threatening.

Case Report: A 56-year-old man developed multisegmental spinal infection with methicillin-resistant Staphylococcus aureus after discectomy at L3/4.

Loads on a telemeterized vertebral body replacement measured in three patients within the first postoperative month.

Background: Little is known about the loads acting on a vertebral body replacement within the first month postoperatively. Among other things, such data are required for choosing the optimal rehabilitation program for a patient and for evaluating the efficacy of aids like crutches and braces.

Methods: Telemeterized vertebral body replacements were implanted into three patients, replacing parts of their fractured vertebral body L1.

Value of preoperative ultrasound marking of calcium deposits in patients who require surgical treatment of calcific tendinitis of the shoulder.

Purpose: The objective of our study was to evaluate whether preoperative ultrasound-guided marking of calcium deposits has a positive effect on the efficiency and speed of localization of calcium deposits during surgery, and whether this technique is a factor that increases the probability of good clinical results.

Methods: Twenty-four patients who required surgery for calcific tendinitis in the years 2001 and 2002 were divided into 2 groups of 12 patients by week. Before undergoing surgery, those in group 1 (weeks 1, 3, 5, etc.

Surgical treatment of spondylodiscitis in the cervical spine: a minimum 2-year follow-up.

Cervical spine spondylodiscitis is a rare, but serious manifestation of spinal infection. We present a retrospective study of 20 consecutive patients between 01/1994 and 12/1999 treated because of cervical spondylodiscitis. Mean age at the time of treatment was 59.

Temporary vertical transarticular-pin fixation of unstable ankle fractures with critical soft tissue conditions.

Unstable ankle fractures are demanding injuries to treat. Open reduction and internal fixation are accepted as standard care, however, in patients with severe soft tissue damage or serious medical conditions, this approach may not always be advisable. Closed reduction with temporary fixation using vertical transarticular pins is one method to maintain joint alignment until an open technique is possible.

Tight hamstring syndrome and extra- or intraspinal diseases in childhood: a multicenter study.

Tight hamstrings syndrome (THS) has been attributed to a number of disorders. Most authors argue that tight hamstring syndrome is determined in the majority of cases by a protruding or slipped vertebral disc. The term "disc related tight hamstring syndrome" is usually used to describe the condition.

Spondylodiscitis in childhood: results of a long-term study.

Study Design: Retrospective study to gather long-term data clinical, paraclinical, and radiographic data on nonoperatively managed cases of childhood spondylodiscitis.

Objectives: To analyze and assess the clinical, laboratory, and radiologic findings in children with spondylodiscitis and to document the efficacy of conservative treatment based on the long-term clinical, functional, and radiologic outcomes of these patients.

Summary Of Background Data: Childhood spondylodiscitis is an extremely rare entity that often presents an nonspecific clinical picture.

Ultrasonographic imaging of fractures of the clavicle in newborn infants.

Fractures of the clavicle in the neonate are usually diagnosed by clinical examination and confirmed by plain radiography. Exposure of newborn infants to irradiation should be avoided if possible. Following the clinical examination of 2978 neonates, 15 had suspected fractures of the clavicle.

Permanent thoracic myelopathy resulting from herniation of a calcified intervertebral disc in a child.

This retrospective study was made to illustrate the rare occurrence of neurologic deficits resulting from intervertebral disc calcification (IDC) in a child. Most authors agree that juvenile IDC is usually a benign, self-limiting disease with excellent prognosis. The symptoms subside spontaneously in 95% of patients.