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  • 1
    Electronic Resource
    Electronic Resource
    Operative therapy in metastases and primary tumors of the spine (1990)
    Springer
    Neurosurgical review 13 (1990), S. 205-210 
    Details
    ISSN: 1437-2320
    Keywords: Spine ; tumors of the spine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Benign and primary malignant tumors of the spine require a ventral procedure to remove the tumor and to stabilize the spine. Experience in the last years has shown that sole laminectomy in children can no longer be recommended. An instrumentation of the spine to prevent kyphosis must be performed. The rate of pseudarthrosis was of course, high when the kyphosis was treated by an exclusive dorsal instrumentation. In patients with severe kyphosis a combined procedure with ventral and dorsal operation is necessary [9]. Solitary metastases of cancer of the prostate, breast, and the thyreoid gland show a better prognosis than metastases of cancer of the lung or the stomach. Thus metastases of the first group which also show a dependency on hormones, should be operated on by a ventral procedure, independent of the location of the tumor. In cases of multiple metastases and bad condition of the patient a ventral operation is not indicated. In these cases, a dorsal procedure with decompression and stabilization allows mobility of the patients until only few days before death. An implantation of instrumentations that include a transpedicular screwing can result in spreading of the tumor to the neighboring vertebrae. Therefore, this kind of operation should be the “ultima ratio”.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313020
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Orthopedic and neurosurgical treatment of severe kyphosis in myelomeningocele (1999)
    Springer
    Neurosurgical review 22 (1999), S. 45-49 
    Details
    ISSN: 1437-2320
    Keywords: Key words Myelomeningocele ; Kyphosis ; Spinal osteotomy ; Complications ; CSF circulation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Kyphosis in myelomeningocele is characterized by a complex pattern of problems during development and therapy. On the one hand, decompensation of upright posture leads to loss of sitting ability and social integration; on the other hand, accompanying malformations and trophic alterations threaten the physical integrity and performance. Neurologic function, cerebrospinal fluid (CSF) circulation, skeletal deformity and the urinary transport system need to be kept in mind and need to be treated with cooperation between the different specialties. Especially during serious surgical interventions such as spinal surgery, neither the nervous system nor the kidneys must be ignored. Sixteen patients underwent kyphectomy in the Orthopedic Department of the University of Mainz between 1993 and 1997, all of them supervised by the Neurosurgical Department. In 13 cases, transversal myelotomy was performed. No insufficiency of CSF circulation was seen; neither were there any CSF fistulae. Particular problems arose from the skin and soft tissue above the gibbus, the lack of muscles and the regeneration deficiency caused by trophic disorders. Therefore, a significantly higher complication rate was found than with other correctional operations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s101430050008
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The operative treatment of spinal deformities in MMC (1993)
    Springer
    Neurosurgical review 16 (1993), S. 45-52 
    Details
    ISSN: 1437-2320
    Keywords: CD-and VDS-instrumentation ; neuromuscular scoliosis ; operative treatment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The results of the operative treatment of scoliosis in 12 patients with MMC and in two patients with associated severe kyphosis are presented. In scoliosis only multi-segmental methods combined with ventral procedures allow a postoperative care without brace or cast. The angle before and after operation with the CDI or CDI/VDS procedures averaged 80.3° and 38.2° respectively (mean corrections of 41.5° and 51.6%). The results show that patients with scoliosis with MMC had a approximately 30% greater preoperative angle than patients with idiopathic scoliosis. An early operation (in progressive curves with more than 30°) may reduce the number and severity of complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00308613
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Development of scoliosis in myelomeningocele. Differences in the history caused by idiopathic pattern (1993)
    Springer
    Neurosurgical review 16 (1993), S. 301-306 
    Details
    ISSN: 1437-2320
    Keywords: Myelomeningocele ; progression rate ; scoliosis ; spinal deformities
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The natural history of scoliosis in the literature concerning the idiopathic and neuromuscular scoliosis in myelomeningocelet patients (MMC) are compared to our own results in 12 patients with MMC and 89 patients operated because of an idiopathic scoliosis. According to known experiences the natural history of scoliosis in MMC is progression even after the end of growth. The chance of developing a scoliosis increases with the patients, age and the level of the lesion. The higher the level of paralysis the more common is a spinal deformity. In literature the progression rate of MMC scoliosis is 2,5–3,5° per year, with the idiopathic pattern 0,5–0,65° per year after end of growth. Our own results of surgically treated patients show a rate of progression of 6,2° per year in MMC. The surgical treatment must start before a severe spinal deformity has developed because of the higher rate of operative complications.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00383841
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  • 5
    Electronic Resource
    Electronic Resource
    Proliferation enhancement by spontaneous multiplication of chromosome 7 in rheumatic synovial cells in vitro (1995)
    Springer
    Human genetics 〈Berlin〉 96 (1995), S. 651-654 
    Details
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Mosaic trisomy of chromosome 7 is known to occur in a variety of non-neoplastic hyperproliferative disorders. In long-term cell cultures established from rheumatic synovium with mosaic trisomy 7, we observed a continuous increase in the proportion of cells with trisomy 7 to over 50% by the 10th in vitro passage. Simultaneous in situ hybridization with a repetitive chromosome-7-specific DNA probe and fluorescent Ki-67 labelling showed a strong correlation between trisomy 7 and an elevated proliferation index in cultured rheumatic synovial cells. Moreover, we observed a fraction of rapidly proliferating cells with up to eight copies of chromosome 7 as the sole cytogenetic change. Frequent somatic pairing of centromeres of two chromosomes 7 in interphase nuclei suggests either atypical non-disjunction with a persisting centromere or selective endoreduplication of chromosome 7.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00210293
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    Sagittal static imbalance in myelomeningocele patients: improvement in sitting ability by partial and total gibbus resection (1999)
    Springer
    European spine journal 8 (1999), S. 451-457 
    Details
    ISSN: 1432-0932
    Keywords: Key words Myelomeningocele ; Sagittal imbalance ; Kyphosis ; Sitting ability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The progression of kyphosis in myelomeningocele is independent of skeletal growth and requires early operative correction and stabilization to prevent a loss of sitting ability. In severe cases, only vertebrectomy makes it possible to achieve correction, stability and skin-closure without tension. In 14 patients with myelomeningocele gibbus, kyphectomy was performed, removing two vertebral bodies on average. The average kyphosis angle decreased from 128° to 81°, enabling most of the patients to participate again in social life by restoring wheelchair mobility. Nevertheless, a significantly higher complication rate was found compared to other correctional operations, lengthening the average hospital stay to 41 days. Special problems arose from trophic disorders of the skin and soft tissue and from the dystrophic muscles below the level of neural malfunction. In three cases, kyphosis reappeared cranial to the fused segments, requiring ventral stabilization. With respect to increasing kyphosis angle, an early intervention should be aimed at. A secondary operation can be necessary, if surgery is performed without taking care of the growth potential.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005860050204
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    Paper (German National Licenses)
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