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  • 1
    ISSN: 1432-0932
    Keywords: Key words Lumbar spine ; Metastases ; Corpectomy ; Vertebral body replacement ; Biomechanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Metastatic spine lesions frequently require corpectomy in order to achieve decompression of the spinal cord and restoration of spinal stability. A variety of systems have been developed for vertebral body replacement. In patients with prolonged life expectancy due to an improvement of both systemic and local therapy, treatment results can be impaired by a loosening at the implant-bone interface or mechanical failure. Furthermore, early detection of a metastatic recurrence using sensitive imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) is possible in these patients without artefact interference. The aim of our pilot study was to evaluate the clinical applicability and results of a new radiolucent system for vertebral body replacement in the lumbar spine. The system consists of bone-integrating biocompatible materials – a polyetherurethane/bioglass composite (PU-C) replacement body and an integrated plate of carbon-fibre reinforced polyetheretherketone (CF-PEEK) – and provides high primary stability with anterior instrumentation alone. In a current prospective study, five patients with metastatic lesions of the lumbar spine were treated by corpectomy and reconstruction using this new system. Good primary stability was achieved in all cases. Follow-up (median ¶15 months) using CT and MRI revealed progressive osseous integration of the PU-C spacer in four patients surviving more than 6 months. Results obtained from imaging methods were confirmed following autopsy by biomechanical investigation of an explanted device. From these data, it can be concluded that implantation of the new radiolucent system provides sufficient long-term stability for the requirements of selected tumour patients with improved prognosis.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2102
    Keywords: Schlüsselwörter Spiral-CT ; Virtuelle Endoskopie ; Larynx ; Key words Helical CT ; Virtual endoscopy ; Larynx
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary This pilot study investigated the feasibility and clinical value of high-resolution virtual real-time laryngoscopy based on helical CT data sets. Nine patients with laryngeal pathology (three with tumors of the vocal cords, two laryngeal carcinomas, one with invasion of the larynx by thyroid carcinoma and six subglottic stenoses) underwent examination by helical CT at a collimation of 1 mm. Following acquisition, the images were processed at a workstation with standard visualization software, such that virtual endoscopy (VE) in real time was possible. The images were then compared with the findings of conventional endoscopy. Because of swallowing artifacts, reconstruction failed in 2 of 12 patients. None of the carcinomas of the vocal cords was recognized at VE or in the cross-sectional CT images. VE provided the correct diagnosis in 8 of 12 cases (laryngeal tumors, subglottic stenoses). Virtual laryngoscopy is capable of simulating the visual findings of endoscopy in cases of laryngeal tumors and subglottic stenoses. Small tumors of the vocal cords are not adequately visualized. The major problem affecting results is motion artifacts resulting from involuntary swallowing.
    Notes: Zusammenfassung Im vorliegenden Beitrag wird eine Pilotstudie zur Überprüfung der Machbarkeit und des klinischen Nutzens einer hochauflösenden virtuellen Echtzeitlaryngoskopie aus Spiral-CT-Datensätzen vorgestellt. 12 Patienten mit Erkrankungen im Kehlkopfbereich (3 Stimmlippentumore, 2 Larynxkarzinome, ein in den Larynx eingebrochenes Schilddrüsenkarzinom und 6 subglottische Stenosen) wurden mittels hochauflösender Spiral-CT (Kollimation 1 mm) untersucht. Anschließend wurden die Bilder auf einer Workstation mit einer standardmäßigen Visualisierungssoftware so rekonstruiert, daß eine virtuelle Endoskopie (VE) in Echtzeit möglich wurde, welche der herkömmlichen Fiberendoskopie gegenübergestellt wurde. 2 der 12 Patienten waren bedingt durch Schluckartefakte nicht zu rekonstruieren. Keines der Stimmlippenkarzinome war in der VE oder den Querschnittsbildern zu erkennen. In 8 von 12 Fällen war die VE diagnostisch (Larynxtumore, subglottische Stenosen). Die virtuelle Laryngoskopie in der hier beschriebenen Technik vermag Larynxtumoren und subglottische Stenosen, nicht aber kleine Stimmbandtumoren in einer dem Kliniker vertrauten endoskopischen Sichtweise darzustellen. Hauptproblem sind Bewegungsartefakte durch unwillkürliche Schluckbewegungen.
    Type of Medium: Electronic Resource
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