Biomedical subjects

A von Strempel

Publications and source records attributed to A von Strempel.

11 recordsLinked to original sources

PubMed2002

Long-term observation and management of resolving infantile idiopathic scoliosis a 25-year follow-up.

Of 42 patients with resolving infantile idiopathic scoliosis, 34 were followed up for more than 25 years. Twenty had been primarily treated in a plaster bed and 14 by physiotherapy. The mean angle of the curve at presentation was 17 degrees and at follow-up it was 5 degrees. No patient had significant progression of the scoliosis during the growth spurt. When adults few had back pain or an increased disability score and there was no interference with work or social activities. The rib-vertebra angle difference proved to be an essential radiological sign when distinguishing resolving from progressive infantile idiopathic scoliosis. There was no advantage of plaster over physiotherapy with regard to either the time to resolution or the functional outcome. Treatment of resolving infantile idiopathic scoliosis in a plaster bed is therefore now outdated.

Adult↗

PubMed1999

[Sports and physical load bearing capacity after spondylodesis in patients with Scheuermann kyphosis].

In this investigation it was examined which is the effect of an extensive spondylodesis by patients with Scheuermann's kyphosis on their sport activity and their physical load capacity. Between 1983 and 1990, 10 patients with severe kyphosis secondary to Scheuermann's disease underwent surgical correction and spinal fusion. In 1997 all 10 patients were clinically and radiologically examined and interviewed at an average follow-up of 9.6 years. At the time of follow-up one patient was active in top sports, seven patients in normal sport, two patients were members in a sports-club and one patient was not interested in sport. Eight patients went in for sports regulary. Mostly the patients were active in gymnastics, cycling and swimming. At follow-up almost all patients found that their physical load capacity and the behaviour in relation to back pain were better than before operation. Half of the patients were exposed to a middle physical load in the daily life. The presented study shows that patients after extensive spondylodesis for Scheuermann's kyphosis and clear reduction of pain are not automatically limited in the daily life, both for sport and professional activity. However, generalized recommendations for the physical load capacity of the operated patient cannot be given, and an individualized decision must be taken for each case.

Adolescent↗

PubMed1998

The stability of bone screws in the os sacrum.

A variety of points of insertion and implantation techniques are recommended for inserting screws into the os sacrum. On the basis of 16 complete human sacrum specimens the following axial pull-out tests were performed: 1. Insertion of convergent measuring screws, 6.0 mm and 7.0 mm in outside diameter respectively, into the body of vertebra S1 using a monocortical and bicortical technique respectively with perforation of the ventral cortex. 2. Insertion of divergent screws into the ala sacralis at the level of S1 with 6-mm and 7 mm screws respectively, using a monocortical technique without perforation of the ventral cortex. 3. Insertion of convergent 6-mm screws into the body of vertebra S2 using a monocortical and bicortical technique respectively with perforation of the ventral cortex. The highest axial pull-out force was reached using convergent 6-mm screws inserted into the body of vertebra S1 using the bicortical technique with perforation of the ventral cortex (2392.4 N). The use of a 7.0-mm screw in the same implantation technique did not result in higher pull-out forces (2274.7 N). The monocortical technique reached a pull-out force of 1657.53 N with a 6-mm screw and 1505.64 N with a 7-mm screw. Convergent insertion of 6-mm screws into the body of S2 resulted in pull-out forces of 537.02 N using a bicortical and only 297.71 N using a monocortical technique. Divergent insertion of screws into the ala sacralis reached a maximal pull-out force of 495.47 N using 6-mm screws and 449.79 N using 7-mm screws. These data resulted from a monocortical implantation technique without perforation of the ventral cortex of the ala sacralis. The results of the present biomechanical study show that convergent bicortical implantation in the body of S1 is the most stable technique for screw fixation in the sacrum. The use of 7-mm rather than 6-mm screws did not lead to increased primary stability. Anatomic studies have shown that a safe area exists in the region of the ventral promontory, so this implantation technique appears to be unobjectionable.

Adult↗

PubMed1994

[Biomechanical prerequisites for examining the stability of osteosynthesis procedures of the spine].

Basic reflections on biomechanical tests of spinal implants are reviewed. Four different pedicle screw systems are compared during loading in extension, flexion, side-bending, and rotation. The thoracolumbar and the lumbar spine were tested. Stability against rotation forces was lowest in all systems. Because of this, a cross-connector is recommended in highly unstable situations. All tests were done in cadaver spines with normal bone mineral density (measured before the tests). The first series of tests was done without destroying the cadavers. A second series was done with maximal load until the implants or the bony bed of the screws failed. The results show that rigid implants more often led to pedicle fractures. An unstable screw rod interface led to implant failure. Cadaver tests can provide answers about the primary stability characteristic only. Fatigue tests are not possible in cadaver spines because they become autolytic before enough cycles can be applied.

Adult↗

PubMed1993

[Sports capacity of patients with scoliosis].

The burden of sport of patients with scoliosis depends on the age, the expected progredience of the deformity and the attained deformation. In children and teenagers treated with an orthesis, total prohibition is not appropriate. All kinds of sport not involving any risk of injury to the participant or the patient wearing an orthesis can be practised. The orthesis may be removed only during swimming. For patients with a fused spine the number of the remaining lumbar moving segments and the deformity are essential for the exercise load. If there are less than three free lumbar segments all kinds of sport with axial and rotationary burdens are not to be recommended. If the spinal bending is more than 50 degrees (Cobb) the limitation of the cardiopulmonary ability is even more severe.

Adolescent↗

PubMed1992

[Post-traumatic recurrent hip joint dislocation].

Recurrent post-traumatic dislocation of the hip joint without an accompanying fracture is very rare. Delayed reduction and a too short immobilization periods seems to favor redislocation. One case is presented together with a discussion of the operative therapy and the intraoperative pathological-anatomical findings with respect to the literature.

Adult↗

PubMedDate not supplied

[Nuclear magnetic resonance tomography in destructive changes of the spine].

Correct treatment of destructive lesions in the vertebral column requires exact radiological evaluation with the traditional techniques of plain films, computed tomography and radionuclide scanning. With the development of magnetic resonance imaging the possibility of visualizing pathological changes of the bone marrow became apparent. To prove the value of MRJ in detecting destructive lesions of the spine 29 patients were investigated using plain radiographs, computertomographies, radionuclide scanning and MRJ. The findings were correlated to the intraoperative aspect of the lesion and the results of the histological investigation in 18 cases. MRJ showed to be a very sensitive manner of detecting bone marrow changes of different kind. Indeed characteristic changes in signal intensity were not to be observed in pathological lesions of inflammatory or tumorous genesis. So the distinction is based on morphological criterias.

Adolescent↗

PubMedDate not supplied

[A case with complicated disorder of the occipito-cervical junction].

Only very few complete aplasias of the posterior atlas arch have been described. Aplasia combines with assimilation of the anterior atlas arch and a basilar impression is an even rarer variant of this developmental anomaly in the occipitocervical region. The clinical symptoms in the case described were limited to persistent nuchal pain and severely limited function of the cervical spine.

Braces↗

PubMedDate not supplied

[Long-term follow-up in patients with idiopathic scoliosis].

The study concludes the results of the clinical and radiological follow-up of 51 patients with idiopathic scoliosis after 20-36 years (mean of 24.5 years). The aim of the study was to find out which parameters can give an answer at the beginning about the expectable prognosis of the scoliosis. Most of all rotation of the apex vertebra, the skeletal maturity and the curve pattern of the scoliosis are a precise factor for prognosis. The term "scoliosis in babies" should be left, because these benign spontaneously resolving type of scoliosis can appear in the second age, too. To separate them from the infantile scoliosis, which often has a bad natural history the term "oblique position scoliosis" should be used instead of scoliosis in babies.

Adolescent↗

PubMedDate not supplied

[Stability of pedicle screws. 1: Maximum pullout force in healthy bony spine trunks with reference to drilling technique].

Pullout direction was axial and oblique to screw axis. Two different techniques of preparing the screw bed are matched: 1) 3.2 mm AO drill and 6.0 mm screws for D7-S1 and 4.5 mm screws for D11-D6, 2) resection of cancellous bone of the pedicle tube and 6.0 mm, 7.0 mm, 8.0 mm screws, which were inserted after measuring each level. With the better technique 1 (saving the cancellous bone) 620N-161N were reached from D1-S1, even if bigger screws could be used with technique 2.

Adult↗

PubMedDate not supplied

[Stability of pedicle screws. 2: Maximum pullout force with reference to bone density].

Maximum pullout strength of pedicle screws in osteoporotic cadaver spines are tested. Bone mineral density was measured before by two noninvasive methods (QCT, DRA). Pullout direction was axial to screw axis. 210 N to 920 N were reached from D1-S1. There is a high correlation between bone mineral density and pullout strength (r = 0, 8-0.9). Augmentation of osteoporotic pedicles with bone cement increases screw stability nearly to that one of non-osteoporotic spines.

Adult↗