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Biomedical subjects

G Bergmann

Publications and source records attributed to G Bergmann.

At least 73 records · Page 4Linked to original sources
PubMed1996

Patient monitoring system for load measurement with spinal fixation devices.

Fractures of the spine can be stabilized by different implants. Their stiffness varies widely and only little is known about the loads acting on these devices. In order to measure the forces and moments in the implant, the internal fixator after Dick was modified. An inductively powered telemetry unit is placed inside the fixator and is hermetically sealed against body fluids. An integrated eight channel telemetry chip was developed to measure the signals of six strain gauge sensors, the implant temperature and the power supply. Because two fixators are implanted together, two telemetry transmitters run at the same time. This paper describes the function of the instrumented implant and the external system components.

Biomechanical Phenomena↗
PubMed1996

In vitro load measurement using an instrumented spinal fixation device.

An AO spinal fixateur interne was modified to study the effects of a corpectomy on implant performance. A hermetically sealed cartridge containing strain gauges and an inductively powered telemetry unit was integrated into the threaded portion of the original implant. Five cadaveric spines were instrumented with the modified implant spanning a single lumbar vertebra. The spines were tested in axial compression, torsion, flexion, extension and lateral bending. Measurements of the three forces and moments within the implant were performed in the intact spine and repeated following a corpectomy and corpectomy plus complete posterior ligamentous injury. The bending moment, increased following corpectomy in all testing modes. The largest increase was in the flexion bending moment, which increased from 155 Nmm to 3328 Nmm following corpectomy.

Aged↗
PubMed1996

Clamping stiffness and its influence on load distribution between paired internal spinal fixation devices.

The load distribution between two internal spinal fixation devices depends, besides other factors, on their stiffness. The stiffness ranges were determined experimentally for the clamps of the AO internal fixator with lateral nut and with posterior nut as well as for the clamps of the SOCON fixator. The stiffness of eight devices each differed by a factor of 3.1 for the clamp with lateral nut, by a factor of 1.5 for the clamp with posterior nut, and by a factor of 1.4 for the clamp of the SOCON fixator. For the AO clamp with lateral nut, the influence of the nut-tightening torque on the stiffness was determined. Using instrumented internal spinal fixation devices mounted to plastic vertebrae and simulating a corpectomy, the load distribution between the implants was measured for different tightening torques. It could be shown that, for the AO internal fixator whose clamps have a lateral nut, a nut-tightening torque > 5 Nm has only a negligible influence on load-sharing between the implants. Tooth damage occurs when the teeth of the clamp body and clamping jaw of the clamp with lateral nut do not gear together exactly, which leads to changes in the clamping stiffness and load-sharing between the two implants.

Humans↗
PubMed1995

Telemeterized load measurement using instrumented spinal internal fixators in a patient with degenerative instability.

STUDY DESIGN: In the present study, the loads in an internal spinal fixation device were measured in vivo. OBJECTIVES: To determine the implant loads for different activities before and after additional anterior stabilization of the spine. SUMMARY OF BACKGROUND DATA: Mathematical models exist for predicting spinal loads. The intradiscal pressure has been measured for many body positions and activities. The loads on internal spinal fixation devices have not been measured before in vivo. METHODS: Telemeterized AO spinal internal fixators were implanted in a patient with degenerative instability. The implants allow the in vivo measurement of three force components and three moments acting in the implant. RESULTS: When the patient was lying in relaxed positions, the implant loads were small. Before additional anterior stabilization, the loads were also small for sitting, standing, and walking. The bending moment in the sagittal plane was less than 3 Nm for these activities. The highest loads within the first 4 weeks after implantation were measured while the patient turned from a supine to a lateral position against the advice of the physiotherapist. After anterior stabilization, the maximum loads for the relaxed lying positions were altered only slightly. Much higher axial forces and bending moments were measured for sitting, standing, and walking. The maximum bending moment increased to 5-8 Nm for these activities. The implant loads for sitting were not higher than for standing. CONCLUSION: Flexion and lateral bending of the upper body and weight-carrying during sitting, standing, or walking should be avoided in the first few months after anterior stabilization.

Bone Screws↗
PubMed1995

In vivo measurement of implant loads in a patient with a fractured vertebral body.

It is not known what loads act on an internal spinal fixation device in patients with a fractured vertebral body. To measure the implant loads in vivo, telemeterized internal spinal fixators were implanted in a patient, and the implant loads measured for numerous body positions and activities before and after anterior fusion. The highest implant loads were found while the patient lifted both extended legs in a supine position. High implant loads were also measured for lateral bending during standing as well as for walking and carrying a load in one hand. The implant loads were small in recumbent positions. In contrast to findings in another patient, who was treated for degenerative instability, implant loads were smaller in the first months after anterior fusion than before. The indication for stabilization and surgical procedure strongly influence implant loads.

Adult↗
PubMed1995

Is staircase walking a risk for the fixation of hip implants?

Considerable forces and moments act at hip prostheses during most kinds of physical activities. High torque around the stem axis may contribute to implant loosening. With instrumented hip prostheses the joint force and its direction, the bending moment in the frontal plane and the torque were measured in two patients during upstairs, downstairs and level walking. The data give information on whether or not stairclimbing causes a more severe loading situation for the implants than walking. While going upstairs at normal speed the joint force is 10% higher than during walking at 3 km h-1. Downstairs it increases by 20%. The bending moments change by nearly the same amounts. Upstairs the torsional moment is about twice as high as during slow walking. But walking at 5 km h-1 or slow jogging causes forces and moments of similar magnitudes. Even higher loads were observed when the patients stumbled without falling. Although torque during staircase walking is high, extreme values exclusively during stairclimbing are not confirmed by our data. The torsional moments now observed in vivo are close to or even exceed the experimentally determined limits of the torsional strength of implant fixations, found in the literature. Obviously, torsional moments play an important role for the potential loosening of hip prostheses.

Aged↗
PubMed1995

Influence of shoes and heel strike on the loading of the hip joint.

The forces and moments acting at the hip joint influence the long-term stability of the fixation of endoprostheses and the course of coxarthrosis. These loads may depend on the kind of footwear and the walking or running style. These factors were investigated in a patient with instrumented hip implants. He wore different sports shoes, normal leather shoes, hiking boots and clogs and walked barefoot with soft, normal and hard heel strikes. The loads were lowest while walking and jogging without shoes. All shoes increased the joint force and the bending moment at the implant slightly but the torsional moment rose by up to 50%. No relation was found between the different type of shoes and the load increase, only shoes with very hard soles were clearly disadvantageous. Soft heels, soles or insoles did not offer advantages. Gait stability seems to play the most important role in increasing the joint loading and should be the criterion for the choice of footwear. Smooth gait patterns with soft heel strikes are the only means to reduce joint loading during slow jogging.

Aged↗
PubMed1995

[Theory-guided development and evaluation of a questionnaire concerning mental health].

In our study, the development of a Mental Health Questionnaire is described and this diagnostic instrument, which is based on historically important personality models, evaluated. Our purpose was to develop scales for Personal well-being, Regulatory competence, Self-actualization and Sense-finding ability. The items belonging to these theoretical constructs were analyzed both by a method of expert rating and statistically. A sample of n = 833 was tested (so-called healthy persons, patients with coronary heart disease [CHD], and patients with psychosomatic or neurotic disorders). Three of the mental health (MH) dimensions (except Sense-finding ability) were confirmed by expert rating. As expected, the following differences between the subgroups reached statistical significance: healthy persons had the highest values for MH, followed by CHD patients and psychosomatic/neurotic patients. Per item, CHD patients showed a characteristic pattern of answering. The combination of research methods we used in this study (i.e., theory-guided expert rating, statistical analysis, per item analysis) has provided results that may be important for further development of MH concepts.

Adaptation, Psychological↗
PubMed1994

A spinal fixation device for in vivo load measurement.

An instrumented spinal fixation device has been developed that allows in vivo measurement of the forces and moments acting on the implant. The telemetry is inductively powered, hermetically sealed by electron beam welding and is active only during the measurements. The instrumented fixateur interne is similar in size to the original Dick internal fixator implant and has the strength of the original implant. Laboratory tests with paired implants mounted in plastic vertebrae show that small changes in the position of the implants have a strong influence on the distribution of the loads on the implants.

Activities of Daily Living↗
PubMed1994

[Telemetric transmission system for in vivo measurement of the stress load of an internal spinal fixator].

For stabilizing fractures of the spine, a number of implantable devices are available. However, not much is known about the loads acting on these devices. In order to measure the forces and moments within the implant, the Dick internal fixation device was modified and fitted out with a hermetically sealed inductively powered telemetry unit. An integrated 8-channel telemetry chip was specially developed to measure the signals of six strain gauge sensors, the temperature of the implant and the supply voltage. Since the internal fixation devices are always implanted in pairs, two telemetry units are operated at the same time. This article details the function of the implanted electronic circuit and the external system components.

Adult↗
PubMed1994

[Effect of clamping tensile strength on load distribution in paired mounted spinal internal fixators].

Paired internal spinal fixation devices are not necessarily loaded symmetrically when the vertebrae are unable to support one another directly. A finite element model has been developed to predict the influence of clamping rigidity on the load distribution. If the stiffness of one clamping element is significantly reduced, the corresponding implant will bear only about 30 percent of the outer bending moment. The theoretical results were confirmed experimentally with sensor-loaded internal spinal fixation devices.

Biomechanical Phenomena↗
PubMed1993

Outcome of bone mineral density in anorexia nervosa patients 11.7 years after first admission.

Osteopenia is a typical finding in patients suffering from anorexia nervosa. Unfortunately, available longitudinal studies are limited by a relatively short follow-up period. Therefore cross-sectional long-term followup studies may help to determine both the outcome of this bone lesion and variables that influence its subsequent development. Of an initial 66 consecutive patients with anorexia nervosa, 51 (77.3%) could be further evaluated. After an average of 11.7 years following first admission, cross-sectional measurements of lumbar and proximal radial bone mineral density (BMD) were performed. The ability to predict BMD using variables obtained from anamnestic and clinical data was then determined by multiple-regression analysis. The BMD of both radial and lumbar bone in anorexic patients with poor disease outcome (as defined by the Morgan-Russell general outcome categories) deviated by -2.18 and -1.73 SD (Z score), respectively. In patients with a good disease outcome lumbar BMD was significantly less reduced compared with radial BMD (-0.26 versus -0.68 SD). Variables reflecting estrogen deficiency and nutritional status in the course of the disease, that is, relative estrogen exposure (for lumbar BMD) and years of anorexia nervosa (for radial BMD), allowed the best prediction of BMD. A marked reduction in cortical and trabecular BMD in anorexic patients with poor disease outcome suggests a higher risk of fractures in these patients. Furthermore, the finding of a persistently reduced cortical and a slightly reduced trabecular BMD, even in patients with good disease outcome, suggests that a recovery of trabecular BMD might be possible, at least in part. Recovery of cortical bone, if possible at all, seems to proceed more slowly.

Absorptiometry, Photon↗
PubMed1993

Hip joint loading during walking and running, measured in two patients.

The resultant hip joint force, its orientation and the moments were measured in two patients during walking and running using telemetering total hip prostheses. One patient underwent bilateral joint replacement and a second patient, additionally suffering from a neuropathic disease and atactic gait patterns, received one instrumented hip implant. The joint loading was observed over the first 30 and 18 months, respectively, following implantation. In the first patient the median peak forces increased with the walking speed from about 280% of the patient's body weight (BW) at 1 km h-1 to approximately 480% BW at 5 km h-1. Jogging and very fast walking both raised the forces to about 550% BW; stumbling on one occasion caused magnitudes of 720% BW. In the second patient median forces at 3 km h-1 were about 410% BW and a force of 870% BW was observed during stumbling. During all types of activities, the direction of the peak force in the frontal plane changed only slightly when the force magnitude was high. Perpendicular to the long femoral axis, the peak force acted predominantly from medial to lateral. The component from ventral to dorsal increased at higher force magnitudes. In one hip in the first patient and in the second patient the direction of large forces approximated the average anteversion of the natural femur. The torsional moments around the stem of the implant were 40.3 N m in the first patient and 24 N m in the second.

Aged↗