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Biomedical subjects

H Kleinert

Publications and source records attributed to H Kleinert.

97 records · Page 6Linked to original sources
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[Artificial discs: review, current status, outlook].

AIM: This paper gives an overview of the current status of artificial discs for the lumbar spine. METHODS: Recent publications and overviews in the literature with pro and contra opinions and the latest procedure of FDA approval are presented and discussed. Despite arguments to the contrary, an FDA panel is in favour of the premarket approval application for the Charité artificial disc because of good late follow-up results. Other lumbar artificial discs will follow. RESULTS: Follow-up studies only exist for the Charité and Prodisc endoprotheses. The results are comparable to those of lumbar fusion. However, randomized controlled studies are still missing. CONCLUSION: Proponents for lumbar artificial discs stand against the criticism of an unpredictable treatment for a condition that cannot be diagnosed with any precision. The current model should be a controlled indication with second opinions followed by professional surgery in spine centers.

Clinical Trials as Topic↗
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[Backache]].

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

[Acute cardiovascular reactions to cervical nerve root infiltration].

AIM: The frequency of cardiovascular adverse effects of cervical nerve root infiltration was investigated by means of a prospective study. METHOD: The hemodynamic and respiratory parameters systolic and diastolic blood pressure, heart rate, respiratory rate and oxygen saturation were monitored continuously in 56 patients undergoing cervical spine nerve root infiltration (injection of 10 ml Lidocain 0.5 %, mean depth of injection 5 cm). The monitored time frame ranged from 5 minutes before to 10 minutes after its administration, an additional holter-monitoring began 1 day prior to the injection. RESULTS: Severe complications such as syncopes were not observed in any of the 56 patients, 4 patients developed presyncopes. None of the registered parameters showed a significant change. In a group of patients with known, pre-existing cardiovascular morbidity, no significant changes occurred either. No relevant cardiac arrhythmias were observed. CONCLUSION: The observed cardiovascular complications were not severe. Most probably, the observed reactions were vasavagal presyncopes. Supine positioning led to immediate recovery in all of these patients. A complete hemodynamic monitoring and the placement of an intravenous line do not seem to be absolute necessities in the routine cervical nerve root infiltration.

Adult↗
PubMedDate not supplied

[Limited, haemoglobin-dependent indication for autologous blood donation in total hip or knee replacement].

AIM: The rejection rate of autologous blood donation before joint replacement is high. The influence of the haemoglobin value and the age of patient before autologous blood donation was examined according to the necessity for blood transfusion. METHOD: In a retrospective study, the data of 233 patients who had donated autologous blood before hip (THR) or knee arthroplasty (TKR) were analysed. RESULTS: 72 patients (30.9 %) received an autologous blood transfusion during surgery or in the further course until the first day after surgery. A multivariate analysis showed no significant influence of age on the need for transfusions (p = 0.093), but a higher haemoglobin value before blood donation reduced the risk significantly to 0.712 per unit (1 g/dl). Therefore the age of the patient was less predictive compared to the haemoglobin value as to whether or not a blood transfusion had been necessary. CONCLUSION: The high security of homologous blood reached in the last years and the knowledge that autologous blood donation reduces the haemoglobin value before surgery has led to the procedure in our hospital only to perform autologous blood donation at the explicit request of the patient.

Arthroplasty, Replacement, Hip↗