[Vertebral body replacement systems: correct surgical implantation technique].
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Bone Cements↗
Biomedical subjects
J Giehl
Publications and source records attributed to J Giehl.
[Treatment of osteoid osteoma with CT-guided drilling and ethanol instillation].
HISTORY AND CLINICAL FINDINGS: For 6 months a 25-year-old man had been suffering from intermittent pain in the left upper leg, alleviated by aspirin. Physical examination was unremarkable: local pain was not elicited. INVESTIGATIONS: Routine radiology and computed tomography confirmed the clinically suspected diagnosis of intracortical osteoid osteoma of the femur. Skeletal scintigraphy showed distinctive local concentration of the contrast material. DIAGNOSTIC PROCEDURE, TREATMENT AND COURSE: The lesion's central area was identified by CT and under general anaesthesia drilled into (5 mm diameter drill bit). As the lesion's edges remained partially intact, the cavity was sterilized with 1-2 ml of 96% ethanol. The patient was mobilized after six hours. He has remained free of pain in the subsequent 7 months. CONCLUSIONS: Minimally invasive, CT-guided percutaneous treatment of an osteoid osteoma can be achieved by a combined radiological and percutaneous orthopaedic procedure as an alternative to open surgery.
Adult↗
Magnetic susceptibility in the vertebral column.
A magnetic resonance method is described which provides good-quality field-mapping images of the spine, although the in vivo signals from red bone marrow of the vertebral bodies exhibit similar fractions of lipid and water protons with their chemical-shift difference of 3.4 ppm. The susceptibilities of bone marrow and intervertebral disks were examined in 20 cadaveric human spines, 9 healthy volunteers, and 9 patients with degenerative disk alterations. The influence of geometrical properties was studied in cylindrical spine phantoms of different size and contents with different susceptibility. The measurements reveal interindividual differences of the susceptibility of the intervertebral disks in healthy subjects. Three out of nine degenerated disks with low signal in T2-weighted spin-echo images showed irregularities of the field distribution within the nucleus pulposus.
Adolescent↗
[Clinical and radiological results of individual hip stems of the type Adaptiva(R) without cement].
AIM: Long-term anchorage of foreign material in vital bone has proven to be the main problem in hip arthroplasty. Bone cement, a material for filling and fitting, allows an excellent solution for older people. Many failures have been blamed on the use of polymethylmethacrylate in younger patients. In our opinion, modelling a stem to the individual anatomic needs of younger patients and to implant it without cement but with a stable press-fit is a good way to transmit stress harmoniously from the prosthesis to the bone and to obtain a long-lasting function. This individual hip stem is now available in the third generation under the name Adaptiva(R). We would like to present our first results. METHOD: Between October 1993 and September 1995 150 individual hip prosthesis of the Adaptiva(R) type have been implanted. In the average the patients were 53,2 years old. The average time of follow-up was 19.9 (12 to 44) months. RESULTS: The Merle d'Aubigné score showed excellent absolute and relative results for pain, mobility and ability to walk. No aseptic loosening of the stem occurred. CONCLUSION: Our early results are promising, but we have to wait for the long-term results, which are part of a current study.
Adult↗