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Die Sonographie der Lendenwirbelsäule und des lumbosakralen Überganges - Sonoanatomie und Möglichkeiten der sonographisch gesteuerten Facettengelenksinfiltration

QUESTION Is sonography helpful in facet joint infiltration of the lumbar spine? METHOD The sonoanatomy of the lumbar spine and the of lumbosacral junction was examined and described in a skeleton and in 10 volunteers. One representative cross section and 3 longitudinal sections were defined. According to these results (no neurological symptoms) the possibilities of ultrasound guided infiltration of the facet joints was examined in 78 patients (36 female, 42 male, average age 55 y., 38-78 y.) with chronic low back pain and increase of pain by hyperextension. 5 ml Carbostesin partially in combination with steroids were applied to each joint. In all cases the tip of the syringe could be placed…

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Health-Related Quality of Life and Somatization in Patients With Long-Term Low Back Pain

Study Design. For this study, a prospective cohort of 109 patients was recruited consecutively at an orthopedic inpatient unit of a university hospital. Three self-report instruments were administered to patients with sciatica believed to be caused by a herniated lumbar disc to examine their quality of life and psychic stress at baseline and at the 1-year follow-up visit. Objectives. To investigate whether patients who have undergone a previous discectomy experience greater psychic stress than patients with no surgery, and to determine whether the groups differed regarding their health-related quality of life at the follow-up visit. Summary of Background Data. Previous studies have describe…

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Mehrsegmentale Fusion der Skoliose bei Duchenne-Muskeldystrophie

Operations in scoliosis in patients suffering from an advanced stage of Duchenne muscular dystrophy are associated with a higher risk due to the extent of the curves, the respiratory insufficiency and frequent cardiomyopathia. Progressive scolioses in 20 wheelchair patients with an age between 10.5-18.3 years (mean 14.6 years) were treated by CDI. The mean preoperative angle in this group was 70.6 degrees, the postoperative angle 31.2 degrees (mean correction 39.4 degrees or 55.8%). The preoperative lordosis of the lumbar spine (mean angle 4.1 degrees) was corrected to 17.8 degrees postoperatively. The average intraoperative blood loss (2300 ccm) was evident more compared with idiopathic sc…

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Effectiveness of low-energy extracorporal shock waves for chronic plantar fasciitis

Summary Over a period of 4 years we performed a prospective randomized trial on 100 patients in order to compare the effects of low-energy extracorporal shock-wave therapy (ESWT) in the treatment of painful heel (chronic plantar fasciitis). Patients in group I were treated three times at weekly intervals with 1000 impulses of 0.08 mJ/mm 2 given around the heel spur. Group II received treatment three times with 10 impulses of the same energy density at weekly intervals. Follow-up examinations were done at 12 and 52 weeks, respectively. The main outcomes assessed were reduction in severity of pressure pain, period of pain-free walking, and patient satisfaction. At 12 weeks, 16 of 50 patients …

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Der Einsatz der Tumorprothese bei sekundär-neoplastischer Destruktion des proximalen Femurendes

Total hip arthroplasty was performed with PMMA-augmented tumor prostheses in 42 individuals suffering from metastatic destruction of the proximal end of the femur at the Orthopedic University Hospital Mainz from 1980 to 1992. Neoplastic lesions had been triggered by carcinomas of the breast in 25 female patients. 24 of our patients presented with pathologic fractures. In all patients capable of walking preoperatively early mobilization could be attained by total hip arthroplasty. Pain relief was achieved in each patient. Resection of the major trochanter and, partially, of the pelvitrochanteric muscle sleeve entailed luxation of the prosthesis six times in 5 individuals during the first pos…

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