Search results for "Sacrum"
showing 9 items of 39 documents
Resección extendida y exenteración pélvica en el cáncer de recto del tercio inferior
2014
Approximately 10% of all low rectal cancer needs surgical resection extended to other pelvic structures. Indication for extended resection should be given according to a precise systemic and local preoperative staging. Magnetic Resonance Imaging is the most important instrument utilized by the Multidisciplinary Team to decide therapeutic strategy according to the surgical risk. The status of the pathological circumferential resection margin is the most important prognostic factor determining local recurrence risk and oncological outcome and for this reason it should be considered pivotal in the decision of the strategy of treatment. When extended resection is performed, the presence of an e…
Transverse fracture-dislocation of the sacrum: a diagnostic pitfall and a surgical challenge.
2002
Transverse fracture-dislocations of the sacrum are rare. Associated lesions of the lumbosacral spine as well as neurological injuries are common. Conventional radiographs of the pelvis often fail to clearly visualize the fracture. Delayed diagnosis increases the risk of progressive neurological disfunction. True lateral sacral views and CT-scans with 3-dimensional reconstructions are very helpful in establishing the full extent of the injury. These examinations should be considered in all patients with a history of high energy trauma and clinical signs indicating lumbosacral injury, such as severe low back pain and neurological disturbances of the lower extremities. The management of transv…
Bone Mass Distribution in the Sacrum
2017
The trabecular architecture and bone mass distribution of each bone follows biomechanical principles and is an adaption to the stress exhibited during lifetime. In patients with osteoporosis, the bone mass decreases and the bone microarchitecture changes. A distinct bone mass distribution in non-osteoporotic and osteoporotic individuals is demonstrated using statistical modelling in the sacrum. The authors studied the sacral bone mass distribution using a 3D statistical model based on clinical CT scans of 92 Europeans. In the group with worse general bone mass (less than 100 Houndsfeld Units (HU) measured in the body of L5), there were large areas of negative HU in the sacral alae. These “a…
Load Distribution in the Lumbar Spine During Modeled Compression Depends on Lordosis.
2021
Excessive or incorrect loading of lumbar spinal structures is commonly assumed as one of the factors to accelerate degenerative processes, which may lead to lower back pain. Accordingly, the mechanics of the spine under medical conditions, such as scoliosis or spondylolisthesis, is well-investigated. Treatments via both conventional therapy and surgical methods alike aim at restoring a “healthy” (or at least pain-free) load distribution. Yet, surprisingly little is known about the inter-subject variability of load bearings within a “healthy” lumbar spine. Hence, we utilized computer tomography data from 28 trauma-room patients, whose lumbar spines showed no visible sign of degeneration, to …
Iliosacral Screw Osteosynthesis
2017
Fragility fractures of the anterior pelvic ring are very often combined with fractures of the posterior pelvic ring. The large majority of the posterior fractures is situated in the sacral ala. Non-operative therapy may be cumbersome in patients with a combination of an anterior with a posterior pelvic ring fracture. Any surgical therapy should be as less invasive as possible. Iliosacral screw fixation is a minimal invasive technique. Variations of the upper sacral anatomy make optimal iliosacral screw placement challenging. The vestibule or isthmus is the narrowest part of the bony corridor from the lateral ilium to the S1 sacral body. It always points towards anterior and superior. The wh…
Screw‐in‐screw fixation of fragility sacrum fractures provides high stability without loosening—biomechanical evaluation of a new concept
2020
Surgical treatment of fragility sacrum fractures with percutaneous sacroiliac (SI) screw fixation is associated with high failure rates. Turn-out is detected in up to 20% of the patients. The aim of this study was to evaluate a new screw-in-screw implant prototype for fragility sacrum fracture fixation. Twenty-seven artificial hemipelvises were assigned to three groups (n = 9) for instrumentation of an SI screw, the new screw-in-screw implant prototype, ora transsacral screw. Before implantation, a vertical osteotomy was set in zone 1 after Denis. All specimens were biomechanically tested to failure in upright position. Validated setup and test protocol were used for complex axial and torsi…
Wirbelsäulenmanifestationen der chronischen rekurrierenden multifokalen Osteomyelitis (CRMO)
2002
Chronic recurrent multifocal osteomyelitis (CRMO) is a systemic osteo-articular disease that is characterized by a sterile, primarily chronic osteomyelitis with various distribution patterns of the individual lesions. In this article, we describe the "axial type" with predominant involvement of the spine, which represents 13 of our 41 CRMO cases of different age groups. The important element of its diagnosis is the typical lympho-plasmacellular spondylitis that can be detected and staged by scintigraphy, MRI and conventional radiography. Potentially affected are all vertebrae from the mid-cervical spine to the sacrum. One or several segments can be involved, sometimes as transient inflammat…
Ikona niemieckiego Orgelbewegung – organy ośrodka Jugendhof Hassitz w Kłodzku-Jurandowie (Goszycach)
2021
One of the first instruments that was produced in Silesia in the spirit of the Orgelbewegung was the organ of the Youth Leisure and Training Centre in Kłodzko-Jurandów. This centre, founded on the initiative of Richard Poppe, became a source of renewal for the Singbewegung in Eastern Germany. The instrument, called Ver sacrum (Sacred Spring), was meant to commemorate and remind everyone of all those who had sacrificed themselves and given their lives for their Fatherland (in particular, the fallen soldiers of the First World War). The organ was built in 1929 by the Sauer company from Frankfurt/ Oder (opus 1400). It had 27 stops (including 21 real stops), and pneumatic key and stop action wi…
Wstydliwy problem erotyzmu
2017
Usually we are ashamed to touch the issue of eroticism, although it is a ąuite natural one and, in fact, very close to us. It seems that roots of this shyness date back to the biblical paradise and to the original sin committed by the first people. Since the exile from paradise the erotic sphere is a kind of taboo that we are afraid to invade. Bataille measures wits with this problem very courageously, showing that eroticism played a key role in the pagan religions. With a help of eroticism it was possible to make a transgression (exceed ban), reach sacrum and thereby fully experience the existence. Then Christianity distanced to eroticism and, paradoxically, by associating it with unclean …