[PLIF and ALIF for the degenerative spondylolisthesis of the lumbar spine]. / PLIF und ALIF zur operativen Therapie der degenerativen lumbalen Instabilität.

AIM: The aim of this study is to compare the course of disease of patients with a degenerative instability of the lumbar spine after PLIF or ALIF. MATERIALS AND METHODS: Between October 1995 and January 2000 115 patients underwent a ventral or dorsal spondylodesis due to a degenerative instability in the Department of Neurosurgery of the Unfallkrankenhaus Berlin Hospital and in the Department of Neurosurgery of the Friedrichshain Hospital in Berlin. At an average of 25 (13-64) months after surgery these patients were followed up in a clinical examination and a questionnaire concerning their sense of pain and quality of life. RESULTS: Significant improvement after surgery has been shown in both groups. The recovery rate was 52 % which is a beneficial result. The fusion rate was 91 %. The postoperative sense of pain declined with regard to the visual pain scale. The intake of analgetics decreased in a quantitative as well as in a qualitative way. With 94 % the acceptance of the operation was comparatively high. The number of complications was low in comparison with the literature (4 %). There was no operative lethality. CONCLUSIONS: With regard to the indications and contraindications the PLIF as well as the ALIF is accepted unquestioningly as an up-to-date method.

[Fractures of the lower cervical spine. Surgical methods and long-term outcome]. / Frakturen der unteren Halswirbelsäule. Operationsmethoden und Langzeitergebnisse.

Between 1980 until 1996 we operated altogether 327 patients because of a discoligamentous or osseous injury of the lower cervical spine. In a retrospective examination we evaluated the type of the injuries, the mechanism of the accidents, the neurological status on admission and the postoperative result. With regard to the long-term results we re-investigated 170 patients who have been operated on in our Department of Neurosurgery. In none of the patients we could find a neurological deterioration after the operation. The prognosis for patients with an incomplete and complete transversal syndrome is worse concerning a regression of the neurological deficit. The ventral spondylodesis in the technique according to Cloward-Crock, Robinson and Smith and Bailey-Badgley with ventral plate fixation provided the best results and we recommend these techniques for injuries of the lower cervical spine.

The traumatic dural sinus injury--a clinical study.

In a period of 13 years 978 cases of severe head injuries were operated on in our clinic. An analysis of the medical reports includes injuries of the superficial dural sinus (39 cases = 4%): among these injuries of the anterior and central part of the superior sagittal sinus (66 per cent), injuries of the transverse sinus (18 per cent), injuries of the posterior part of the superior sagittal sinus (8 per cent), and combined injuries of different dural sinuses (8 per cent). Clinical data, i.e. the causes of accident, radiological examination results, intracranial lesions, operation techniques and outcome are analysed and discussed. The analysis of cases with dural sinus injuries shows a high mortality rate (total mortality rate: 16 patients = 41%; intra-operative mortality rate: 8 patients = 20%).

[Postoperative results following severe craniocerebral trauma]. / Operationsergebnisse nach schwerem Schädel-Hirn-Trauma.

918 patients were operated because a severe head injury in our Neurotraumatological Clinic during a period of 12 years. 733 patients (80 per cent) could been evaluated as well with regard to the Glasgow Coma Scale and the Glasgow Outcome Scale as analysed in four diagnose groups corresponding to the period of live. Patients with epidural haematoma and open head injuries showed a better forecast than patients with acute subdural haematoma. Those with contusion of the brain and less than 8 points in the Glasgow Coma Scale or those in a higher age had a bad prognosis.

[Results of the surgical management of frontobasal injuries]. / Ergebnisse der operativen Versorgung von frontobasalen Verletzungen.

The author reports about 183 patients with frontobasal injuries. 50 per cent of them were operated immediately because open injuries or intracranial complications. The other half was operated in an interval of 5 to 10 days after injury. The localisation of the frontobasal lesion, clinical results according to the Glasgow Coma Scale and Glasgow Outcome Scale as well as the operation methods are demonstrated and discussed. The operative closure of the dura failure with an unipedicled periosteal flaps ensures good results in the most cases.

[The need for spongiosa grafting in thoracolumbar vertebral body fractures]. / Zur Notwendigkeit der Spongiosaplastik bei thorakolumbalen Wirbelkörperbrüchen.

Report on examination of 31 patients with fractures of spine in thoracolumbar region. All patients were treated by external fixation without accomplishing a plastic of spongiosa. The permanent SI-Index after operation is coming to 0.85. The outcome by use of external fixation is attesting our opinion, that with this method a plastic of spongiosa isn't necessary.

[Results of surgical treatment of 170 injuries of the middle and lower cervical spine]. / Ergebnisse der operativen Behandlung von 170 Verletzungen der mittleren und unteren Halswirbelsäule.

The article presents the results of examination of 170 patients with a cervical spine injury, who had been operated by ventral interbody fusion. It presents operative procedures and discusses the results concerning to neurological deficit before treatment. Cloward-Crock's and Bailey-Badgley's technique together with anterior plate fixation yields immediate stabilization and provides the best functional outcome.

[Experimental studies of chemonucleolysis with aprotinin]. / Experimentelle Untersuchungen zur Chemonukleolyse mit Aprotinin.

We have attend operatively exstirpated tissue of intervertebral disks to solution with 250.000 I. E. and 500.000 I.E. aprotinin. After preparation and colouring of the tissue we examinate by microscope. We couldn't find out neither a macroscopic nor microscopic evident effect of chemonucleolysis of aprotinin. Our opinion is, that an application of aprotinin to reduction of intradiscal pressure or to chemonucleolysis isn't effectively.

[Fixateur externe as a definitive treatment method of unstable thoracolumbar spinal fractures in emergency conditions--technical modification and clinical experiences]. / Der Fixateur externe (F.E.) als definitive Behandlungsmethode für instabile thorakolumbale Wirbelbrüche unter Notfallbedingungen--technische Modifikation und klinische Erfahrungen.

A survey on 31 injuries of thoracolumbar spine, 27 were accompanied with neurological deficiency. Treatment was exclusively by means of percutan attached f.e. until bony consolidation. An average treatment time of 152 days took place. Mean rate of correction was about 0.24 (Beck's SI-Index). The former applied frame construction was substituted by self developed spindle fixateur system, adapted to the requirements of traumatology of the spine in emergency situations.