A doubling of atmospheric CO2 mitigates the effects of severe drought on maize through the preservation of soil water.

BACKGROUND AND AIMS: Drought limits maize production in many regions of the world, and this is likely to intensify in future. Elevated atmospheric CO2 (eCO2) can mitigate this by reducing stomatal conductance and water loss without reducing yield. The magnitude of this effect depends on the interaction of eCO2 and drought severity, but scarce data collected under severe drought conditions limit predictions of future maize production. METHODS: We compared the severe drought × eCO2 responses of six maize genotypes from semi-arid and sub-humid growing regions. KEY RESULTS: Genotypic differences were apparent in growth, gas exchange, water relations, grain quality, and biomass at maturity, but the response to eCO2 was consistent. Plants under drought and eCO2 had similar biomass and yield to irrigated plants at ambient CO2. Reduced stomatal conductance and water loss preserved soil moisture equivalent to 35 mm of rainfall and allowed sustained photosynthesis at higher rates for a longer period after watering stopped. Under irrigation, eCO2 improved maize growth but not grain yield. CONCLUSIONS: The results suggest that eCO2 may extend the future land area available to rainfed maize cultivation, but cannot circumvent the absence of seasonal rainfall that restricts maize growth. Elevated CO2 will reduce water requirements of irrigated maize when atmospheric conditions drive high evapotranspiration.

Fracture reduction and screw position after 3D-navigated and conventional fluoroscopy-assisted percutaneous management of acetabular fractures: a retrospective comparative study.

BACKGROUND: Navigational techniques in orthopaedic trauma surgery have developed over the last years leaving the question of really improving quality of treatment. Especially in marginal surgical indications, their benefit has to be evident. The aim of this study was to compare reduction and screw position following 3D-navigated and conventional percutaneous screw fixation of acetabular fractures. The study hypothesis postulated that better fracture reduction and better screw position are obtained with 3D navigation. MATERIALS AND METHODS: Preoperative and postoperative CT scans of 37 acetabular fractures treated by percutaneous screw fixation (24 3D-navigated, 13 conventional) were evaluated. Differences in pre- and postoperative fracture gaps and steps were compared in all reconstructions as well as the screw position relative to the joint and the fracture. RESULTS: The differences in fracture gaps and fracture steps with and without 3D navigation were not significantly different. Distance of the screw from the joint line, angle difference between screw and ideal angle relative to the fracture line, length of the possible corridor used and position of the screw thread did not show any significant differences. CONCLUSION: Comparison of 3D-navigated and conventional percutaneous surgery of acetabular fractures on the basis of pre- and postoperative CTs revealed no significant differences in terms of fracture reduction and screw position.

Patients with laboratory evidence of West Nile virus disease without reported fever.

In 2013, the national surveillance case definition for West Nile virus (WNV) disease was revised to remove fever as a criterion for neuroinvasive disease and require at most subjective fever for non-neuroinvasive disease. The aims of this project were to determine how often afebrile WNV disease occurs and assess differences among patients with and without fever. We included cases with laboratory evidence of WNV disease reported from four states in 2014. We compared demographics, clinical symptoms and laboratory evidence for patients with and without fever and stratified the analysis by neuroinvasive and non-neuroinvasive presentations. Among 956 included patients, 39 (4%) had no fever; this proportion was similar among patients with and without neuroinvasive disease symptoms. For neuroinvasive and non-neuroinvasive patients, there were no differences in age, sex, or laboratory evidence between febrile and afebrile patients, but hospitalisations were more common among patients with fever (P < 0.01). The only significant difference in symptoms was for ataxia, which was more common in neuroinvasive patients without fever (P = 0.04). Only 5% of non-neuroinvasive patients did not meet the WNV case definition due to lack of fever. The evidence presented here supports the changes made to the national case definition in 2013.

The EIGER detector for low-energy electron microscopy and photoemission electron microscopy.

EIGER is a single-photon-counting hybrid pixel detector developed at the Paul Scherrer Institut, Switzerland. It is designed for applications at synchrotron light sources with photon energies above 5 keV. Features of EIGER include a small pixel size (75 µm × 75 µm), a high frame rate (up to 23 kHz), a small dead-time between frames (down to 3 µs) and a dynamic range up to 32-bit. In this article, the use of EIGER as a detector for electrons in low-energy electron microscopy (LEEM) and photoemission electron microscopy (PEEM) is reported. It is demonstrated that, with only a minimal modification to the sensitive part of the detector, EIGER is able to detect electrons emitted or reflected by the sample and accelerated to 8-20 keV. The imaging capabilities are shown to be superior to the standard microchannel plate detector for these types of applications. This is due to the much higher signal-to-noise ratio, better homogeneity and improved dynamic range. In addition, the operation of the EIGER detector is not affected by radiation damage from electrons in the present energy range and guarantees more stable performance over time. To benchmark the detector capabilities, LEEM experiments are performed on selected surfaces and the magnetic and electronic properties of individual iron nanoparticles with sizes ranging from 8 to 22 nm are detected using the PEEM endstation at the Surface/Interface Microscopy (SIM) beamline of the Swiss Light Source.

Stigma-related stress, shame and avoidant coping reactions among members of the general population with elevated symptom levels.

BACKGROUND: It is unclear whether mental illness stigma affects individuals with subthreshold syndromes outside clinical settings. We therefore investigated the role of different stigma variables, including stigma-related stress and shame reactions, for avoidant stigma coping among members of the general population with elevated symptom levels. METHODS: Based on a representative population survey, general stress resilience, stigma variables, shame about having a mental illness as well as avoidant stigma coping (secrecy and social withdrawal) were assessed by self-report among 676 participants with elevated symptom levels. Stigma variables and resilience were examined as predictors of avoidant stigma coping in a path model. RESULTS: Increased stigma stress was predicted by lower general stress resilience as well as by higher levels of perceived stigma, group identification and perceived legitimacy of discrimination. More shame was associated with higher perceived legitimacy. Lower resilience as well as more perceived stigma, group identification and perceived legitimacy predicted avoidant coping. Stigma stress partly mediated effects of resilience, perceived stigma and group identification on avoidant coping; shame partly mediated effects of perceived legitimacy on coping. Stigma stress and shame were also directly and positively related to avoidant stigma coping. Analyses were adjusted for symptoms, neuroticism and sociodemographic variables. CONCLUSIONS: Stigma may affect a larger proportion of the population than previously thought because stigma variables predicted secrecy and withdrawal among members of the general population with elevated, but overall mild symptom levels. Avoidant stigma coping likely has harmful effects, potentially exacerbating pre-existing psychological distress and undermining social networks. This highlights the need to reduce public stigma as well as to support individuals with subthreshold syndromes in their coping with stigma stress and shame reactions.

Optical Shaping of X-Ray Free-Electron Lasers.

In this Letter we report the experimental demonstration of a new temporal shaping technique for x-ray free-electron lasers (FELs). This technique is based on the use of a spectrally shaped infrared (IR) laser and allows optical control of the x-ray generation process. By accurately manipulating the spectral amplitude and phase of the IR laser, we can selectively modify the electron bunch longitudinal emittance thus controlling the duration of the resulting x-ray pulse down to the femtosecond time scale. Unlike other methods currently in use, optical shaping is directly applicable to the next generation of high-average power x-ray FELs such as the Linac Coherent Light Source-II or the European X-FEL, and it enables pulse shaping of FELs at the highest repetition rates. Furthermore, this laser-shaping technique paves the way for flexible tailoring of complex multicolor FEL pulse patterns required for nonlinear multidimensional x-ray spectroscopy as well as novel multicolor diffraction imaging schemes.

[Intraoperative virtual implant planning for volar plate osteosynthesis of distal radius fractures]. / Intraoperative virtuelle Implantatplanung bei der volaren Plattenosteosynthese distaler Radiusfrakturen.

BACKGROUND: Digital planning of implants is in most cases conducted prior to surgery. The virtual implant planning system (VIPS) is an application developed for mobile C-arms, which assists the virtual planning of screws close to the joint line during surgery for treatment of distal radius fractures with volar plate osteosynthesis. The aim of this prospective randomized study was to acquire initial clinical experiences and to compare the VIPS method with the conventional technique. METHOD: The study included 10 patients for primary testing and 30 patients with distal radius fractures of types A3, C1 and C2, divided in 2 groups. In the VIPS group, after placement of the plate and fracture reduction, a virtual 3D model of the plate was matched with the image of the plate from the fluoroscopic acquisition. Next, the length and position of the screws close to the joint line were planned on the virtual plate. The control group was treated with the same implant in the conventional way. Data were collected regarding screw replacement, fluoroscopy and operating room (OR) times. RESULTS: The VIPS group included six A3, one C1 and eight C2 fractures, while the control group consisted of six A3 and nine C2 fractures. Three screws were replaced in the VIPS group and two in the control group (p = 0.24). The mean intraoperative fluoroscopy time of the VIPS group amounted to 2.58 ± 1.38 min, whereas it was 2.12 ± 0.73 min in the control group (p = 0.26). The mean OR time in the VIPS group was 53.3 ± 34.5 minutes and 42.3 ± 8.8 min (p = 0.23) in the control group. CONCLUSION: The VIPS enables a precise positioning of screws close to joint line in the treatment of distal radius fractures; however, for routine use, further development of the system is necessary.

[3D safety in osteosynthesis adjacent to joints]. / 3-D-Sicherheit bei gelenknahen Osteosynthesen.

BACKGROUND: The results and immediate consequences of intraoperative three-dimensional (3D) imaging in the treatment of AO classification type C fractures of the distal radius, the tibial head and the tibial pilon were analyzed and compared with published results on general intraoperative revision rates following intraoperative 3D-imaging. METHODS: In this retrospective study 279 patients with AO type C fractures of the distal radius (n = 84), tibial head (n = 109) and tibial pilon (n = 86) who underwent intraoperative 3D-imaging were included. The findings of the 3D-imaging and the intraoperative revision rates were analyzed and compared with previously published results of our working group. RESULTS: In 70 out of 279 patients (25 %) an intraoperative revision was carried out following 3D-imaging. The revision rates were 15 % for fractures of the distal radius, 27 % for fractures of the tibial head and 32 % for fractures of the tibial pilon. The most common reason for immediate intraoperative revision was the necessity for improved repositioning due to a remaining step in the articular surface in 51 out of 279 patients (18%). CONCLUSION: Intraoperative revision rates following 3D-imaging increased with the severity of the injury pattern. Intraoperative 3D-imaging should be routinely used in the treatment of fractures of the tibial head, tibial pilon and even in comminuted distal radius fractures due to the high intraoperative revision rates found in the present study. Alternatively, a postoperative computed tomography (CT) control should be performed.

Herbivore population regulation and resource heterogeneity in a stochastic environment.

Large-mammal herbivore populations are subject to the interaction of internal density-dependent processes and external environmental stochasticity. We disentangle these processes by linking consumer population dynamics, in a highly stochastic environment, to the availability of their key forage resource via effects on body condition and subsequent fecundity and mortality rates. Body condition and demographic rate data were obtained by monitoring 500 tagged female goats in the Richtersveld National Park, South Africa, over a three-year period. Identifying the key resource and pathway to density dependence for a population allows environmental stochasticity to be partitioned into that which has strong feedbacks to population stability, and that which does not. Our data reveal a density- dependent seasonal decline in goat body condition in response to concomitant density-dependent depletion of the dry-season forage resource. The loss in body condition reduced density-dependent pregnancy rates, litter sizes, and pre-weaning survival. Survival was lowest following the most severe dry season and for juveniles. Adult survival in the late-dry season depended on body condition in the mid-dry season. Population growth was determined by the length of the dry season and the population size in the previous year. The RNP goat population is thereby dynamically coupled primarily to its dry-season forage resource. Extreme environmental variability thus does not decouple consumer resource dynamics, in contrast to the views of nonequilibrium protagonists.

[Percutaneous stabilization of traumatic spondylolisthesis in a child]. / Perkutane Stabilisierung der traumatischen Spondylolisthese eines Kindes.

A 12-year-old boy suffered a rare occurrence of a traumatic spondylolisthesis (L5/S1) without neurological alterations after being partially buried underneath a collapsing brick wall. Additionally he sustained a third degree open fracture of the left distal fibula and epiphysiolysis of the left distal tibia. A closed reduction and percutanous dorsal instrumentation L5/S1 as well as an open reduction and osteosynthesis of the tibia and fibula were performed. After 6 months the instrumentation was completely removed and an unrestrained range of motion of the lumbar spine and the upper ankle joint was regained.

Oral prolonged-release ketamine in treatment-resistant depression - A double-blind randomized placebo-controlled multicentre trial of KET01, a novel ketamine formulation - Clinical and safety results.

INTRODUCTION: We investigated the antidepressant effects of a novel oral prolonged-release formulation of racemic ketamine (KET01) in patients suffering from treatment-resistant depression (TRD) as add-on therapy. MATERIAL AND METHODS: Patients were randomized to an additional 160 mg/day or 240 mg/day KET01 or placebo for 14 days. The primary endpoint was change in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline to day 15. For treatment group comparisons, we used ANOVA with pairwise least squares mean difference tests in a mixed model repeated measures analysis. RESULTS: Twenty-seven patients completed the double-blind protocol before trial premature termination due to poor recruitment during the COVID-19 pandemic. Mean (SD) MADRS scores on day 15 were 23 (10.32) in placebo, 25 (8.28) with 160 mg/day and 17 (10.32) with 240 mg/day KET01. MADRS change was numerically larger but statistically non-significant in the 240 mg/day KET01 group vs placebo on day 7 (-5.67; p = 00.106) and day 15 was (difference: 4.99; p = 00.15). In exploratory analysis, baseline leukocyte count correlated with response to KET01 (p = 00.01). Distribution of adverse event rates were comparable between the treatment arms. Safety analysis did not identify increased risk of suicidality, dissociation, hear rate, systolic and diastolic blood pressure associated with trial treatment. DISCUSSION: Our results suggest that adjunctive oral administration of prolonged-release ketamine at a dose of 240 mg/day shows a positive, although statistically non-significant, trend towards antidepressant efficacy, however, the benefit could not be confirmed due to premature trial termination. Given its ease of use and low side effects, further trials are warranted to investigate this route of ketamine administration as a promising potential treatment of TRD.

Associations between IQ and alcohol consumption in a population of young males: a large database analysis.

PURPOSE: This study aimed at exploring the relationship between intelligence quotient (IQ) and alcohol consumption in a large sample of young males. This study explored whether IQ influences alcohol drinking and which pathways might be involved. We further hypothesized that IQ differences between lifetime abstainers and former drinkers exist, and that they primarily result from different group characteristics. METHOD: Within a psychiatric-epidemiological survey using a cross-sectional design IQ-tests were administered to approximately 50,000 Swiss conscripts at age of about 20 years. The sample was divided into four alcohol consumption categories (rare, occasional, moderate and daily drinking) and two non-drinker categories (former drinking and lifetime abstinence). Probabilities for different levels of consumption or former drinking against lifetime abstention in relation to IQ were estimated using multinomial logistic regression. Models were adjusted for education, disability pension, tobacco/cannabis use, migration, parental alcohol disorders, and mental health. RESULTS: After adjusting for confounders full-scale IQ displayed positive associations with being a rare (OR 1.13; CI 95 % 1.07-1.19), occasional (OR 1.41; CI 95 % 1.33-1.48), and moderate drinker (OR 1.53; CI 95 % 1.45-1.62), and negative associations with being a former drinker (OR 0.85; CI 95 % 0.79-0.93). Daily drinking was positively associated only with the performance subscale IQ (OR 1.12; CI 95 % 1.02-1.22). Confounders contributed significantly to the IQ-alcohol association and, therefore, highlight the distinction of non-drinkers into lifetime abstainers and former drinkers. CONCLUSIONS: Our data confirmed the positive link between IQ and moderate drinking. Lower IQ in non-drinkers, however, seems to be related to earlier consumption and the presence of other risk factors.

[Digital X-ray: interhospital data transfer by CD-ROM. Prospective data evaluation during the import process]. / Digitales Röntgen: interhospitaler Datentransfer auf CD-ROM. Prospektive Datenevaluation während des Arbeitsprozesses.

BACKGROUND: Increasing numbers of radiological imaging diagnostics are archived in digital form. In addition to the results of diagnostics performed in hospital a growing number of patients present with digital results of outpatient radiological investigations. These digitized images represent a challenge for the internal hospital work flow. The aim of the study was to determine the expenditure for the hospital when dealing with digital outpatient diagnostic results. METHOD: Several parameters were observed and analyzed within the import process of nearly 400 CD-ROMs over a time period of 5 months. Only a negligible number of data on CD-ROMs could not be transferred into the hospital archive (1.5%). The duration of the process depended on the amount of data and the time period. RESULTS: During regular hours the import process took on average 13 min per CD and 19 min per patient while the time increased significantly during on-call duties. This study demonstrates the significance of the import of digital outpatient radiological diagnostic results into the hospital archive which can in particular influence patient treatment.

[From victim to offender: characteristics of sexually abused violent and sex offenders]. / Vom Opfer zum Täter: Merkmale sexuell missbrauchter Gewalt- und Sexualstraftäter.

INTRODUCTION: Prospective studies on victims of sexual abuse and retrospective studies on offender populations have indicated a connection between experiences of childhood sexual abuse (CSA) and delinquency in adulthood. METHOD: Using a representative sample of violent and sex offenders from the Canton of Zurich (Switzerland; N=354), the aim of this study was to identify the characteristics of offenders who have experienced CSA. Two multivariable models for CSA were generated. RESULTS: CSA was documented for 13% of the sex offenders and 5.8% of the violent offenders. Child molesters displayed the highest prevalence rate with 18.9%. Multivariable analyses identified Swiss nationality, having stayed in a foster home and violence in the nuclear family as the strongest risk factors for CSA. In a second model, only offender characteristics from adulthood were taken into account as predictors: child molesters, offenders who prostituted themselves and repeat violent and sex offenders had a significantly higher risk of belonging to the group of offenders who had experienced CSA. DISCUSSION: The results suggest that the experience of CSA leads to an elevated and chronic risk for committing child abuse.

Strain wave pathway to semiconductor-to-metal transition revealed by time-resolved X-ray powder diffraction.

One of the main challenges in ultrafast material science is to trigger phase transitions with short pulses of light. Here we show how strain waves, launched by electronic and structural precursor phenomena, determine a coherent macroscopic transformation pathway for the semiconducting-to-metal transition in bistable Ti3O5 nanocrystals. Employing femtosecond powder X-ray diffraction, we measure the lattice deformation in the phase transition as a function of time. We monitor the early intra-cell distortion around the light absorbing metal dimer and the long range deformations governed by acoustic waves propagating from the laser-exposed Ti3O5 surface. We developed a simplified elastic model demonstrating that picosecond switching in nanocrystals happens concomitantly with the propagating acoustic wavefront, several decades faster than thermal processes governed by heat diffusion.

Effectivity of current sterility methods for transgastric NOTES procedures: results of a randomized porcine study.

BACKGROUND AND AIM: Natural-orifice transluminal endoscopic surgery (NOTES) is an emerging transluminal technique in which interventions are carried out by entering the abdominal cavity via a natural orifice such as the stomach. Infection is a potential risk of the procedure, and the potential pathogens are different from those encountered with skin incisions. Currently, available data regarding prophylactic anti-infective treatment are limited. We compared the effectiveness of topical antimicrobial lavage of mouth and stomach and proton pump inhibitor therapy with gastric cleansing with sterile saline solution in preventing NOTES-related contamination and infection. METHODS: A randomized survival swine study was performed. Eight pigs underwent preparation with intravenously administered proton pump inhibitors, mouth and gastric lavage (chlorhexidine), and gastric irrigation (diluted neomycin), plus single-shot intravenous antibiotics. Control group (n = 8) underwent gastric cleansing with sterile saline solution. Peritoneal biopsy, multiple smears, and dilutions for cultures were taken and incubated. The swine were sacrificed after 14 days. Bacterial load was expressed in colony-forming units (CFU). RESULTS: One pig died due to gallbladder perforation after 3 days, 2/15 swine presented minor clinical signs of infection in the 14-day follow-up (all 3 pigs were in the control group). Mean C-reactive protein levels were 5.7 +/- 2.4 g/dL (therapy group) and 12.2 +/- 3.8 g/dL (control) ( P = 0.17). Bacterial growth was seen in 1/8 swine (therapy group) and 6/8 swine (control group) ( P = 0.002). Bacterial load was 282 CFU/mL (therapy) vs. 3.2 x 10 (5) CFU/mL (control) ( P = 0.023) in the follow-up. CONCLUSION: The use of intravenous antibiotics in addition to topical antimicrobial lavage of mouth and stomach and treatment with proton pump inhibitors decreased the peritoneal bacterial load to almost zero and this was associated with a significantly lower peritoneal infection rate compared with saline-only lavage.

[Outpatient surgery in hospital. An instrument for resource optimization?]. / Ambulante Chirurgie am Krankenhaus. Ein Instrument zur Belegungssteuerung?

The societies of western countries are facing enormous economic and social challenges. Despite a declining population size the number of elderly patients is growing and will lead to an increase in cases of trauma in the near future. In addition, the health care system will have to be financed by a reduced labor force. To realize the ambitious political goal of providing comprehensive medical care an economization of hospital treatment must be achieved. The bottleneck within the surgical specialties in case of efficient scheduling will be the capacity utilization of the operating theatres. Additional separate outpatient operating theatres adjacent to hospitals could be an efficient instrument for using resources and economizing medical procedures. Considering the socio-demographic alterations of our society an adequate discussion regarding the general medical conditions is essential.

Diagnostic accuracy of intraoperative CT-imaging in complex articular fractures - a cadaveric study.

Anatomic reconstruction of articular fractures is one of the critical factors in later achieving good functional outcome. Intraoperative 3D imaging has been shown to offer better evaluation and therefore can significantly improve the results. The purpose of this study was to assess the difference between intraoperative three-dimensional fluoroscopy (3D) and intraoperative computed tomography (iCT) imaging regarding fracture reduction, implant placement and articular impressions in a distal humeral fracture model. AO type 13-B2 fracture pattern were created in upper extremity cadaver specimens. Articular step-offs, intra-articular screw placement and intraarticular impressions of different degrees of severity were created. All specimens had imaging performed. For each articular pattern 3D fluoroscopy in standard (3Ds) and high quality (3Dh) were performed (Arcadis Orbic, Siemens, Germany) as well as an intraoperative CT scan (iCT, Airo, Brainlab, Germany). Three observers evaluated all imaging studies regarding subjective and objective parameters. iCT is more precise than 3D fluoroscopic imaging for detection of articular impressions. Articular step-offs and intraarticular screw placement are similar for iCT and 3D. Subjective imaging quality is the highest for iCT and lowest for 3Ds. Intraoperative CT may be particularly useful in assessing articular impressions and providing a good subjective image quality for the surgeon.

[The challenge of auditing by medical health insurance inspectors: development of individual case inspections according to 275ff SGB V]. / Herausforderung: MDK-Prüfung: Entwicklung der Einzelfallprüfungen gemäss 275ff SGB V.

BACKGROUND: The German DRG (diagnosis-related groups) system has changed since the inauguration in 2005, whereby written inquiries and on-site auditing have been carried out by the medical inspection service for health insurance companies (MDK). Modifications in the G-DRG system are reflected in changes in the MDK visitations. This article describes exactly how these examinations have changed over time. In order to achieve this all auditing reports were evaluated. RESULTS: In the beginning correct coding and documentation were the most interesting items for the health insurance fund inspectors. Nowadays, length of in-patient treatment and specific points relating to current changes in the G-DRG system are being questioned. All areas of the hospital have now been examined during this period. There was no change in the loss resulting from the regular examinations over the years. However, the effort and input of manpower are extremely high. CONCLUSIONS: To cope with the changes in the German DRG system hospitals have to be flexible. The experiences with the regular MDK visitations can positively influence hospital organizational structures.

[Cervical spine injuries in the elderly patient]. / Verletzungen der Halswirbelsäule im Alter.

Studies have shown that the numbers of injuries of the cervical spine increase in elderly patients. An early clinical examination and adequate diagnostics are necessary to initiate the appropriate treatment. A computed tomography (CT) scan is recommended to exclude injuries of the cervical spine. Dynamic fluoroscopy and magnetic resonance imaging (MRI) can additionally be helpful to detect instabilities. The treatment of the injury depends on the extent of the fracture and includes conservative treatment options with soft or rigid ortheses for cervical spine immobilization, retention with a halo fixator or open/closed reduction and fixation. In the selection of treatment it should be taken into consideration that the use of rigid immobilization or a halo fixator is associated with a significant reduction of the quality of life. In the region of the upper cervical spine only unstable fractures of the atlas and of the axis should be operatively treated. In the region of the subaxial cervical spine fractures are prone to be unstable due to the lack of flexibility of the cervical spine in elderly patients. Therefore, fractures of types B and C according to AO Spine, for which operative treatment is recommended, are regularely seen. In addition, a pre-existing stenosis of the spinal cord may lead to neurological symptoms which negatively influence the clinical outcome.