9 results on '"Michael Zegg"'
Search Results
2. Cervical Disc and Ligamentous Injury in Hyperextension Trauma: MRI and Intraoperative Correlation
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Michael Zegg, Benjamin Henninger, Rene Schmid, Dietmar Krappinger, Anna Spicher, Christian Kremser, Verena Kaser, and Stefanie Ostermann
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Adult ,Male ,injury ,Hyperextension ,cervical spine ,030218 nuclear medicine & medical imaging ,Lesion ,03 medical and health sciences ,Anterior longitudinal ligament ,0302 clinical medicine ,Hematoma ,Multidetector Computed Tomography ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Intervertebral Disc ,Spinal Cord Injuries ,Original Research ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Cervical Cord ,Magnetic resonance imaging ,Intervertebral disc ,Middle Aged ,Spinal cord ,medicine.disease ,Magnetic Resonance Imaging ,Sagittal plane ,medicine.anatomical_structure ,Clinical Investigative Study ,Female ,Neurology (clinical) ,medicine.symptom ,Nuclear medicine ,business ,030217 neurology & neurosurgery ,MRI - Abstract
BACKGROUND AND PURPOSE To identify and evaluate diagnostic magnetic resonance imaging (MRI) features in patients with suspicion of discoligamentous cervical injury after hyperextension trauma of the cervical spine. METHODS MR images with a standard protocol (1.5 T, including sagittal T2‐weighted images and short tau inversion recovery [STIR]) in 21 patients without any sign of fracture or instability on multidetector computed tomography of the cervical spine were assessed. Among other structures we evaluated the following: prevertebral hematoma, anterior longitudinal ligament (ALL), intervertebral disc, and spinal cord. Presence and the anatomic level of injury were identified and recorded. Results were then compared with intraoperative findings as a reference standard. Simple descriptive statistical analysis, agreement coefficients (given by calculating the percent agreement), and the determination of Gwet's AC1 coefficient were used to analyze our results. RESULTS The overall percent agreement between STIR and intraoperative findings was 90.9% (AC1 = .881) and for T2 69.7% (AC1 = .498). For the ALL, the overall agreement was 87.9% (AC1 = .808) and for the intervertebral disc 78.8% (AC1 = .673), in which STIR always showed a higher agreement. Prevertebral hematoma was found in 20 of 21 patients with the maximum thickness at the same anatomic level as the intraoperatively proven lesion in 12 of 18 patients (67%). Edema and/or hemorrhage of the spinal cord was shown in 16 of 21 being at the same anatomic level as the intraoperatively confirmed pathology in 16 of 16 patients (100%). CONCLUSIONS MRI is a reliable tool for the evaluation of discoligamentous injuries in the cervical spine, with ancillary features proven as helpful information. more...
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- 2019
Catalog
3. Bilateral medial medullary syndrome following anterior screw fixation of type 2 odontoid fracture, a case report of two patients
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Bettina Pfausler, Anna Spicher, Dietmar Krappinger, Michael Zegg, and Martha Nowosielski
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medicine.medical_specialty ,Brain Stem Infarctions ,business.industry ,Bone Screws ,Tetraparesis ,Case Report ,Dermatology ,Perioperative ,medicine.disease ,Surgery ,Screw fixation ,Lesion ,Fracture Fixation, Internal ,Neurology ,Odontoid Process ,medicine ,Paralysis ,Cervical Vertebrae ,Humans ,Spinal Fractures ,medicine.symptom ,Medial medullary syndrome ,business ,Medulla ,Odontoid fracture - Abstract
INTRODUCTION: Medial medullary syndrome (MMS) has not been reported after anterior screw fixation of an odontoid type 2 fracture. CASE PRESENTATION: We report on two cases who suffered from an unstable type 2 odontoid fracture following a skiing and a domestic fall accident. Prior to anterior screw fixation surgery both patients presented without neurologic deficits but postoperatively developed a bilateral MMS, including an incomplete tetraparesis, impaired sensation of position and movement as well as tactile discrimination and paralysis of the tongue muscle with deviation to the paralyzed side. MRI showed a typical heart-shaped ischaemic lesion in the medial medulla bilaterally. The search for aetiologic factors was uneventful in both patients except for severe atherosclerosis. DISCUSSION: Due to the close proximity of the ischaemic area to the surgical site, we here propose the perioperative mechanical manipulation of the upper cervical spine during surgery of patients with atherosclerosis as a new aetiology for MMS. more...
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- 2021
4. Monosegmental anterior column reconstruction using an expandable vertebral body replacement device in combined posterior–anterior stabilization of thoracolumbar burst fractures
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Dietmar Krappinger, Anna Spicher, Michael Zegg, Max Mueller, Richard A. Lindtner, Rene Schmid, and Christian Kammerlander
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Adult ,Male ,musculoskeletal diseases ,medicine.medical_specialty ,Trauma Surgery ,Posture ,Kyphosis ,Thoracolumbar fracture ,Vertebral body replacement ,Thoracic Vertebrae ,Posterior anterior ,Anterior column reconstruction ,Fracture Fixation, Internal ,03 medical and health sciences ,0302 clinical medicine ,Burst fracture ,Monosegmental ,Humans ,Medicine ,Orthopedics and Sports Medicine ,360° fusion ,Fractures, Comminuted ,Combined posterior–anterior stabilization ,030222 orthopedics ,Lumbar Vertebrae ,business.industry ,Equipment Design ,General Medicine ,Middle Aged ,Surgical correction ,medicine.disease ,Spinal injury ,Radiography ,Vertebral body ,Spinal Fusion ,medicine.anatomical_structure ,Radiological weapon ,Cancellous Bone ,Orthopedic surgery ,Spinal Fractures ,Female ,Surgery ,Tomography, X-Ray Computed ,business ,Nuclear medicine ,Cancellous bone ,030217 neurology & neurosurgery - Abstract
Introduction In combined posterior–anterior stabilization of thoracolumbar burst fractures, the expandable vertebral body replacement device (VBRD) is typically placed bisegmentally for anterior column reconstruction (ACR). The aim of this study, however, was to assess feasibility, outcome and potential pitfalls of monosegmental ACR using a VBRD. In addition, clinical and radiological outcome of monosegmental ACR was related to that of bisegmental ACR using the same thoracoscopic technique. Methods Thirty-seven consecutive neurologically intact patients with burst fractures of the thoracolumbar junction (T11–L2) treated by combined posterior–anterior stabilization were included. Monosegmental ACR was performed in 18 and bisegmental ACR in 19 patients. Fracture type and extent of vertebral body comminution were determined on preoperative CT scans. Monosegmental and bisegmental kyphosis angles were analyzed preoperatively, postoperatively and at final radiological follow-up. Clinical outcome was assessed after a minimum of 2 years (74 ± 45 months; range 24–154; follow-up rate 89.2%) using VAS Spine Score, RMDQ, ODI and WHOQOL-BREF. Results Monosegmental ACR resulted in a mean monosegmental and bisegmental surgical correction of − 15.6 ± 7.7° and − 14.7 ± 8.1°, respectively. Postoperative monosegmental and bisegmental loss of correction averaged 2.7 ± 2.7° and 5.2 ± 3.7°, respectively. Two surgical pitfalls of monosegmental ACR were identified: VBRD positioning (1) onto the weak cancellous bone (too far cranially to the inferior endplate of the fractured vertebra) and (2) onto a significantly compromised inferior endplate with at least two (even subtle) fracture lines. Ignoring these pitfalls resulted in VBRD subsidence in five cases. When relating the clinical and radiological outcome of monosegmental ACR to that of bisegmental ACR, no significant differences were found, except for frequency of VBRD subsidence (5 vs. 0, P = 0.02) and bisegmental loss of correction (5.2 ± 3.7° vs. 2.6 ± 2.5°, P = 0.022). After exclusion of cases with VBRD subsidence, the latter did not reach significance anymore (4.9 ± 4.0° vs. 2.6 ± 2.5°, P = 0.084). Conclusions This study indicates that monosegmental ACR using a VBRD is feasible in thoracolumbar burst fractures if the inferior endplate is intact (incomplete burst fractures) or features only a single simple split fracture line (burst-split fractures). If the two identified pitfalls are avoided, monosegmental ACR may be a viable alternative to bisegmental ACR in selected thoracolumbar burst fractures to spare a motion segment and to reduce the distance for bony fusion. more...
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- 2018
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5. The impact of lateral pedicle screw misplacement and subsequent correction of screw trajectory on screw anchorage. A biomechanical analysis
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Peter Ferlic, Richard A. Lindtner, Anna Spicher, Rene Schmid, Richard Bostelmann, Werner Schmoelz, and Michael Zegg
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Orthodontics ,Trajectory ,Neurology. Diseases of the nervous system ,RC346-429 ,Pedicle screw ,Geology - Published
- 2021
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6. Blobbing injury patterns
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Michael Zegg, Anna Spicher, Peter Kaiser, David Sailer, and Rohit Arora
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Elbow ,Severity of Illness Index ,Retrospective data ,Fractures, Bone ,Young Adult ,Accident Prevention ,Risk Factors ,medicine ,Craniocerebral Trauma ,Humans ,Child ,General Environmental Science ,Retrospective Studies ,business.industry ,Extremities ,Middle Aged ,Cervical spine ,Surgery ,Conservative treatment ,medicine.anatomical_structure ,Spinal Injuries ,Athletic Injuries ,General Earth and Planetary Sciences ,Body region ,Spine injury ,Accidental Falls ,Female ,Ankle ,business ,human activities ,Foot (unit) - Abstract
Introduction “Blobbing” is a modern outdoor activity where a participant sits on the end of a partially inflated air bag (“blobber”) and is launched into the water when another participant jumps onto the air bag from a platform on the opposite side (“jumper”). This is the first study to evaluate the injury patterns associated with blobbing. Patients and methods A retrospective data analysis was conducted based on 86 patients who sustained blobbing injuries between January 2011 and December 2016. The date of birth, gender, day of injury, diagnosis, body region of trauma, and treatment were recorded for the patients. Treatment was subclassified into conservative or surgical treatment. The position of the participant was recorded as either a jumper or a blobber. Results One-third of the patients sustained a spine injury, which was the most common body part injured. The most frequent type of injury was cervical spine distortion. All shoulder (n = 9), elbow (n = 3), hand (n = 2), knee (n = 3), and foot (n = 12) injuries occurred in jumpers, whereas all ear (n = 6) and lung (n = 5) injuries occurred in blobbers. Head (n = 5) and spine (n = 33) injuries were distributed in jumpers and blobbers. Sixty-nine patients were treated with conservative treatment. Three ankle fractures and two spine fractures were treated with immediate surgical treatment. Twelve patients were treated with conservative treatment but were referred for potential surgery at their hospital at home. Conclusion Both jumpers and blobbers were prone to injuries. More severe injuries with the potential for surgical treatment occurred in jumpers, presumably because of bad landings. This analysis of the injury patterns in blobbers might lead to the introduction of protective gear and changes in the behavior of participants in order to reduce the risk of injury. more...
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- 2018
7. Spondylotic traumatic central cord syndrome: a hidden discoligamentous injury?
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Verena Kaser, Benjamin Henninger, Michael Zegg, Dietmar Krappinger, Anna Spicher, Rene Schmid, and Richard A. Lindtner
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Joint Instability ,medicine.medical_specialty ,Central Cord Syndrome ,03 medical and health sciences ,Anterior longitudinal ligament ,0302 clinical medicine ,Segmental instability ,medicine ,Humans ,Orthopedics and Sports Medicine ,Aged ,Retrospective Studies ,Hyperextension injury ,030222 orthopedics ,medicine.diagnostic_test ,business.industry ,Cervical hyperextension ,Magnetic resonance imaging ,Middle Aged ,Spinal cord ,Central cord syndrome ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Spinal Injuries ,Cervical Vertebrae ,Surgery ,Neurosurgery ,Radiology ,Spondylosis ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
To revisit the concept of spondylotic traumatic central cord syndrome (TCCS) by assessing the frequency of discoligamentous injury and to correlate magnetic resonance imaging (MRI) and intraoperative findings. A retrospective analysis of twenty-three consecutive patients (mean age: 62.7 ± 14.8 years) with profound spondylotic TCCS after acute cervical hyperextension trauma but without signs of instability on initial CT scans who underwent anterior surgical decompression and fusion was performed. Sensitivity and specificity of MRI in the detection of anterior longitudinal ligament disruption were calculated. The topographic relations between surgically verified segmental instabilities and spinal cord signals on MRI were analyzed. The cervical MRI scans of all patients were evaluated by the radiologist on call at time of admission, re-assessed by a specialized MRI radiologist for the purpose of this study and compared with intraoperative findings. Intraoperative findings revealed 25 cervical spine segments with hyperextension instability in 22 of 23 (95.7%) patients. The radiologist on call correctly assessed segmental hyperextension instability in 15 of 25 segments (sensitivity: 0.60, specificity: 1.00), while the specialized MRI radiologist was correct in 22 segments (sensitivity: 0.88, specificity: 1.00). In 17 of 23 (73.9%) patients, the level of spinal cord signal on MRI matched the level of surgically verified segmental instability. Our findings challenge the traditional concept of spondylotic TCCS as an incomplete cervical spinal cord injury without discoligamentous injury and emphasize the importance of MRI as well as the radiologist’s level of experience for the assessment of segmental instability in these patients. These slides can be retrieved under Electronic Supplementary Material. more...
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- 2018
8. Die Masquelet-Technik zur Behandlung großer dia- und metaphysärer Knochendefekte
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A. Dal Pont, Dietmar Krappinger, Richard A. Lindtner, Michael Zegg, and B. Huber
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Gynecology ,medicine.medical_specialty ,Masquelet technique ,business.industry ,Trauma Severity Indexes ,Treatment outcome ,Bone surgery ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,Hand surgery ,business - Abstract
Behandlung groser dia- und metaphysarer Knochendefekte (> 3 cm) in zwei operativen Eingriffen mit einem zeitlichen Abstand von 4–8 Wochen. Dia- und metaphysare Knochendefekte vorwiegend am Unter- und Oberschenkel. Knochendefekte mit Gelenkbeteiligung, persistierender Knocheninfekt oder Osteomyelitis, insuffiziente Weichteildeckung im Bereich des Knochendefekts, Osteoporose. Ersteingriff: Ausgiebiges Knochendebridement und Weichteildeckung, Einbringen eines Zementspacers in den Knochendefekt zur Induktion einer synovialen Fremdkorpermembran, interne oder externe Stabilisierung. Zweiteingriff: Entfernen des Zementspacers und Fullung des von der induzierten Membran umgebenen Knochendefekts mit autologer Spongiosa, ggf. Verfahrenswechsel auf eine interne Fixation. Schmerzabhangige Teil- bis Vollbelastung nach dem Ersteingriff. Abrollende Mobilisation nach dem Zweiteingriff bis zum Auftreten von radiologischen Zeichen eines Remodellings des Regenerats. In der Regel Belassen des Implantats. Insgesamt wurden 6 Patienten (4 Manner, 2 Frauen) im Alter von 15–66 Jahren mit Knochendefekten von durchschnittlich 7 cm (Spanne 4–10 cm) mit der Masquelet-Technik behandelt. Es handelte sich um 2 femorale aseptische Pseudarthrosen und 4 tibiale Pseudarthrosen (je 2 septische und aseptische Pseudarthrosen), dabei in einem Fall um eine periprothetische Pseudarthrose an der Tibia bei schaftgefuhrter Knieprothese. Die Stabilisierung nach Debridement erfolgte an der Tibia in allen Fallen zunachst mit einem Ringfixateur, am Femur einmal mit einem Marknagel und einmal mit einer winkelstabilen Platte. Der Zweiteingriff wurde zwischen 6 und 9 Wochen nach dem Ersteingriff durchgefuhrt. Dabei wurde in 3 von 4 Fallen an der Tibia ein Verfahrenswechsel auf eine interne Fixation durchgefuhrt. Die Spongiosa wurde entweder vom Beckenkamm oder in RIA-Technik („Reamer-Irrigator-Aspirator“) entnommen. Bei der Patientin mit dem periprothetischen Knochendefekt kam es nach 5 Monaten zu einem Plattenbruch und konsekutiver Unterschenkelamputation. In einem Fall wurde aufgrund einer Pseudarthrose an der Andockstelle eine lokale Spongiosaplastik durchgefuhrt. Alle Patienten waren nach 6 Monaten schmerzfrei und vollbelastend mobil. Der Ilizarov-Fixateur konnte bei einem 15-jahrigen Patienten 5 Monate nach dem Zweiteingriff entfernt werden. Die restlichen Implantate wurden belassen. more...
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- 2015
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9. Treatment and outcome with traumatic lesions of the olecranon and prepatellar bursa: a literature review apropos a retrospective analysis including 552 cases
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Michael Zegg, Rene Attal, Christoph Raas, Marina Popovscaia, and Peter Kaiser
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endocrine system ,medicine.medical_specialty ,animal structures ,Bursitis ,Knee Joint ,Olecranon ,medicine.medical_treatment ,Knee Injuries ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Retrospective analysis ,Humans ,Orthopedics and Sports Medicine ,Orthopedic Procedures ,030212 general & internal medicine ,Olecranon Process ,030222 orthopedics ,Olecranon bursa ,Prepatellar bursa ,business.industry ,Incidence (epidemiology) ,General Medicine ,Bursa, Synovial ,medicine.disease ,Surgery ,Bursectomy ,medicine.anatomical_structure ,Orthopedic surgery ,business ,Elbow Injuries - Abstract
Traumatic lesions of the olecranon bursa (OB) and prepatellar bursa (PB) are injuries commonly seen in orthopaedic trauma units. These injuries are associated with a high rate of complications. At present, only little is known about the incidence, complication rate, and treatment approaches in patients with acute open bursae.A total of 552 patients who had been treated for acute traumatic lesions of either the olecranon bursa or the prepatellar bursa, or both at our department were retrospective identified in the years between 2009 and 2014. An analysis of the medical history of these patients was carried out to investigate the incidence of bursa injuries, circumstances, concomitant injuries, complication rate, and treatment approaches. In addition, a systematic literature search on PubMed was conducted.The incidence of traumatic lesions of the OB or PB in trauma patients was 0.2% (198/100,000; 62% OB, 38% PB). Bursectomy was performed in 83.7%. Concomitant injuries were present in 41% of the cases, with no significant influence on the complication rate (P = 0.367). The overall complication rate was 19.7%. Revision surgery was necessary in 4.5% of the patients. No significant differences between OB and PB injuries were noted with regard to the complication rate (P = 0.221). There were also no significant differences in the complication rate between patients who received bursectomy and those with conservative treatment (P = 0.364). Regression analyses showed that prophylactic antibiotic administration significantly reduced the risk of infection (P = 0.04).Traumatic lesions of the OB and PB are associated with a high risk of complications. Prophylactic antibiotic therapy can potentially reduce the risk of infection and the need for revision surgery. more...
- Published
- 2016
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