Volker K H Sonntag

Objective. —To compare the efficacy of methylprednisolone administered for 24 hours with methyprednisolone administered for 48 hours or tirilazad mesylate administered for 48 hours in patients with acute spinal cord injury.Design. —Double-blind, randomized clinical trial.Setting. —Sixteen acute spinal cord injury centers in North America.Patients. —A total of 499 patients with acute spinal cord injury diagnosed in National Acute Spinal Cord Injury Study (NASCIS) centers within 8 hours of ...

BACKGROUND: The comparative effectiveness of performing instrumented (rigid pedicle screws affixed to titanium alloy rods) lumbar spinal fusion in addition to decompressive laminectomy in patients with symptomatic lumbar grade I degenerative spondylolisthesis with spinal stenosis is unknown.

METHODS: In this randomized, controlled trial, we assigned patients, 50 to 80 years of age, who had stable degenerative spondylolisthesis (degree of spondylolisthesis, 3 to 14 mm) and symptomatic ...

Studies in animals indicate that methylprednisolone and naloxone are both potentially beneficial in acute spinal-cord injury, but whether any treatment is clinically effective remains uncertain. We evaluated the efficacy and safety of methylprednisolone and naloxone in a multicenter randomized, double-blind, placebo-controlled trial in patients with acute spinal-cord injury, 95 percent of whom were treated within 14 hours of injury. Methylprednisolone was given to 162 patients as a bolus ...

STUDY DESIGN: A multicenter, retrospective study using computed tomographic and magnetic resonance imaging data to establish quantitative, reliable criteria of canal compromise and cord compression in patients with cervical spinal cord injury.

OBJECTIVES: To develop and validate a radiologic assessment tool of spinal canal compromise and cord compression in cervical spinal cord injury for use in clinical trials.

SUMMARY OF BACKGROUND DATA: There are few quantitative, reliable criteria ...

Thirty patients were treated surgically for spinal epidural hematoma (SEH). Twelve of these cases resulted from spinal surgery, seven from epidural catheters, four from vascular lesions, three from anticoagulation medications, two from trauma, and two from spontaneous causes. Pain was the predominant initial symptom, and all patients developed neurological deficits. Eight patients had complete motor and sensory loss (Frankel Grade A); six had complete motor loss but some sensation ...

OBJECTIVE: To evaluate risk factors for the development of dysphagia after anterior cervical surgery.

METHODS: The records of 249 patients who underwent anterior cervical surgery were reviewed. The presence and severity of dysphagia were assessed with the Dysphagia Disability Index 6 weeks and 3, 6, and 12 months after surgery. Age; sex; ethnicity; cigarette smoking; previous cervical surgeries; reoperation for same pathology; type of procedure, incision, and instrumentation; number and ...

OBJECT: The object of this study was to investigate the effects of iatrogenic pedicle perforations from screw misplacement on the mean pullout strength of thoracic pedicle screws.

METHODS: Forty human thoracic vertebrae (T6-11) from human cadavers were studied. Before pedicle screws were inserted, the specimens were separated into 4 groups according to the type of screw used: 1) standard pedicle screw (no cortical perforation); 2) screw with medial cortical perforation; 3) screw with ...

STUDY DESIGN: A prospective, randomized, pilot clinical trial compared recombinant human bone morphogenetic protein-2 (rhBMP-2) with iliac crest autograft bone for the treatment of human cervical disc disease.

OBJECTIVE: To examine the safety and effectiveness of using INFUSE Bone Graft (rhBMP-2 applied to an absorbable collagen sponge), as compared with an autogenous iliac crest bone graft placed inside the CORNERSTONE-SR fibular allograft, in anterior cervical discectomy and interbody ...

STUDY DESIGN: In vitro human cadaveric study simultaneously quantifying sagittal plane flexibility and spinal canal stenosis.

OBJECTIVE: To compare biomechanical stability and the change in cross-sectional area during flexion and extension after laminectomy and open-door laminoplasty.

SUMMARY OF BACKGROUND DATA: Spinal canal stenosis has been quantified in vitro but has not been quantified in studies of laminectomy or laminoplasty.

METHODS: Cadaveric specimens were loaded in ...

OBJECT: The authors sought to determine the biomechanical effectiveness of threaded interbody cages or dowels compared with that achieved using pedicle screw instrumentation in resisting Grade I lumbar spine degenerative spondylolisthesis.

METHODS: Thirty-three levels obtained from seven cadaveric lumbar spines were instrumented with cages or dowels, pedicle screw/rod instrumentation, or both. Entire specimens were loaded with nonconstraining torques. Each level was loaded with ...

The 1-year follow-up data of a multicenter randomized controlled trial of methylprednisolone (30 mg/kg bolus and 5.4 mg/kg/hr for 23 hours) or naloxone (5.4 mg/kg bolus and 4.0 mg/kg/hr for 23 hours) treatment for acute spinal cord injury are reported and compared with placebo results. In patients treated with methylprednisolone within 8 hours of injury, increased recovery of neurological function was seen at 6 weeks and at 6 months and continued to be observed 1 year after injury. For ...

STUDY DESIGN: Retrospective review of acute axis fractures treated at a tertiary referral center.

OBJECTIVE: To determine the optimal treatment of axis fractures based on 340 cases from a single institution.

SUMMARY OF BACKGROUND DATA: Axis fractures account for almost 20% of acute cervical spine fractures. However, their management and the clinical criteria predictive of nonoperative failure remain unclear.

METHODS: Admission imaging studies and clinical variables were obtained for 340 ...

The combination of movement, location, and anatomy of the axis predisposes it to multiple and varied fracture/dislocations distinct from other vertebrae. We examine all forms of axis fractures and address the appropriate treatment for each specific fracture type. In a retrospective review of 625 cervical spine fractures during an 8-year period, we found 107 axis fractures. There were 25 hangman's fractures (23%), 59 odontoid fractures (55%), and 23 miscellaneous fractures (22%). Each ...

STUDY DESIGN: In a clinical retrospective study, the authors review long-term results of occipitocervical fusion using a wide diameter, contoured, threaded Steinmann pin.

OBJECTIVES: To evaluate the clinical and radiographic results of occipitocervical fusion using this technique in a variety of abnormalities including rheumatoid arthritis. SUMMARY OF BACKGROUND DATA. The various surgical techniques and hardware developed for occipitocervical fusion have been associated with mixed ...