[Stereotactic body radiotherapy (SBRT) -- an overview under special consideration of SBRT and LITT in the therapy of liver metastases]. / Extrakranielle stereotaktische Radiotherapie (ESRT) - eine Ubersicht unter besonderer Berücksichtigung von ESRT und LITT in der Behandlung von Lebermetastasen.

Stereotactic body radiotherapy (SBRT) is a high dose radiotherapy, the radiation dose is applicated one-time or in a few fractions exactly to the tumor or metastases under maximal separation from the normal tissue. Because of this a major expenditure of medical and technical efforts are necessary, a detailed description of the proceedings is following in the methodic part of this article. Indications of SBRT are especially medical irresectable lung tumors of early stages, primary liver/biliary tumors and pulmonary or liver metastases if there is an oncological benefit for the patients. The side effects are moderate, the local tumor control rate is between 78 to 100 %. Depending on the primary tumor the overall survival is prolonged statistically significant. In the Klinikum Krefeld indications of SBRT vs chemotherapy, LITT or resection are discussed by an interdisciplinary conference of gastroenterologists/oncologists, radiologists, radiooncologists and surgeons. An example of LITT will be shown also.

[In vitro stability study of an improved implant system for minimally invasive transforaminal approach]. / In-vitro-Stabilitätsuntersuchung eines neuartigen Implantatsystems für den minimal-invasiven transforaminalen Zugang.

Calf specimens from the L3-4 and L5-6 levels were used for in vitro stability testing of a new transforaminal lumbar interbody fusion (TLIF) implant. Results were compared with those of the conventional posterior lumbar interbody fusion (PLIF) technique using two cuboid spacers. The specimens were loaded with pure moments of 10 Nm in flexion, extension, lateral bending, and axial rotation without any axial preload. They were allowed to move freely and unconstrained in all directions. In extension the PLIF implants showed slightly higher degrees of stiffness than the TLIF implant. While the conventional PLIF technique results in an increased range of motion by a factor of 2.5 after implant insertion, the TLIF approach prevents segmental destabilization in axial rotation. The facet joint arthrodesis using resorbable pins reveals biomechanically interesting results and will therefore be investigated in further studies.