The biomechanics of iatrogenic spinal destabilization and implant failure

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Revision spinal surgery is usually indicated in cases of persistent or recurrent symptoms related to neural compression, spinal deformity, or construct failure. An understanding of fundamental biomechanical principles of both spinal decompression and reconstructive strategies is essential to avoid unnecessary subsequent spinal operations.

Abbreviations used in this paper:ALL = anterior longitudinal ligament; IAR = instantaneous axis of rotation; PLL = posterior longitudinal ligament; VB = vertebral body.

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Address reprint requests to: Richard P. Schlenk, M.D., Department of Neurosurgery, The Cleveland Clinic Foundation, 9500 Euclid Avenue, S80, Cleveland, Ohio 44195. email:

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