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Edward C. Benzel

S ince the development of universal spine instrumentation techniques, several reports have described their utility for the treatment of thoracic and lumbar spine trauma. Most have advocated traditional multiple-level instrumentation techniques. 5–8, 10–12 However, the use of shorter constructs has been proposed in order to reduce the incidence of long-term complications. 2, 4 The short-rod/two-claw (SRTC) technique of universal spine instrumentation offers an advantage with respect to late instrumentation-related patient complaints and complications. 2 An

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Edward C. Benzel and Nevan G. Baldwin

posttraumatic instability of the thoracic or upper lumbar spine were surgically managed during an 8-month period, ending April 15, 1993, at the University of New Mexico Affiliated Hospitals in Albuquerque, New Mexico. The patients' mean age was 33.6 years (range 16 to 56 years) and seven of the 10 were male. The mean follow-up interval to date has been greater than 12 months in the nine surviving patients. The demographic and outcome data regarding these patients are presented in Table 1 . TABLE 1 Clinical summary of 10 patients with posttraumatic instability of the

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Michael F. Shriver, Valerie Zeer, Vincent J. Alentado, Thomas E. Mroz, Edward C. Benzel and Michael P. Steinmetz

E xposure of the lumbar spine is achieved through a variety of intraoperative surgical positions. 4 The prone, kneeling, knee-chest, knee-elbow, and lateral decubitus positions represent plausible positions that allow for exposure of the lumbar spine. However, each of these positions has an array of unique complications. 4 , 6 , 11 , 14 , 28 , 30 These complications result from excessive pressure applied to ventral or lateral structures, causing potentially significant postoperative morbidity. 4 , 9 , 11 , 14 , 15 , 22 , 31 , 33 , 39 , 47 While certain

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Jay M. Levin, Robert D. Winkelman, Joseph E. Tanenbaum, Edward C. Benzel, Thomas E. Mroz and Michael P. Steinmetz

satisfaction is particularly acute for common and costly procedures, which have the largest potential impact on hospital reimbursement. The incidence and cost of lumbar spine surgery are increasing in the United States. 4 , 8 , 22 , 25 , 28 For example, aggregate hospital charges for surgical treatment of lumbar stenosis has increased by 40% between 2002 and 2007, mostly attributed to the rising rate of complex fusions performed. Additionally, as the United States population continues to age, the prevalence of spinal stenosis, the most common indication for lumbar spine

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Edward C. Benzel, Lee Kesterson and Erich P. Marchand

T he application of universal spinal instrumentation techniques to the treatment of thoracic and lumbar spine fractures has greatly enhanced the surgeon's ability to gain immediate and sustained spinal stability. The largest body of experience with universal spinal instrumentation in spine trauma to date has been the Cotrel-Dubousset (CD) system. * 4–6, 9, 10 We present our recent 1-year experience with the treatment of 28 thoracic and/or lumbar fractures at the University of New Mexico using a newer form of universal instrumentation, the Texas Scottish Rite

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Edward C. Benzel

difficult than posterior procedures. The reward with regard to neurological outcome, however, warrants their use. 2 The lateral extracavitary approach to the thoracic and lumbar spine, which was introduced by Capener 5 and popularized by Larson, et al. , 8, 9 offers the advantage of allowing the surgeon to simultaneously decompress the ventral spinal cord and to place instrumentation devices dorsally. It also permits the performance of these two procedures through the same incision, under the same anesthesia, and in the appropriate sequence. 3 The lateral

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clinical differences will develop. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 2013.1.FOC-LSRSABSTRACTS Poster Abstract Poster 3. Use Of Recombinant Human Bone Morphogenetic Protein-2 (rhBMP-2) Without Iliac Crest Bone Graft In Posterolateral Lumbar Spine Fusion (PLF) Daniel K. Park , MD , Sung Soo Kim , and Scott Boden , MD William Beaumont Hospital, Orthopedic Surgery, Southfield, MI 1 2013 34 1 The Science of Neurosurgical Practice A2

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A1 Copyright held by the American Association of Neurological Surgeons. You may not sell, republish, or systematically distribute any published materials without written permission from JNSPG. 2014 Introduction The objective of this study is to examine the long-term outcomes of patients undergoing non-instrumented posterolateral fusion of the lumbar spine. Methods We present 376 patients who underwent in situ, non-instrumented arthrodesis for lumbar degenerative disease over a 20-year period at a single institution. Patients were followed for an

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SP was widest at 11.09 ± 2.85 mm. L5 had a slope of 23.68 ± 10.51 degrees relative to the mechanical axis, which was steeper than other levels. At L2-L5, more SPs have convex morphology. Conversely, L1 exhibits convex morphology only 38.7% of the time ( Table 1 ). Discussion: Past studies have examined the quantitative anatomy of the lumbar spine as it pertains to pedicle fixation for posterior spinal fusions. Little work, however, has been done to examine lumbar spinous processes and their variable morphology. Spinous process length, width, height and slope

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Nevan G. Baldwin and Edward C. Benzel

. Clinical Results The bicortical iliac fixation technique was used in three patients for whom more than 1 year of follow-up data are available. Each patient had a complex lumbar spine deformity and all had undergone previous surgical procedures, including spine instrumentation. In each case, the deformity was of such severity that sacral fixation was needed to apply the appropriate corrective forces and achieve rigid immobilization. Postoperative anteroposterior and lateral radiographs obtained in one of the patients are shown in Fig. 3 . All three patients have