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Michael Y. Wang

autograft bone from the facetectomies, as well as rh-BMP-2 (InFuse, Medtronic Sofamor Danek) at a dose of up to 1.05 mg/level. A 25-mm Optimesh cage (Spineology) is then inserted and internally filled with allograft granular matrix. The device is inserted through a 7-mmdiameter portal and inflated within the disc space, restoring intervertebral height. It should be noted that both of these products used in this setting are considered off label by the FDA. Once filled and inflated, the cages are crimped shut and the nerve roots inspected to ensure there is no impingement

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Paul Khoueir, K. Anthony Kim and Michael Y. Wang

✓Numerous new posterior dynamic stabilization (PDS) devices have been developed for the treatment of disorders of the lumbar spine. In this report the authors provide a classification scheme for these devices and describe several clinical situations in which the instrumentation may be expected to play a role. By using this classification, the PDSs that are now available and those developed in the future can be uniformly categorized.

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George M. Ghobrial and Michael Y. Wang

, this paradigm is far more manageable when compared to the obstacles encountered with implementation of targeted-treatment therapies for primary SCI mechanisms. Against that background, Grasmücke and coinvestigators present their experience with the use of the Hybrid Assistive Limb (HAL, Cyberdyne Inc.) exoskeleton, a mechanical device capable of locomotive gait assistance via electromyographic stimuli. 3 This represents the latest generation in assistive mechanical exoskeletons, whereby neurological feedback drives exoskeleton use. The aim of this study was to

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Michael Y. Wang and Spencer Block

were attributable to a surgeon's lack of awareness that a surgical instrument, sponge, or device had been inadvertently left within the patient, in orthopedic and spinal surgery, implants can be left behind because of the inherent difficulties and risks associated with removing objects buried within the spinal column. Most frequently, these retained implants comprise broken screws or implants buried deep within a pedicle or vertebral body that were originally implanted for a specific purpose. They are composed of metal alloys that have been tested to be inert and

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The evolution of minimally invasive spine surgery

JNSPG 75th Anniversary Invited Review Article

Jang W. Yoon and Michael Y. Wang

endoscopic work, 2) poor reimbursement for these procedures, 3) differences in capital equipment purchasing power between nations, leading to a dearth of microscopes in the developing world, 4) lack of interest by major US medical device manufacturers, and 5) philosophical differences in the goals of spinal surgery MISS for Spinal Fixation and Fusion Advancements in spinal instrumentation have played a critical parallel and additive role with decompressive techniques in expanding the armamentarium of MISS. Michele and Krueger first described the pedicle screw fixation

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Michael Y. Wang and Praveen V. Mummaneni

), or expandable cages ( Fig. 2 ) (Globus Medical or Synthes Spine). These interbody devices were filled with rhBMP-2 (InFuse, Medtronic Sofamor Danek). Posterior supplemental fixation was performed with the use of Viper percutaneous pedicle screws and connecting rods (DePuy Spine) introduced through the proximal or distal screw entry site. The screw insertion technique was based on using primarily anteroposterior fluoroscopy, and no image guidance was used. Posterolateral intersegmental fusion was achieved at levels without interbody fusion by exposing the facet

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Michael Y. Wang and Jay Grossman

efficient placement of an interbody device to allow for fusion through Kambin's triangle. This also permits indirect neural decompression by restoring intervertebral height. Osteobiologics are necessary to promote fusion through such a small corridor. Use of conscious sedation reduces the side effects of general anesthesia, and it also allows for live neurological monitoring through patient feedback. Finally, liposomal bupivacaine provides prolonged local analgesia during the first 3 days after surgery, which is typically the most painful period. These component

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Paul Khoueir, Daniel J. Hoh and Michael Y. Wang

publication, 3 in this case report we describe in more detail the novel technique employing a new titanium hinged rod as a device for both controlled spinal correction and permanent internal fixation. Case Report History and Physical Examination This 57-year-old man with a history of AS sustained a traumatic lower cervical fracture 3 months prior to presentation at our institution. At the time of the initial fracture, the patient was seen at an outside hospital and was managed conservatively using a cervical orthosis. Over the following 4 months, the patient

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Timur M. Urakov and Michael Y. Wang

authors mentioned that several groups have made an effort to introduce novel hardware to secure C-1 and C-2 in a way that preserves cervical mobility to some extent. Most of these techniques involved an anterior transoral approach and provided only limited improvement in the range of motion. The transoral approach also carries a high risk profile, including the risk of infection and dysphagia. Preservation of cervical spine mobility is extremely important for the quality of daily activities, and novel devices that carry a low risk associated with implantation and ensure

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Michael Y. Wang, Enrico Tessitore, Neil Berrington and Andrew Dailey

most neurosurgeons’ first exposure to this important and growing area of research. Disclosures Dr. Wang reports being a consultant for DePuy-Synthes Spine, K2M, Spineology, and Stryker; receiving royalties from Children’s Hospital of Los Angeles, DePuy-Synthes Spine, Springer Publishing, and Quality Medical Publishing; being a member of the board at Vallum; and holding stock in Innovative Surgical Devices and Medical Device Partners. Dr. Tessitore reports being a consultant for DePuy Synthes, NuVasive, Brainlab, and Spineart and receiving training fees from DePuy