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Michael Y. Wang, Ram Vasudevan and Stefan A. Mindea

. The anterior and posterior longitudinal ligaments are preserved to allow tensioning of these structures, with cage distraction to improve structural rigidity and allow for indirect neural decompression. Cage height is chosen based on preoperative disc height, mobility of the motion segment with intraoperative manipulation, bone density, and degree of indirect decompression needed. An appropriately sized polyetheretherketone (PEEK) or carbon fiber cage is then filled with two recombinant human bone morphogenetic protein–2 (rhBMP-2) sponges (InFuse, Medtronic

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Michael Y. Wang, Matthew D. Cummock, Yong Yu and Rikin A. Trivedi

the exiting and traversing nerve roots. This was followed by disc removal and placement of a carbon fiber cage and rhBMP-2 sponges. The retractor was then removed, and the pedicles of interest were cannulated using a Jamshidi needle under anteroposterior and lateral fluoroscopic guidance. This needle was then exchanged for a Kirschner wire placement, which allowed insertion of a cannulated awl, tap, and Viper pedicle screw (Depuy Spine, Inc.). The screw heads were then connected with percutaneously inserted rods bilaterally. All operations included bilateral

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Roland D. Donk, Michael G. Fehlings, Wim I. M. Verhagen, Hisse Arnts, Hans Groenewoud, André L. M. Verbeek and Ronald H. M. A. Bartels

discectomy without fusion, with fusion or with arthroplasty . BMC Musculoskelet Disord 7 : 85 , 2006 10.1186/1471-2474-7-85 3 Bartels RH , Donk RD , Feuth T : Subsidence of stand-alone cervical carbon fiber cages . Neurosurgery 58 : 502 – 508 , 2006 16528190 10.1227/01.NEU.0000197258.30821.50 4 Benzel EC : Biomechanics of Spine Stabilization Rolling Meadows, IL , AANS , 2001 . 85 5 Bonnet DG , Wright TA : Cronbach's alpha reliability: interval estimation, hypothesis testing, and sample size planning . J Organ Behav 36 : 3 – 15 , 2015 10

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Osamah J. Choudhry, Lana D. Christiano, Rahul Singh, Barbara M. Golden and James K. Liu

, titanium cage, and carbon fiber cage), the relative containment of the BMP carrier sponge by this device may differ and affect the potential for unwanted displacement of BMP sponge material. Future research should aim to understand the mechanism behind the inflammatory complications of BMP and how to prevent them. Certain studies have already made progress toward this goal. In an in vivo murine model, Lee et al. 13 demonstrated a dose-dependent inflammatory effect caused by direct contact of the BMP with surrounding soft tissue. This has led some researchers to

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Jason Moore, Narayan Yoganandan, Frank A. Pintar, Jason Lifshutz and Dennis J. Maiman

constructs . J Bone Joint Surg Am 85 : 1749 – 1756 , 2003 45 Pavlov PW , Spruit M , Havinga M , Anderson PG , van Limbeek J , Jacobs WC : Anterior lumbar interbody fusion with threaded fusion cages and autologous bone grafts . Eur Spine J 9 : 224 – 229 , 2000 46 Pellise F , Puig O , Rivas A , Bago J , Villanueva C : Low fusion rate after L5-S1 laparoscopic anterior lumbar interbody fusion using twin stand-alone carbon fiber cages . Spine 27 : 1665 – 1669 , 2002 47 Quinnell RC , Stockdale HR : Some experimental

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Bryan Barnes, Gerald E. Rodts, Mark R. McLaughlin and Regis W. Haid Jr.

% fusion rate in a mean 28-month follow-up period when using impacted carbon cages. Compared with titanium cages, TCBDs may have the advantage of allowing easier radiographic assessment of fusion and may be more amenable to surgical revision. Moreover, TCBDs have a modulus of elasticity similar to that of native bone in the area of implantation as opposed to titanium and carbon fiber cages. Theoretically, this may increase the rate of fusion—over that provided by titanium cages—by minimizing stress shielding of the graft and decreasing the degree of subsidence. There

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Tobias Pitzen, Juay Seng Tan, Marcel F. Dvorak, Charles Fisher and Thomas Oxland

: Analysis of harvest morbidity and radiographic outcome using autograft for anterior cervical fusion . Spine (Phila Pa 1976) 22 : 2222 – 2227 , 1997 15 Steffen T , Downer P , Steiner B , Hehli M , Aebi M : Minimally invasive bone harvesting tools . Eur Spine J 9 : Suppl 1 S114 – S118 , 2000 16 Vavruch L , Hedlund R , Javid D , Leszniewski W , Shalabi A : A prospective randomized comparison between the cloward procedure and a carbon fiber cage in the cervical spine: a clinical and radiologic study . Spine (Phila Pa 1976) 27

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Frank Kandziora, Georg Schollmeier, Matti Scholz, Jan Schaefer, Alexandra Scholz, Gerhard Schmidmaier, Ralf Schröder, Herman Bail, Georg Duda, Thomas Mittlmeier and Norbert P. Haas

, including a new threaded cage. Spine 22 : 26 – 31 , 1997 Brodke DS, Dick JC, Kunz DN, et al: Posterior lumbar interbody fusion. A biomechanical comparison, including a new threaded cage. Spine 22: 26–31, 1997 4. Brooke NS , Rorke AW , King AT , et al : Preliminary experience of carbon fibre cage prostheses for treatment of cervical spine disorders. Br J Neurosurg 11 : 221 – 227 , 1997 Brooke NS, Rorke AW, King AT, et al: Preliminary experience of carbon fibre cage prostheses for treatment of cervical

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Fred C. Lam, Adam S. Kanter, David O. Okonkwo, James W. Ogilvie and Praveen V. Mummaneni

colleagues 13 , 14 first reported the use of carbon fiber cages in PLIF. 118 Hoshijima et al. 48 and Eck and associates 34 reported their experiences with titanium mesh cages in PLIF and ALIF surgery, respectively, with reasonable fusion rates and maintenance of lordosis in the latter 1990s. In 2002, Lenke and Bridwell 63 reviewed their experience with the use of mesh cages in the treatment of 130 patients with AIS and reported adequate sagittal alignment and an acceptable pseudarthrosis rate. Equal efficacy was reported in the adult population by Eck et al. 35 in

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Mario Cabraja, Alexander Abbushi, Daniel Koeppen, Stefan Kroppenstedt and Christian Woiciechowsky

cages, carbon fiber cages, and autograft iliac crest or allograft fibula, show a lower rate of long-term subsidence. 30 The small values of 2.0° and 0.7°, representing loss of correction in the anterior and posterior groups, respectively, lie within measurement errors, but the differences between both groups resemble similar findings in the literature. 3 , 26 , 28 , 42 The screw breakage and screw loosening in the anterior group might be explained by a less effective load sharing of constrained plates compared with dynamic plates. 32 Conclusions The aims of