Search Results

You are looking at 1 - 10 of 97 items for :

  • "adjacent level degeneration" x
Clear All
Restricted access

James S. Harrop, Marco T. Silva, Ashwini D. Sharan, Steven J. Dante and Frederick A. Simeone

has been shown to reduce motion by 50 to 100%, 8 which may improve axial neck pain. This, however, may result in increased stresses on the adjacent vertebral segments. 23, 24 Hilibrand, et al., 23 have shown that 10 years after cervical interbody fusion 19% of their patients suffered accelerated adjacent-level degeneration. Procedure-Related Complications Posterior cervical foraminotomy is a safe procedure associated with a very low rate of complications (0–4%). 1, 2, 21, 37 The greatest complications are wound infections or serous drainage. 21, 22

Restricted access

Steven Casha and Michael G. Fehlings

against graft extrusion. Additionally, it is thought to provide rigid immobilization in flexion, extension, torsion, and lateral bending, which may lead to better fusion rates, as expected throughout the skeletal system based on the orthopedic experience. Plating may also be useful in contouring the surgically treated cervical spine to maintain lordosis, and this may decrease the likelihood of adjacent-level degeneration, progressive deformity, and chronic postoperative axial pain. Furthermore, because the plate provides good internal fixation the use of a postoperative

Full access

Harvey E. Smith, David W. Wimberley and Alexander R. Vaccaro

Discectomy, decompression, and fusion are traditionally used to manage cervical disc disease accompanied by neural element compression that is refractory to conservative management. Concerns regarding stress at levels adjacent to fusion and possible adjacent-level degeneration as well as a desire to maintain a more normal biomechanical environment have led to investigation of cervical disc replacement as an alternative to fusion procedures. Cervical disc prostheses currently under investigation are constructed of predominantly metal-on-polyethylene or metal-on-metal bearing surfaces, and use roughened titanium surfaces and osteoconductive coatings to facilitate fixation. The unique anatomy and biomechanics of the cervical spine must be considered when extrapolating from the experience of appendicular arthroplasty and lumbar disc replacement.

Restricted access

A comparison of simulator-tested and -retrieved cervical disc prostheses

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004

Paul A. Anderson, Jeffrey P. Rouleau, Jeffrey M. Toth and K. Daniel Riew

test. This wear rate is equivalent to 0.18 mm 3 per million cycles for a total volume of 0.19% of the total device at the completion of the test. Explanted Prestige Discs Like the Bryan explants, individual Prestige devices were not weighed prior to implantation. Thus, the extent and depth of the wear patterns were used for comparison. Of the three known explanted Prestige discs, one was revised because of improper placement, one was revised because of infection, and one was revised to treat adjacent-level degeneration that was asymptomatic at the index

Restricted access

Lali H. S. Sekhon, William Sears and Neil Duggal

arthroplasty in two scenarios of previous surgery: first, in patients who have undergone previous posterior laminoforaminotomy for radiculopathy and, second, in patients with symptomatology associated with adjacent level degeneration who have undergone a previous anterior interbody fusion. In this study we discuss the data obtained in 15 patients who underwent anterior cervical decompression and placement of an artificial disc to treat symptoms that occurred after previous surgery. The previous operations were stratified into one of two categories: posterior cervical

Restricted access

James T. Robertson, Stephen M. Papadopoulos and Vincent C. Traynelis

is, can acceleration of degenerative changes be separated from the production of degenerative change? Additionally, this observation does not mean that these degenerative changes will not become symptomatic in time, but only a fraction result in the need for surgery in time. Thus, there is clinical and radiographic/neuroimaging evidence that arthrodesis is associated with an increased incidence of adjacent-segment disease. The degree of importance of adjacent-level degeneration remains unproven. Whether it is independent of the degenerative process has also still

Restricted access

Prospective randomized controlled study of the Bryan Cervical Disc: early clinical results from a single investigational site

Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2005

Domagoj Coric, Frederick Finger and Peggy Boltes

treated level and may potentially decrease the occurrence of adjacent-level degeneration. 7 , 12 , 17 A prospective randomized controlled multicenter US Food and Drug Administration investigational device exemption study has been completed in which we compared the clinical outcomes obtained in patients treated with the Bryan Cervical Disc System (Medtronic Sofamor Danek, Memphis, TN) and those obtained in patients who underwent ACDF. In the present study we report the early results acquired from a single investigational site, documenting the safety and effectiveness

Restricted access

Rudolf Bertagnoli, James J. Yue, Andrea Fenk-Mayer, Jonathan Eerulkar and John W. Emerson

L3–5 fusion and preoperative MR images ( lower left and right ) revealing adjacent-level degeneration at L1–2 and L2–3. F ig . 2. Postoperative AP (left) and lateral (right) adiographs showing L1–2 and L2–3 ADR above a previous L3–5 fusion site. Statistical Analysis Two primary research questions are of interest: 1) whether significant improvement occurred between baseline and the 3-month postsurgery examination (proximal effect); and 2) whether improvement was maintained from 3 months to 2 years postsurgery. Because of the size and

Restricted access

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

maintaining stability, 24 , 39 , 52 , 56 and promoting arthrodesis 27 , 45 , 46 at the level of surgery has also been demonstrated. Even with the relative success of ALIF, key questions exist regarding the associated promotion of adjacent-segment degeneration. This has led to the development of disc arthroplasty, the intention of which is to preserve motion and mitigate adjacent-level degeneration. Theories of adjacent-segment degeneration include the suspicion that increased construct stiffness at the fused level may result in excessive stress/motion at adjacent levels

Restricted access

Rob D. Dickerman, Ashley Reynolds and R.N. Matthew Bennett

instrumentation can be safely performed without a total facetectomy and further prevent adjacent-level degeneration. References 1 Ghiselli G , Wang JC , Bhatia NN , Hsu WK , Dawson EG : Adjacent segment degeneration in the lumbar spine . J Bone Joint Surg Am 86 : 1497 – 1503 , 2004 2 Haher TR , O'Brien M , Dryer JW , Nucci R , Zipnick R , Leone DJ : The role of lumbar facet joints in spinal stability. Identification of alternative paths of loading . Spine 19 : 2667 – 2670 , 1994 3 Schlenk RP , Stewart T , Benzel EC