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Li-Yu Fay, Peng-Yuan Chang, Jau-Ching Wu, Wen-Cheng Huang, Chun-Hao Wang, Tzu-Yun Tsai, Tsung-Hsi Tu, Hsuan-Kan Chang, Ching-Lan Wu and Henrich Cheng

, 17 , 18 , 30 , 31 Although there are still issues with this fusion surgery, spinal arthrodesis has been a popular choice of strategy of surgical management for lumbar spondylosis. 1 , 9 , 11 , 25 , 29 In recent decades, there has been an emerging option of dynamic stabilization for lumbar spondylosis with preservation of spinal segmental motion. The Dynesys dynamic stabilization (DDS) system (Zimmer Spine), a spinal motion preservation system, consists of a pedicle screw–based stabilization device for the lumbar spine. The DDS was designed to unload the

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Curtis A. Dickman, Volker K. H. Sonntag, Stephen M. Papadopoulos and Mark N. Hadley

performed on 36 patients over the last 5 years and has been associated with minimal perioperative morbidity and mortality and with a high incidence (97%) of postoperative stability. The techniques and clinical merits of this form of atlantoaxial arthrodesis are reviewed. Clinical Material and Methods Thirty-six patients with C1–2 instability or traumatic C1–2 injuries were treated with posterior wiring and fusion using the operative techniques described. The clinical and radiographic features of these patients as well as their outcomes are outlined. All patients

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Patrick J. Reid and Paul J. Holman

knowledge, the case we describe is the first reported instance of iatrogenic pyogenic osteomyelitis of the upper cervical spine treated with anterior decompression and delayed posterior arthrodesis. Case Report History and Examination This 58-year-old obese diabetic man presented to the emergency department with the chief symptom of excruciating pain at the base of the skull and transient weakness in the right upper extremity. His axial neck pain had slowly progressed over the 4 months prior to his admission and was located diffusely in the mid-to upper

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Nancy Abu-Bonsrah, C. Rory Goodwin, Gezzer Ortega, Fizan Abdullah, Edward Cornwell, Rafael De la Garza-Ramos, Mari L. Groves, Michael Ain, Paul D. Sponseller and Daniel M. Sciubba

S pinal arthrodesis is commonly performed in the pediatric population for a number of indications, including pediatric deformity, trauma, and tumor-induced instability. 1 , 2 , 5 , 7 , 10 , 13 , 14 , 16 , 17 , 23–25 Patients undergoing spinal arthrodesis are at significant risk for developing complications and having unplanned readmissions and/or reoperations. These clinical outcomes are undesirable for patients, physicians, and the health care system in general, as they can result in increased cost and decreased quality of life. Greater understanding of the

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Eiichi Murakami, Daisuke Kurosawa and Toshimi Aizawa

low back but also to the groin area, the leg, and even the foot. 3 , 6 , 24 In addition, nociceptors have been confirmed in the posterior sacroiliac ligaments. 23 Therefore, the SIJ is recognized as one of the sources of low-back pain. For SIJ pain, conservative therapies such as rest, oral analgesics, fixation with a pelvic belt, physical therapy, or SIJ infiltration should mainly be applied. However, if the pain is not improved using these conservative therapies, SIJ arthrodesis may be the treatment of choice. To date, a number of posterior, 2 , 13 , 27 lateral

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Mohamad Bydon, Risheng Xu, David Santiago-Dieppa, Mohamed Macki, Daniel M. Sciubba, Jean-Paul Wolinsky, Ali Bydon, Ziya L. Gokaslan and Timothy F. Witham

institution in the past 23 years. We summarize the preoperative, perioperative, and long-term postoperative outcomes of these patients. In addition, we compare the likelihood of ASD development as a function of fusion location. Methods Data were obtained for all patients undergoing instrumented lumbar arthrodesis for the treatment of degenerative lumbar disease at our institution over a 23-year period from 1990 to 2013. Arthrodesis procedures performed for oncology, infection, trauma, scoliosis, and rheumatological pathology were excluded. Patients with metabolic bone

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Mohammed Adeeb Sebai, Panagiotis Kerezoudis, Mohammed Ali Alvi, Jang Won Yoon, Robert J. Spinner and Mohamad Bydon

lesions, large tumors with extradural extension, or adjacent bone erosion may necessitate wider bone removal (e.g., total facetectomy) to allow for adequate tumor exposure. In such cases, concomitant arthrodesis might be indicated in order to prevent postoperative complications, including instability, deformity, pain, and neurological deficit. 1 The majority of current studies have focused on the outcomes of patients undergoing spinal PNST resection without making a clear distinction among different procedure types. 12 , 20 , 23 , 29 Therefore, literature regarding

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Corey T. Walker, S. Harrison Farber, Tyler S. Cole, David S. Xu, Jakub Godzik, Alexander C. Whiting, Cory Hartman, Randall W. Porter, Jay D. Turner and Juan Uribe

O ver the last decade, the utilization of minimally invasive anterolateral retroperitoneal approaches for lumbar interbody arthrodesis has increased. Advantages over a posterior approach include 1) direct visualization of a large amount of disc space and more extensive endplate preparation, 67 2) larger interbody devices that span the entire vertebral body width and decrease the likelihood of subsidence, 37 , 46 3) greater indirect decompression and restoration of disc height, particularly for coronal angulations, 57 and 4) an ability to avoid the thecal sac

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Fred H. Geisler, Richard D. Guyer, Scott L. Blumenthal, Paul C. McAfee, Andrew Cappuccino, Fabien Bitan and John J. Regan

: Surgical technique of lumbar artificial disc replacement with the Charité artificial disc . Neurosurgery 56 : 1 Suppl ONS46 – ONS57 , 2005 5 Geisler FH , Blumenthal SL , Guyer RD , McAfee PC , Regan JJ , Johnson JP , : Neurological complications of lumbar artificial disc replacement and comparison of clinical results with those related to lumbar arthrodesis in the literature: results of a multicenter, prospective, randomized investigational device exemption study of Charité intervertebral disc. Invited submission from the Joint Section Meeting on

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Morio Matsumoto, Kazuhiro Chiba, Takashi Tsuji, Hirofumi Maruiwa, Yoshiaki Toyama and Jun Ogawa

based on three-point fixation. 3–5, 9 Several problems associated with posterior atlantoaxial arthrodesis have been noted. Toyama, et al., 13, 14 have reported that malalignment of the cervical spine developed after posterior atlantoaxial arthrodesis because of an increased atlantoaxial fixation angle (that is, hyperlordosis between C-1 and C-2); the increased angle was caused by excessive tightening of the posterior wires. They concluded that the ideal atlantoaxial angle and distance between the C-1 posterior arch and the C-2 lamina to prevent such postoperative