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Markus Wenger and Thomas-Marc Markwalder

longer follow-up period are required for definitive evaluation of the method. Abbreviations used in this paper CT = computerized tomography ; DDD = degenerative disc disease ; DSH = disc space height ; MR = magnetic resonance . References 1. Caspar W : A new surgical procedure for lumbar disc herniation causing less tissue damage through a microsurgical approach. Adv Neurosurg 4 : 74 – 77 , 1977 Caspar W: A new surgical procedure for lumbar disc herniation causing less tissue

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Martin N. Stienen, Nicolas R. Smoll, Holger Joswig, Marco V. Corniola, Karl Schaller, Gerhard Hildebrandt and Oliver P. Gautschi

F or patients with degenerative disc disease (DDD), accurate measurement of degree of pain, functional impairment, and health-related quality of life (HRQOL) is of paramount importance, as these are key decision-making determinants for surgical management. 5 A panel of reliable and valid scales, including the visual analog scale (VAS) for pain intensity, the Oswestry Disability Index (ODI) and the Roland-Morris Disability Index (RMDI) for functional impairment, and the SF-12 as well as the EQ-5D (Euro-QoL Group) for HRQOL, is available. 18 However, these

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Asdrubal Falavigna, Orlando Righesso, Vincent C. Traynelis, Alisson Roberto Teles and Pedro Guarise da Silva

clinical outcome. 7 Studies have shown that patient satisfaction was a key indication of success after surgical interventions. 17–24 , 26 Considering the discrepancies in results of previous studies and the studies' methodological limitations, we developed a prospective study to evaluate the impact of a deep wound infection after instrumented lumbar arthrodesis for symptomatic degenerative disc disease on functional outcome and patient satisfaction. Methods Study Design and Sample A prospective study was conducted in 13 patients who developed a deep wound

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Sheeraz Qureshi, Vadim Goz, Steven McAnany, Samuel K. Cho, Andrew C. Hecht, Rick B. Delamarter and Michael G. Fehlings

serves as an alternative to ACDF in the treatment of single-level degenerative disc disease (DDD). Cervical disc replacement offers the potential advantage of preserving intervertebral motion, which theoretically may protect adjacent levels from accelerated degeneration. 18 , 22 Cervical disc replacement also obviates the possibility of pseudarthrosis, which is the most common reason for reoperation at the index level after ACDF. Four large multicenter national randomized clinical trials have evaluated the clinical outcomes of CDR compared with ACDF. 18 , 21–23 , 26

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Khalil J. Chedid and Mokbel K. Chedid

In this paper past, present, and future treatments of degenerative disc disease (DDD) of the lumbar spine are outlined in a straight forward manner. This is done to review previous knowledge of the disease, define current treatment procedures, and discuss future perspectives. An analysis of a subject of this magnitude dictates that one describes as accurate a history as possible: an anatomical/historical “tract” with emphasis on all possible deviations.

Although spinal disorders have been recognized for a long time, the view of DDD as a particular disease entity is a more recent development. In this paper, the authors attempt to outline the history of DDD of the lumbar spine in an unbiased and scientific fashion. Physiological, diagnostic, and therapeutic implications will all be addressed in this study.

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Reginald J. Davis, Kee D. Kim, Michael S. Hisey, Gregory A. Hoffman, Hyun W. Bae, Steven E. Gaede, Ralph F. Rashbaum, Pierce Dalton Nunley, Daniel L. Peterson and John K. Stokes

C ervical total disc replacement (TDR) is intended to treat neurological symptoms and neck pain associated with degeneration of intervertebral discs in the cervical spine. 1 , 24 , 41 Anterior cervical discectomy and fusion has been the standard treatment for these indications since the procedure was first developed in the 1950s. 2 , 3 , 18 , 46 Cervical TDR devices were originally developed and implanted in the 1990s and have since become part of the continuum of care for cervical degenerative disc disease (DDD). 9 , 49 Cervical TDR is an attractive

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Nico Sollmann, Dominik Weidlich, Barbara Cervantes, Elisabeth Klupp, Carl Ganter, Hendrik Kooijman, Claus Zimmer, Ernst J. Rummeny, Bernhard Meyer, Thomas Baum, Jan S. Kirschke and Dimitrios C. Karampinos

observed an association between T2 values and the individual response to ESI with local anesthetics performed after MRN. In a clinical routine, patients suffering from severe or longer-lasting LRS commonly undergo anatomical imaging as one of the first diagnostic steps with the aim of detecting structural pathologies as possible causes for the condition. However, although anatomical MRI, in particular, is capable of detecting degenerative disc disease as a major cause of LRS, the situation becomes complicated because it has been shown repeatedly that imaging findings do

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Anna MacDowall, Martin Skeppholm, Lars Lindhagen, Yohan Robinson, Håkan Löfgren, Karl Michaëlsson and Claes Olerud

protection against ASP has been realized in practice. 19 The national Swedish Spine Registry (Swespine) was founded in 1993 and cervical spine procedures have been included in it since 2006. 26 With use of the Swespine register, the primary aim of this study was to compare the 5-year clinical outcome difference in Neck Disability Index (NDI) in patients with cervical degenerative disc disease and radiculopathy who had been treated with ADR compared with patients treated with fusion surgery. Secondary outcomes were the EuroQol–5 Dimensions (EQ-5D) health survey findings

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Tobias A. Mattei

investigate other factors, especially the status of the facet joints, that may contribute to the observed correlation between lower BMD and reduced levels of low-back pain. Finally, as there seems to be increasing evidence that BMD plays a significant role in degenerative disc disease, 3 it seems of paramount importance for future clinical studies to evaluate the long-term effects of currently widespread medical therapies for osteoporosis (such as the use of biphosphonates, calcium and vitamin D, and parathyroid hormone analogs) on the degeneration status of

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Anna MacDowall, Nuno Canto Moreira, Catarina Marques, Martin Skeppholm, Lars Lindhagen, Yohan Robinson, Håkan Löfgren, Karl Michaëlsson and Claes Olerud

degenerative disc disease (DDD) and radiculopathy. Secondary outcomes were the EQ-5D and pain scores; tertiary outcomes were secondary surgery and assessment of motion and ASP. Methods Trial Design This trial has been described previously, reporting the 2-year follow-up 29 and the predictors to 5-year outcomes. 17 Briefly, we conducted a multicenter randomized clinical superiority trial in which patients with cervical radiculopathy were randomly assigned to undergo either unconstrained ADR using the Discover artificial disc (DePuy Spine, Johnson & Johnson), or fusion using