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Chris J. Neal, Michael K. Rosner and Timothy R. Kuklo

its elimination through fusion. 1, 5, 6, 12 Geisler and colleagues 7 have outlined the following four major benefits of lumbar disc arthroplasty: 1) correction of abnormal motion; 2) restoration of disc space height, lumbar lordosis, and the instantaneous axis of rotation; 3) maintenance of corrected intervertebral motion; and 4) relief of pain and return of function. By preserving the motion segment, arthroplasty represents an attempt to prevent adjacent-segment degeneration while treating the underlying disease. When patients present with chronic lumbar pain

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Paul McAfee, Larry T. Khoo, Luiz Pimenta, Andy Capuccino, Domagoj Coric, Robert Hes, Bart Conix, Farbod Asgarzadie, Azmi Hamzaoglu, Yigal Mirofsky and Yoram Anekstein

M , Herkowitz HN , Brower R , Montgomery DM , Kurz LT : 1997 Volvo Award winner in clinical studies. Degenerative lumbar spondylolisthesis with spinal stenosis: a prospective, randomized study comparing decompressive laminectomy and arthrodesis with and without spinal instrumentation . Spine 22 : 2807 – 2812 , 1997 5 Gamradt SC , Wang JC : Lumbar disc arthroplasty . Spine 5 : 95 – 103 , 2005 6 Geisler FH : Surgical technique of lumbar artificial disc replacement with the Charite artificial disc . Neurosurgery 56 : 1 Suppl 46

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Policy on Conflict of Interest Journal of Neurosurgery Publishing Group 1 2008 8 1 1 2 10.3171/SPI-08/01/001 SPI-08_01_001 Lumbar disc arthroplasty compared with interbody fusion Paul C. McCormick 1 2008 8 1 3 6 10.3171/SPI-08/01/003 SPI-08_01_003 Distribution of in vivo and in vitro range of motion following 1-level arthroplasty with the CHARITÉ artificial disc compared with fusion Bryan W. Cunningham Paul C. McAfee Fred H. Geisler Gwen Holsapple Karen Adams Scott L. Blumenthal Richard D. Guyer Andrew Cappuccino John J. Regan Ira L. Fedder P. Justin

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Paul C. McCormick

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Oren N. Gottfried and Darrel S. Brodke

Lumbar disc arthroplasty is now a common treatment for lumbar degenerative disc disease. Whereas the immediate and delayed complications in patients with artificial lumbar discs are well reported, the durability of artificial disc hardware after severe spine trauma is unknown. The authors describe the management of a rare case of a traumatic lumbar burst fracture in a patient who had undergone disc arthroplasty. This 31-year-old male contractor had undergone placement of an L4–5 Charité artificial disc (DePuy Spine) and L5–S1 anterior lumbar fusion 10 months before he fell from a roof and sustained a traumatic L-3 burst fracture with significant canal compromise and cauda equina injury. Despite the considerable compressive load on his spine, the artificial disc (L4–5) remained intact without any radiological signs of hardware failure, and the vertebrae above (L-4) and below (L-5) the artificial disc had no signs of injury. For the L-3 burst fracture the patient underwent an open decompressive laminectomy at L2–3 and posterior fusion with instrumentation from L-2 to L-4. At 24 months postinjury, he had returned to full work activities as a contractor with minimal back pain and mild right lower-extremity sensory changes and weakness left over from the trauma. The total disc arthroplasty at L4–5 is functional and has preserved motion, and there is a solid fusion at L2–4 and L5–S1. This case demonstrates that a lumbar artificial disc can tolerate a significant load from trauma and remain functional without hardware failure even after a traumatic burst fracture at the adjacent lumbar vertebral body and shows the successful treatment of this fracture, with posterior fusion preserving the motion of an artificial disc.

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.H.Sc. Doron Rabin 1 M.D., F.R.C.S.C. Marie Fink 1 B.Sc. Neil Duggal 1 M.D., F.R.C.S.C. 6 2010 28 6 E6 10.3171/2010.3.FOCUS1058 2010.3.FOCUS1058 The predictive value of the baseline Oswestry Disability Index in lumbar disc arthroplasty Harel Deutsch M.D. 6 2010 28 6 E7 10.3171/2010.3.FOCUS1060 2010.3.FOCUS1060 Dynamic interspinous process stabilization: review of complications associated with the X-Stop device Christian Bowers M.D. Amin Amini M.D., M.Sc. Andrew T. Dailey M.D. Meic H. Schmidt M.D. 6 2010 28 6 E8 10.3171/2010.3.FOCUS1047 0280008 Analysis of load

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Harel Deutsch

improvement. The purpose of this study is to determine if the baseline ODI significantly predicts outcomes after lumbar arthroplasty. Methods In this retrospective study, between 2004 and 2008 all patients underwent a single-level lumbar disc arthroplasty at L4–5 or L5–S1. All surgeries were done by one surgeon at a single institution. Devices used include the DePuy Charité artificial disc and the Aesculap Activ-L artificial lumbar disc. Twenty-four patients were identified, but 1-year follow-up was only available for 20 patients. Data including the ODI, VAS scores

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Ivan J. Antosh, John G. DeVine, Clyde T. Carpenter, Brian J. Woebkenberg and Stephen M. Yoest

resonance imaging is considered the standard modality when assessing the spinal canal, neural foramina, and adjacent discs both before and after disc replacement. Its limitations have been well documented in the presence of spinal implants, but its usefulness in disc arthroplasty has not been well studied. 8 Neal et al. 12 demonstrated that MR imaging could be successfully used to evaluate the adjacent segments following lumbar disc arthroplasty using the Maverick TDR system (Medtronic Sofamor Danek), a Co-Cr–based, metal-on-metal design. Sekhon et al., 14 however

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Luiz Pimenta, Leonardo Oliveira, Thomas Schaffa, Etevaldo Coutinho and Luis Marchi

, Le Huec JC , Krishna M : Subsidence and malplacement with the Oblique Maverick Lumbar Disc Arthroplasty: technical note . Spine J 8 : 650 – 655 , 2008 18 McAfee PC , Cunningham B , Holsapple G , Adams K , Blumenthal S , Guyer RD , : A prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part II: evaluation of radiographic outcomes and correlation of surgical technique accuracy with clinical

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Shu-Guang Gao, Guang-Hua Lei, Hong-Bo He, Hua Liu, Wen-Feng Xiao, Ting Wen, Jie-Yu Liang and Kang-Hua Li

3 Auerbach JD , Jones KJ , Milby AH , Anakwenze OA , Balderston RA : Segmental contribution toward total lumbar range of motion in disc replacement and fusions: a comparison of operative and adjacent levels . Spine (Phila Pa 1976) 34 : 2510 – 2517 , 2009 4 Chen SH , Zhong ZC , Chen CS , Chen WJ , Hung C : Biomechanical comparison between lumbar disc arthroplasty and fusion . Med Eng Phys 31 : 244 – 253 , 2009 5 Cho W , Wu C , Mehbod AA , Transfeldt EE : Comparison of cage designs for transforaminal lumbar