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Spinal stability with anterior or posterior Ray threaded fusion cages

Patrick W. Hitchon, Vijay Goel, Thomas Rogge, Andrew Dooris, John Drake, and James Torner

that each of the three implants in extension was significantly more rigid than the spine after discectomy. In spines treated via the anterior approach, discectomy and the necessary excision of the anterior longitudinal ligament were shown to destabilize the spine in all six directions, reaching significance only in right and left axial rotation. In fact, the degree of instability in right and left axial rotation rendered by anterior-approach discectomy exceeded that by posterior-approach discectomy (p ≤ 0.05). The importance of the disc in spinal stability has been

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Long-term stability after multilevel cervical laminectomy for spinal cord tumor resection in von Hippel-Lindau disease

Clinical article

Ashok R. Asthagiri, Gautam U. Mehta, John A. Butman, Martin Baggenstos, Edward H. Oldfield, and Russell R. Lonser

%) are located dorsal to the dentate ligament and are most frequently found within the dorsal root entry zone (66%). 15 , 19 Because spinal cord hemangioblastomas are most frequently located within or on the dorsal aspect of the spinal cord, they are resected via a posterior approach that includes laminectomies. Although the features associated with cervical instability after laminectomy in patients undergoing resection of sporadic spinal cord tumors are becoming better defined, little is known about long-term spinal stability in patients with multiple neoplasia

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The biomechanical effect of single-level laminectomy and posterior instrumentation on spinal stability in degenerative lumbar scoliosis: a human cadaveric study

Christine M. E. Rustenburg, Sayf S. A. Faraj, Roderick M. Holewijn, Idsart Kingma, Barend J. van Royen, Agnita Stadhouder, and Kaj S. Emanuel

instrumentation on the stability of the degenerative scoliotic lumbar spine have never been quantified. Therefore, the first aim of this study was to assess the effects of laminectomy and posterior instrumentation on the stability of lumbar spines with degenerative scoliosis. Spinal stability was analyzed by measuring the range of motion (ROM) and stiffness around the neutral zone (NZ) of the spinal segments. Since intervertebral DD is believed to have a detrimental effect on the ROM and NZ stiffness of the affected spinal segments, 41 our second aim was to assess the ROM and

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Reproducibility, temporal stability, and functional correlation of diffusion MR measurements within the spinal cord in patients with asymptomatic cervical stenosis or cervical myelopathy

Benjamin M. Ellingson, Noriko Salamon, Davis C. Woodworth, Hajime Yokota, and Langston T. Holly

. Most DTI studies in patients with spondylosis have been cross-sectional, examining the relationship between DTI and functional status at a single time point; the variability and longitudinal stability of DTI measurements in the spinal cord in advanced cervical spondylosis have not been previously reported. The current study quantified the variation in DTI measurements by examining repeated MRI investigations in a cohort of patients with asymptomatic cervical stenosis and cervical spondylotic myelopathy (CSM) who were treated nonoperatively and prospectively monitored

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Biomechanics of a laterally placed sacroiliac joint fusion device supplemental to S2 alar-iliac fixation in a long-segment adult spinal deformity construct: a cadaveric study of stability and strain distribution

Bernardo de Andrada Pereira, Piyanat Wangsawatwong, Jennifer N. Lehrman, Anna G. U. Sawa, Derek P. Lindsey, Scott A. Yerby, Jakub Godzik, Alexis M. Waguespack, Juan S. Uribe, and Brian P. Kelly

across the sacroiliac joint significantly reduced range of motion (ROM) compared with that in the intact joint. 22–24 Multiple biomechanical studies have demonstrated that using 1 sacroiliac joint screw results in less stability than that achieved with the placement of 2 screws across the joint. 25–28 The general hypothesis—that increased number of fixation points across the sacroiliac joint improves stability—is corroborated by these studies; however, data are scarce about this effect in long-segment constructs used to address adult spinal deformity. Because of

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Vertebral body reconstruction with a modified Harrington rod distraction system for stabilization of the spine affected with metastatic disease

Ehud Arbit and Joseph H. Galicich

should therefore be reserved for spinal reconstruction after removal of benign neoplasms, primary malignancies of the spine after meticulous surgical extirpation, and the occasional patient in whom the primary malignancy has been extirpated and who has, presumably, a solitary spine metastasis without evidence of cancer elsewhere. The main requirements of a synthetic vertebral body construct include the ability to withstand compression and extension loading, to provide stability in flexion, extension, and rotation, and to correct kyphosis. Replacement of vertebral

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Stabilizing effect of posterior lumbar interbody fusion cages before and after cyclic loading

Annette Kettler, Hans-Joachim Wilke, Rupert Dietl, Matthias Krammer, Christianto Lumenta, and Lutz Claes

, 14 However, all of these cages serve to stabilize the spinal segments primarily by distracting them 1 and secondarily by allowing bone ingrowth and bone fusion. For efficient formation of bone tissue adequate stability is required, but the initial stability is likely reduced with decreasing distraction height that might be caused by repeated movements of the spine during normal activity. Therefore, in addition to the immediate stabilizing effect of interbody fusion cages, the effect of cyclic loading on spinal stability is of remarkable biological and clinical

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Defining the inherent stability of degenerative spondylolisthesis: a systematic review

Andrea M. Simmonds, Y. Raja Rampersaud, Marcel F. Dvorak, Nicolas Dea, Angela D. Melnyk, and Charles G. Fisher

review. Outcomes with segmental lordosis, reduction of translation, and instrumentation related to these pathologies and to health-related quality of life should be investigated further. Conclusions Spinal stability is an important factor to consider in the evaluation of patients with DLS. Facet effusion, restabilization signs including disc height loss, and disc angle change on dynamic radiographs are important parameters in the assessment of stability. In addition, clinical presentation with leg-dominant pain may be an important parameter to consider. Once the

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In vitro biomechanical comparison of an anterior and anterolateral lumbar plate with posterior fixation following single-level anterior lumbar interbody fusion

Wesley M. Johnson, Tann A. Nichols, Deepika Jethwani, and Bernard H. Guiot

of posterior PS/rod fixation. 3 , 5 , 6 , 10 , 12 , 14 , 18 The majority of the available implants are designed for placement in an anterior midline position at the caudal end of the lumbosacral spine. Often vascular anatomy makes implantation of a midline plate system difficult, even as low as the L4–5 interspace. 16 Thus, an optimally designed system would allow the plate to be inserted off center; if such placement continued to improve segment stability. The aim of this study was to evaluate the in vitro ROM of the human L4–5 spinal unit and the effects of a

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Multilevel oblique corpectomy without fusion in managing cervical myelopathy: long-term outcome and stability evaluation in 268 patients

Clinical article

Salvatore Chibbaro, Giuseppe Mirone, Orphée Makiese, and Bernard George

posterior route (laminectomy or open door laminoplasty). However, the best choice of surgical approach is still controversial. We believe that MOC is a valid and safe alternative for the management of CSM and yields good clinical results and long-term spinal stability without the use of bone grafting and/or instrumentation. Methods We conducted a prospective study in a series of 268 consecutive patients who underwent treatment for cervical myelopathy at our institution between January 1992 and December 2005. The enrollment criteria for this study are displayed in