Corpectomy with titanium cage reconstruction in the cervical spine.

Multi-level anterior cervical discectomy and fusion (ACDF) has been utilized by many surgeons to address multi-level cervical disease with the use of autograft or allograft. High failure rates have been reported in three-level decompressions when autograft is used, which increases with the use of allograft. This has led many surgeons to advocate anterior cervical corpectomy with strut grafting where only two surfaces are needed for fusion compared to the multiple surfaces required for multi-level ACDF.

Stress Reduction in Adjacent Level Discs via Dynamic Instrumentation: A Finite Element Analysis.

Background: Conventional (rigid) fusion instrumentation is believed to accelerate the degeneration of adjacent discs by increasing stresses caused by motion discontinuity. Fusion instrumentation that employs reduced rod stiffness and increased axial motion, or dynamic instrumentation, may partially alleviate this problem, but the effects of this instrumentation on the stresses in the adjacent disc are unknown. We used a finiteelement model to calculate and compare the stresses in the adjacent-level disc that are induced by rigid and dynamic posterior lumbar fusion instrumentation.

Anterior cervical discectomy and fusion with implantable titanium cage: initial impressions, patient outcomes and comparison to fusion with allograft.

Background Context: The use of metal cage prosthetic devices in anterior cervical discectomy with fusion (ACDF) has increased rapidly. One of these devices is the titanium Rabea cage (Signus, Alzenau, Germany) [correction]. There are no peer-reviewed objective reports on the use of these cages in cervical discectomy.

Prospective multiple outcomes study of outpatient lumbar microdiscectomy: should 75 to 80% success rates be the norm?

Object: The authors assessed the efficacy and outcomes of lumbar microdiscectomy performed on an outpatient basis by administering six questionnaires before and at five time points after surgery. The results were compared with those reported in literature in which the success rates vary between 70% and 80% and in excess of 90%. The authors use the methodology and data derived from their study to evaluate critically the relevance of these two categories of success rates.