Cervical fusion for treatment of degenerative conditions: development of appropriate use criteria.

Background Context: High quality evidence is difficult to generate, leaving substantial knowledge gaps in the treatment of spinal conditions. Appropriate use criteria (AUC) are a means of determining appropriate recommendations when high quality evidence is lacking.

Purpose: Define appropriate use criteria (AUC) of cervical fusion for treatment of degenerative conditions of the cervical spine.

Effects of motion segment level, Pfirrmann intervertebral disc degeneration grade and gender on lumbar spine kinematics.

MRI allows non-invasive assessment of intervertebral disc degeneration with the added clinical benefit of using non-ionizing radiation. What has remained unclear is the relationship between assessed disc degeneration and lumbar spine kinematics. Kinematic outcomes of 54 multi-segment (L1-Sacrum) lumbar spine specimens were calculated to discover if such an underlying relationship exists with degeneration assessed using the Pfirrmann grading system.

Relaxation response of lumbar segments undergoing disc-space distraction: implications to the stability of anterior lumbar interbody implants.

Study Design: A biomechanical study of human cadaveric lumbar spine segments undergoing disc-space distraction for insertion of anterior lumbar interbody implants.

Objective: To measure the distraction force and its relaxation during a period of up to 3 hours after disc-space distraction as a function of the distraction magnitude and disc level.

Summary Of Background Data: Interbody implants depend on compressive preload produced by disc-space distraction (annular pretension) for initial stabilization of the implant-bone interface.

Evaluation of pullout strength and failure mechanism of posterior instrumentation in normal and osteopenic thoracic vertebrae.

Object: There is limited data on the pullout strength of spinal fixation devices in the thoracic spine among individuals with different bone quality. An in vitro biomechanical study on the thoracic spine was performed to compare the pullout strength and the mechanism of failure of 4 posterior fixation thoracic constructs in relation to bone mineral density (BMD).

Methods: A total of 80 vertebrae from 11 fresh-frozen thoracic spines (T2-12) were used.

Response of Charité total disc replacement under physiologic loads: prosthesis component motion patterns.

Background Context: Total disc replacement (TDR) has been recommended to reduce pain of presumed discogenic origin while preserving spinal motion. The floating core of Charité TDR is professed to allow the replication of the kinematics of a healthy disc under physiologic loads. While segmental motion after Charité TDR has been measured, little is known about the effects of a physiologic compressive preload on vertebral motion and the motion of prosthesis components after TDR.