Kinematics of cervical total disc replacement adjacent to a two-level, straight versus lordotic fusion.

Study Design: In vitro biomechanical study.

Objective: To characterize cervical total disc replacement (TDR) kinematics above two-level fusion, and to determine the effect of fusion alignment on TDR response.

Summary Of Background Data: Cervical TDR may be a promising alternative for a symptomatic adjacent level after prior multilevel cervical fusion.

Biomechanical evaluation of segmental occipitoatlantoaxial stabilization techniques.

Study Design: Biomechanical study using human cadaveric cervical spines.

Objective: To evaluate the construct stability of 3 different segmental occipitoatlantoaxial (C0-C1-C2) stabilization techniques.

Summary Of Background Data: Different C0-C1-C2 stabilization techniques are used for unstable conditions in the upper cervical spine, all with different degrees of risk to the vertebral artery.

Effect of two-level total disc replacement on cervical spine kinematics.

Study Design: Biomechanical study using human cadaver spines.

Objective: To characterize kinematics of cervical spines implanted with total disc replacement (TDR) at 2-levels referencing the implanted and adjacent levels.

Summary Of Background Data: Cervical TDR is an appealing alternative to fusion particularly when treating multilevel disease, where the advantages of maintaining motion and reducing adjacent level stresses with TDR are compelling.

Percutaneous core excision and radiofrequency thermo-coagulation for the ablation of osteoid osteoma of the spine.

Percutaneous radiofrequency ablation is the treatment of choice for osteoid osteoma of the appendicular skeleton. However, difficulties in localizing the lesion in the spine and its proximity to neural elements have yet to make it the prevalent treatment for spine. This study assesses the safety and effectiveness of two percutaneous techniques for ablating osteoid osteoma of the spine.

Altered disc pressure profile after an osteoporotic vertebral fracture is a risk factor for adjacent vertebral body fracture.

This study investigated the effect of endplate deformity after an osteoporotic vertebral fracture in increasing the risk for adjacent vertebral fractures. Eight human lower thoracic or thoracolumbar specimens, each consisting of five vertebrae were used. To selectively fracture one of the endplates of the middle VB of each specimen a void was created under the target endplate and the specimen was flexed and compressed until failure.

An evidence-based medicine approach in determining factors that may affect outcome in lumbar total disc replacement.

Study Design: Literature research.

Objective: To analyze the available evidence about a variety of factors that might affect outcome of lumbar artificial disc replacement.

Summary Of Background Data: Evaluating the scientific merit of new technology is important for a clinician considering incorporating these techniques.

Effect of the Total Facet Arthroplasty System after complete laminectomy-facetectomy on the biomechanics of implanted and adjacent segments.

Background Context: Lumbar fusion is traditionally used to restore stability after wide surgical decompression for spinal stenosis. The Total Facet Arthroplasty System (TFAS) is a motion-restoring implant suggested as an alternative to rigid fixation after complete facetectomy.

Purpose: To investigate the effect of TFAS on the kinematics of the implanted and adjacent lumbar segments.

Enhancing the stability of anterior lumbar interbody fusion: a biomechanical comparison of anterior plate versus posterior transpedicular instrumentation.

Study Design: Biomechanical study using human cadaver spines.

Objective: To assess the stabilizing effect of a supplemental anterior tension band (ATB, Synthes) plate on L5-S1 anterior lumbar interbody fusion (ALIF) using a femoral ring allograft (FRA) under physiologic compressive preloads, and to compare the results with the stability achieved using FRA with supplemental transpedicular instrumentation.

Summary Of Background Data: Posterior instrumentation can improve the stability of ALIF cages.

Effect of uncovertebral joint excision on the motion response of the cervical spine after total disc replacement.

Study Design: In vitro biomechanical study.

Objective: To quantify the effects of uncinatectomy on cervical motion after total disc replacement (TDR).

Summary Of Background Data: The effect of uncinatectomy on TDR motion is unknown.

Balloon kyphoplasty for the treatment of pathological vertebral compressive fractures.

Background: Previous clinical studies have shown the safety and effectiveness of balloon kyphoplasty in the treatment of pathological vertebral compression fractures (VCFs). However, they have not dealt with the impact of relatively common comorbid conditions in this age group, such as spinal stenosis, and they have not explicitly addressed the use of imaging as a prognostic indicator for the restoration of vertebral body height. Neither have these studies dealt with management and technical problems related to surgery, nor the effectiveness of bone biopsy during the same surgical procedure.

Principles of management of osteometabolic disorders affecting the aging spine.

Osteoporosis is the most common contributing factor of spinal fractures, which characteristically are not generally known to produce spinal cord compression symptoms. Recently, an increasing number of medical reports have implicated osteoporotic fractures as a cause of serious neurological deficit and painful disabling spinal deformities. This has been corroborated by the present authors as well.