Intraosseous Basivertebral Nerve Ablation for the Treatment of Chronic Low Back Pain: 2-Year Results From a Prospective Randomized Double-Blind Sham-Controlled Multicenter Study.

Background: The purpose of the present study is to report the 2-year clinical outcomes for chronic low back pain (CLBP) patients treated with radiofrequency (RF) ablation of the basivertebral nerve (BVN) in a randomized controlled trial that previously reported 1-year follow up.

Methods: A total of 147 patients were treated with RF ablation of the BVN in a randomized controlled trial designed to demonstrate safety and efficacy as part of a Food and Drug Administration-Investigational Device Exemption trial. Evaluations, including patient self-assessments, physical and neurological examinations, and safety assessments, were performed at 2 and 6 weeks, and 3, 6, 12, 18, and 24 months postoperatively.

Sacroiliac Joint Pain and Its Treatment.

The sacroiliac joint (SIJ) as a source of symptoms has been controversial; however, as knowledge about the joint increased, its role as a pain generator in patients complaining of symptoms that are often attributed to spinal pathology has become better appreciated. The literature reports that the SIJ is the pain origin in as many as 30% of patients presenting with low back pain. Clinically, the SIJ can be challenging to evaluate; however, assessing pain location, patient posture/movement, and provocative manual testing are useful in making the presumptive diagnosis of SIJ disruption.

NFlex Dynamic Stabilization System : Two-Year Clinical Outcomes of Multi-Center Study.

Objective: Pedicle-based dynamic stabilization systems, in which semi-rigid rods or cords are used to restrict or control spinal segmental motion, aim to reduce or eliminate the drawbacks associated with rigid fusion. In this study, we analyzed the two-year clinical outcomes of patients treated with the NFlex (Synthes Spine, Inc.), a pedicle-based dynamic stabilization system.

An ex vivo biomechanical comparison of a novel vertebral compression fracture treatment system to kyphoplasty.

Background: Vertebral compression fracture repair aims to relieve pain and improve function by restoring vertebral structure and biomechanics, but is still associated with risks arising from polymethylmethacrylate cement extravasation. The Kiva® Vertebral Compression Fracture Treatment System, a stacked coil implant made of polyetheretherketone and delivered over a guide-wire, is a novel device designed to provide height restoration and mechanical stabilization, while improving cement containment and minimizing disruption of cancellous bone. The objective of this study was to determine whether the Kiva system is as effective as balloon kyphoplasty at restoring mechanical properties in osteoporotic vertebral compression fractures.

Early Clinical & Radiographic Results of NFix II Posterior Dynamic Stabilization System.

Background: Complications associated with rigid posterior instrumented fusions of the lumbar spine include pseudarthrosis, accelerated adjacent-segment disease, hardware failure, and iatrogenic fixed sagittal imbalance. Posterior pedicle screw/rod-based dynamic stabilization systems, in which semirigid rods or cords are used to restrict or control, rather than completely eliminate spinal segmental motion, aim to reduce or eliminate these fusion-associated drawbacks. In this study, we analyzed the early radiographic and clinical outcomes of patients treated with the NFix II System (N Spine, Inc.

Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease.

Study Design: A prospective, randomized, multicenter, Food and Drug Administration-regulated Investigational Device Exemption clinical trial.

Objective: To evaluate the safety and effectiveness of the ProDisc-L (Synthes Spine, West Chester, PA) lumbar total disc replacement compared to circumferential spinal fusion for the treatment of discogenic pain at 1 vertebral level between L3 and S1.

Summary Of Background Data: As part of the Investigational Device Exemption clinical trial, favorable single center results of lumbar total disc replacement with the ProDisc-L have been reported previously.

A preliminary comparative study of radiographic results using mineralized collagen and bone marrow aspirate versus autologous bone in the same patients undergoing posterior lumbar interbody fusion with instrumented posterolateral lumbar fusion.

Background Context: Multiple bone graft substitutes for spinal fusion have been studied with varying results.

Purpose: The purpose of this study was to assess the effectiveness of a mineralized collagen matrix combined with bone marrow, versus autologous bone, in the same patients undergoing a posterior lumbar interbody fusion and an instrumented posterolateral lumbar fusion.

Study Design/setting: A prospective, comparative study.

Treatment of neurogenic claudication by interspinous decompression: application of the X STOP device in patients with lumbar degenerative spondylolisthesis.

Object: Interspinous process decompression (IPD) theoretically relieves narrowing of the spinal canal and neural foramen in extension and thus reduces the symptoms of neurogenic intermittent claudication (NIC). The purpose of this study was to compare the efficacy of IPD with nonoperative treatment in patients with NIC secondary to degenerative spondylolisthesis.

Methods: The authors conducted a randomized controlled study in patients with NIC; they compared the results obtained in patients treated with the X STOP IPD device with those acquired in patients treated nonoperatively.

Techniques for aspirating bone marrow for use in spinal surgery.

Objective: The osteogenicity of bone marrow has been well documented in the literature. The use of bone marrow as a source of osteoprogenitor cells for spinal fusion surgery is increasing. Improper aspiration technique can lead to dilution of bone marrow and a subsequent reduction in osteoprogenitor cells.

Comparison of stiffness and failure load of two cervical spine fixation techniques in an in vitro human model.

Objective: Recently, an unpaired threaded cage has been introduced as a fusion device for the cervical spine. No biomechanical comparison of a stand-alone single interbody threaded cage to a standard plated Smith-Robinson construct has been reported. Accordingly, an in vitro biomechanical comparison of a single threaded cylindrical interbody fusion cage versus a plated Smith-Robinson cervical discectomy and fusion construct was conducted to establish whether a single cylindrical interbody cage in the cervical spine would perform mechanically as well as a plated structural interbody graft.

A prospective, randomized controlled clinical trial of anterior lumbar interbody fusion using a titanium cylindrical threaded fusion device.

Study Design: A prospective, randomized, controlled clinical trial comparing a cylindrical threaded titanium cage to a femoral ring allograft control for anterior lumbar interbody fusion.

Objective: To compare these two implants with regard to arthrodesis. Secondary outcome measures included pain relief, neurological status, and general health status.

The use of bioabsorbable implants in the spine.

Background Context: Bioabsorbable implants are commonplace in sports medicine surgeries, especially in shoulder and knee ligamentous reconstruction. Their use is now expanding to the realm of spinal reconstructive surgery. Newer polymers offer reduced incidence of the side effects of aseptic sterile sinus formation and have appropriate resorption time parameters for spine use.

Current treatment of gunshot wounds to the spine.

The incidence of spinal cord injury from gunshot wounds in penetrating trauma continues to increase with the violent nature of society. This particularly is true in urban areas, as is found with other violent crime. Either the direct path of the bullet or the concussive effects cause injury to the spine and spinal column.

Bioabsorbable anterior lumbar plate fixation in conjunction with cage-assisted anterior interbody fusion.

Object: An in vitro biomechanical study was conducted to determine the effects of anterior stabilization on cage-assisted lumbar interbody fusion biomechanics in a multilevel human cadaveric lumbar spine model.

Methods: Three spine conditions were compared: harvested, bilateral multilevel cages (CAGES), and CAGES with bioabsorbable anterior plates (CBAP), tested under flexion-extension, lateral bending, and axial rotation. Measurements included vertebral motion, applied load, and bending/rotational moments.

Clinical and radiographic outcomes of anterior lumbar interbody fusion using recombinant human bone morphogenetic protein-2.

Study Design: A prospective, nonblinded, multicenter study of outcomes in patients undergoing single-level anterior lumbar discectomy and interbody fusion with InFUSE Bone Graft.

Objective: To determine the safety and effectiveness of InFUSE Bone Graft applied to an absorbable collagen sponge in anterior lumbar interbody fusion with threaded cortical allografts.

Summary Of Background Data: In primates, InFUSE Bone Graft used with allograft dowels was shown to increase rates of interbody fusion by promoting osteoinduction and enhancing incorporation of the allograft.

Bioabsorbable anterior lumbar plate fixation in conjunction with anterior interbody fusion cages.

An in vitro biomechanical study was conducted to determine the effects of anterior stabilization on lumbar interbody cage fusion biomechanics in a multilevel human cadaveric lumbar model. Three spine conditions were compared: harvested, bilateral multilevel cages (CAGES), and CAGES with bioabsorbable anterior plates (CBAP), tested under flexion/extension, lateral bending, and axial rotation. Measurements included vertebral motion, applied load, and bending/rotational moments.