Journal of spinal disorders & techniques
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J Spinal Disord Tech · Jun 2014
Do lordotic Cages Provide Better Segmental Lordosis Versus Non-lordotic Cages in Lateral Lumbar Interbody Fusion (LLIF)?
Retrospective Comparative Radiographic Review. ⋯ Lordotic cages provided significant increase in operative level segmental lordosis compared to non-lordotic cages although overall lumbar lordosis remained unchanged. Anterior and posterior disc heights were significantly increased by both cages, providing basis for indirect spinal decompression.
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J Spinal Disord Tech · Jun 2014
Early-term and mid-term histologic events during single-level posterolateral intertransverse process fusion with rhBMP-2/collagen carrier and a ceramic bulking agent in a nonhuman primate model: implications for bone graft preparation.
We used a nonhuman primate lumbar intertransverse process arthrodesis model to evaluate biological cascade of bone formation using different carrier preparation methods with a single dose of recombinant human bone morphogenetic protein-2 (rhBMP-2) at early time points. ⋯ At the early time period, histology showed that bone formation appeared to originate at the transverse processes and the intertransverse membrane, indicating that the dorsal muscle bed may not be the only location for bone formation. Histology also showed that the collagen carrier for rhBMP-2 is mostly resorbed by 4 weeks. Our results and previous literature indicate that ceramic bulking agents are needed to provide resistance to compression caused by paraspinal muscles on the fusion bed in the posterolateral environment. Histology showed that ceramic bulking agents may offer long-term scaffolding and a structure to supporting bone formation of the developing fusion mass.
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J Spinal Disord Tech · Jun 2014
Case ReportsPosterior hybrid technique for ossification of the posterior longitudinal ligament associated with segmental instability in the cervical spine.
Retrospective case series. ⋯ This hybrid posterior technique seems to be effective and safe in the treatment of selected patients with OPLL associated with segmental instability. The potential benefits of this technique include a stable environment for spinal cord recovery and prevention of progressive kyphosis and OPLL.
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J Spinal Disord Tech · Jun 2014
Comparative Study Clinical TrialComparison of the clinical outcome in overweight or obese patients after minimally invasive versus open transforaminal lumbar interbody fusion.
This is a prospective single-center nonrandomized control clinical study involving 81 overweight or obese patients who underwent minimally invasive or open transforaminal lumbar interbody fusion (TLIF). ⋯ MiTLIF is a safe and reliable procedure for treatment of overweight or obese patients. The minimally invasive technique offers several potential advantages when compared with the open procedure. Although this technique needs a longer x-ray exposure time, it may still be a good option for overweight or obese patients.
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J Spinal Disord Tech · Jun 2014
Biomechanical analysis of various footprints of transforaminal lumbar interbody fusion devices.
A biomechanical finite element modeling study of the human lumbar spine. ⋯ An articulating, large footprint, peripherally placed TLIF device affords substantial biomechanical advantages. This device may be able to reduce the incidence of subsidence because of its ability to reduce and distribute the endplate stresses in the stronger peripheral region. It may also reduce the posterior hardware failure incidence owing to its ability to reduce the screw stresses as compared with traditional TLIF. Although double TLIF has been demonstrated to have similar biomechanical advantages as the AVID, complications associated with double TLIF (ie, larger surgical incision, longer surgical procedure, placement and alignment challenges) support AVID as a better optimized alternative.