European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Adjacent segment disease (ASD) is an increasing problematic complication following lumbar fusion surgeries. ASD requires appropriate treatment, although there are only few reports on surgery for ASD. This study aimed to clarify surgical outcomes of posterior lumbar interbody fusion (PLIF) for ASD. ⋯ PLIF is effective for ASD after PLIF in the short term, although it tends to lead to a high incidence of recurrent ASD.
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Development of a dynamic stabilization system often involves costly and time-consuming design iterations, testing and computational modeling. The aims of this study were (1) develop a simple parametric model of lumbar flexion instability and use this model to identify the appropriate stiffness of a flexion restricting stabilization system (FRSS), and (2) in a cadaveric experiment, validate the predictive value of the parametric model. ⋯ Testing demonstrated excellent predictive value of the parametric model, and that the FRSS attained the desired biomechanical performance developed with the model. A simple parametric model may allow efficient optimization of kinematic design parameters.
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To evaluate a new anterior atlantoaxial transarticular locking plate system using finite element analysis. ⋯ The anterior atlantoaxial transarticular locking plate system not only provided stronger fixation, but also decreased screw-bearing stress and screw-bone interface stress compared to simple anterior atlantoaxial transarticular screw fixation.
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To relate the progress of vertebral segmental stability after interbody fusion surgery with radiological assessment of spinal fusion. ⋯ In vivo vertebral segment stability, defined as a significant reduction in ROM, is achieved in an early stage of spinal fusion, well before a radiological bony fusion between the vertebrae can be observed. Therefore, plain radiography underestimates vertebral segment stability.
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To understand the relative histopathological effects of PEEK particulate debris when applied within the epidural versus the intervertebral disc space. We hypothesized that due to the avascular nature of the intervertebral disc acting as a barrier to immune cells, the intradiscal response would be less than the epidural response. ⋯ The results of this study are similar to past investigations of PEEK, whose results have not been shown to elicit an aggressive immune response. The degree to which these results will translate to the clinical environment remains to be established, but the pattern of subtle elevations in inflammatory cytokines indicated both a mild persistence of responses to PEEK debris, and that intradiscal implant debris will likely result in less inflammation than epidural implant debris.