Spine
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Comparative Study
Biomechanical comparison of cervical spine reconstructive techniques after a multilevel corpectomy of the cervical spine.
An in vitro biomechanical study of several reconstructive techniques after a two-level cervical corpectomy. ⋯ The biomechanical results obtained suggest that posterior segmental instrumentation confers significant stability to a multilevel cervical corpectomy regardless of the presence or absence of anterior instrumentation. In cases in which the stability of a multilevel reconstruction procedure is tenuous, the surgeon should strongly consider the placement of segmental posterior instrumentation to significantly improve the overall stability of the fusion construct.
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Biomechanical study. ⋯ Based on the results of this biomechanical comparison, the calf spines instrumented with the wedge-rod system for fusionless correction were significantly stiffer as compared to the intact calf spine. The wedges alone were not as stiff as the intact spine. This suggests that the theory of performing transverse osteotomies of vertebral bodies with fixation with wedge-rod construct for 8 to 12 weeks, followed by removal of the rod, could provide adequate fixation and correction of a scoliotic deformity without requiring fusion of motion segments.
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Retrospective case series review. ⋯ Surgical correction was achieved in over half the levels that would have been operated by standard posterior segmental fixation. Bony healing due to the bone-on-bone apposition was achieved uneventfully after apical correction of the spinal curvature in all patients. Use of dual rod instrumentation (Kaneda Anterior Scoliosis System) is fundamental in maintaining the correction of the curvature achieved in the operating room. The preoperative planning technique worked well.
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Lumbar spinal instability was evaluated using radiographic parameters and intraoperative biomechanical measurement. ⋯ Disc angle in flexion and ROM were the most prognostic parameters of lumbar distraction instability. Although the option of spinal arthrodesis method should be determined based on both clinical manifestation and imaging studies, the current study demonstrated that providing of anterior column support is biomechanically reasonable for degenerative spondylolisthesis with segmental kyphosis in flexion.
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Radiographic evaluation of bony union and clinical outcome were investigated after posterior lumbar interbody fusion (PLIF) performed with only local bone. ⋯ A 100% bony union rate was obtained 12 months after PLIF with only local bone. The results showed that clinical viability of local bone as a source of bone graft in PLIF.