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Anterior cervical fusion: a inite element model study on motion segment stability including the efect of osteoporosis cholesterol levels ratio canada generic zocor 10 mg with mastercard. Biomechanical analysis of bone mineral density, insertion technique, screw torque, and holding strength of anterior cervical plate screws. Initial stability of cervical spine ixation: predictive value of a inite element model. Efects of disc height and distractive forces on grat compression in an anterior cervical discectomy model. One-stage internal ixation and anterior fusion in complex cervical spinal disorders. Vocal fold paralysis ater anterior cervical spine surgery: incidence, mechanism, and prevention of injury. Anterior screw ixation of odontoid fractures comparing younger and elderly patients. Endoscopic endonasal atlantoaxial transarticular screw ixation technique: an anatomical feasibility and biomechanical study. Anterior cervical instrumentation enhances fusion rates in multilevel reconstruction in smokers. Anterior decompression and arthrodesis of the cervical spine: long-term motor improvement. Banked ibula and the locking anterior cervical plate in anterior cervical fusions following cervical discectomy. Biomechanical analysis of a new concept: an add-on dynamic extension plate for adjacent-level anterior cervical fusion. A new stand-alone cervical anterior interbody fusion device: biomechanical comparison with established anterior cervical ixation devices. Loosening at the screw-vertebra junction in multilevel anterior cervical plate constructs. Biomechanical rigidity of cadaveric cervical spine with posterior versus combined posterior and anterior instrumentation. Initial intervertebral stability ater anterior cervical discectomy and fusion with plating. Short-term comparison of cervical fusion with static and dynamic plating using computerized motion analysis. Use of a bioabsorbable anterior cervical plate in the treatment of cervical degenerative and traumatic disk disruption. Bioresorbable polylactide interbody implants in an ovine anterior cervical discectomy and fusion model: three-year results. Early failure of bioabsorbable anterior cervical fusion plates: case report and failure analysis. Pseudarthrosis failures of anterior subaxial cervical spine fusion using a plate with a single screw per vertebral body: a case series.
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Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study cholesterol levels malaysia discount zocor 10 mg buy on line. Hypertrophied ligamentum lavum in lumbar spinal canal stenosis: pathogenesis and morphologic and immunohistochemical observation. Importance of correlating static and dynamic imaging studies in diagnosing degenerative lumbar spondylolisthesis. Dynamic degenerative lumbar spondylolisthesis: diagnosis with axial loaded magnetic resonance imaging. Lumbosacral segmental motion in normal individuals: have we been measuring instability properly Roentgenographic evaluation of lumbar spine lexion-extension in asymptomatic individuals. Surgical compared with nonoperative treatment for lumbar degenerative spondylolisthesis. Nonsurgically managed patients with degenerative spondylolisthesis: a 10- to 18-year follow-up study. Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. Association of estrogen receptor gene polymorphism in patients with degenerative lumbar spondylolisthesis. Etiology of spondylolisthesis: assessment of the role played by lumbar facet joint morphology. Disc height and lumbar index as independent predictors of degenerative spondylolisthesis in middle-aged women with low back pain. Natural history of degenerative spondylolisthesis: pathogenesis and natural course of the slippage. Degenerative lumbar spinal stenosis: diagnostic value of the history and physical examination. Anatomic changes of the spinal canal and intervertebral foramen associated with lexion-extension movement. Chapter 64 Degenerative Spondylolisthesis spinal stenosis among Medicare beneiciaries. Decompression in the surgical management of degenerative spondylolisthesis: advantages of a conservative approach in 290 patients. Degenerative lumbar spondylolisthesis-induced radicular compression: nonfusion-related decompression in selected patients without hypermobility on lexion-extension radiographs. Microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis including degenerative spondylolisthesis.
Spinal fusion is a common treatment for various conditions cholesterol in eggs bad buy generic zocor 10 mg, including deformity, trauma, and degenerative disc disease with instability. Nonetheless, signiicant rates of pseudarthrosis (up to 26%) have been reported in the literature. New bone formation is essential to arthrodesis of the spine and is heavily inluenced by the local bone environment and grating substitutes. Successful grating materials require three essential components: an osteogenic potential capable of directly providing mature osteoblasts and stem cells that will drive new bone formation, osteoinductive factors that are able to signal the osteoblastic diferentiation of osteoprogenitor stem cells, and an osteoconductive scafold that assists neovascularization and supports the ingrowth of bone. In addition to these properties, the ideal bone substitute should be without risks of disease transmission. Autologous bone grats are the only grating materials that possess all three properties; they can provide immediate and long-term mechanical stability, and are therefore considered the standard. Local bone is a cortical bone grat in which cell migration is decreased due to small pore size. In order to avoid morbidity associated with harvesting autogenous grat and to optimize bone formation for fusion, several classes of bone substitutes have been developed. Although bone substitutes do not provide the same osteogenic, osteoinductive, and osteoconductive properties as autograts, various grating materials have demonstrated eiciency for bone formation in basic science and clinical studies. Furthermore, advances in the understanding of bone remodeling, the development of osteoinductive proteins and small molecules, and the synthesis of new osteoconductive carriers hold a promising future for biologic treatments of spinal conditions. Allografts Allograts are composed of cadaveric bone and have been employed traditionally as bone grat extenders. Allograts have good osteoconductive and minimal osteoinductive properties; however, they lack growth factors and osteogenic cells due to the processing that they undergo in order to decrease their antigenicity. Allograt bone may be applied to the grat bed in a crushed particulate form or can be formulated to create structural spacers. Osteogenic Cells +++ + - - - - - ++ +++ - - ++ Osteoinductive Factors ++ + + + - ++ +++ + - ++ +++ +++ Osteoconductive Matrix +++ + + + +++ + - - - - - - Initial Biomechanical Strength - +++ ++ + + - - - - - - - Donor Site Morbidity ++ ++ - - - - + + + - - + stability and are best suited for interbody arthrodesis but sufer from increased grat resorption and slow bone remodeling. Corticocancellous allograts initially impart little mechanical support to the fusion site but, because of its relatively large surface area, are integrated more rapidly than cortical bone. Preservation is achieved through freezing or freezedrying in order to decrease its antigenicity and permit storage for extended periods of time. Freeze-drying reduces immunogenicity even more than freezing, but on rehydration, these grats may lose up to 50% of their mechanical strength. Disease transmission is one of the main concerns with allograts, particularly viral diseases, such as human immunodeiciency virus and hepatitis. Nevertheless, there have been only two documented cases of human immunodeiciency virus transmission from allograt bone, both of which involved unprocessed grats. Jorgenson and colleagues39 conducted a prospective analysis of autograts versus allograts in posterolateral lumbar fusion in the same patient and concluded that ethylene oxidetreated allograt is inferior to autograt and should not be used for posterior lumbar fusions.
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Owen, 24 years: Imaging studies should be correlated with speciic indings on history and physical examination that would be expected on the basis of the speciic neural elements that are compressed. Iohexol (Omnipaque 240) is injected to conirm proper spread of the contrast medium within the joint space, also conirming that there is no intravascular runof.
Nemrok, 21 years: Neurologic Deterioration Delay in diagnosis and subsequent neurologic deterioration is still frequent, occurring in 0. Posteriorly, the vertebral arteries are vulnerable to injury during insertion of Magerl and C2 pars and pedicle screws because the drill bit traverses the C2 body.
Trompok, 57 years: Numerous authors have reported similar fusion rates using bone harvested from the lamina, spinous processes, and facet joints, without using iliac grat. Of children with leukemia, 10% or more will initially have normal automated counts.
Leon, 43 years: When the peritoneum has started to roll medially and the iliac artery has been palpated, the next landmark to be palpated should be the L5S1 disc level. Standard dermatomal charts can be helpful, but there is variability among individuals; thus, this is highly subjective.
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