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Ebook Dynamic reconstruction of the spine: Part 2

(BQ) Part 2 book “Dynamic reconstruction of the spine” has contents: Minimally invasive posterior dynamic stabilization system, anterior exposure to the lumbar spine, the mobidisc prosthesis, complications of lumbar disc arthroplasty, annulus repair, assessment of lumbar motion kinematics in vivo, and other contents. | | 20.02.15 - 13:27 Dynamic Stabilization for Revision of Lumbar Spinal Pseudarthrosis 29 Dynamic Stabilization for Revision of Lumbar Spinal Pseudarthrosis with Transition Paul C. McAfee, Liana Chotikul, Erin M. Shucosky, and Jordan McAfee 29.1 Introduction With the Agile and N-Hance spinal devices being withdrawn from the market and not being available for sale in the United States, the practical application of dynamic stabilization is limited. Furthermore, the prospective randomized Food and Drug Administration (FDA) study of the Dynesys Dynamic Stabilization System (Zimmer Spine, Minneapolis, MN) was not approved. This leaves the Transition Stabilization System (Globus Medical, Inc., Audubon, PA) as the main remaining instrumentation system available for clinical use in the treatment of spinal pseudarthrosis. It was felt in the original design that the use of a bumper of polycarbonate urethane (PCU) would be effective in damping the force of correction transitioning from the rigid titanium rod portion of an instrumentation system to the uninstrumented mobile portion of the spine outside the vertebral levels of surgery.1 There were three indications for using the Transition: (1) topping off, (2) hybrid cases with one or two levels of solid rod combined with one or more levels of PCU, and (3) load sharing between the posterior dynamic rod and an anterior poly ether ketone (PEEK) spacer at the same vertebral level. We reviewed a series of 85 consecutive cases treated as one of these three indications in the setting of revision surgery.2 Spinal fusion revision should be more reliably achieved with the use of a dynamic instrumentation system that allows more of the load to be sequentially borne by the spinal fusion. If 100% of the load is absorbed by the spinal instrumentation the pedicle screws bear higher cantilever bending stresses, there are higher strains on the solid metal rods, and a higher incidence of pedicle screw breakage can be expected. The focus of .