By James J. Yue MD, Rudolph Bertagnoli MD, Paul C. McAfee MD, Howard S. An MD
New motion-preserving units are revolutionizing backbone surgery.but the educational curve for those operations is steep, and nice cognizance has to be given to sufferer and machine choice and the appropriate execution of every approach. just one reference spells out precisely tips to practice those new techniques.and its peerless writer staff, created from key investigators taken with the units' real medical trials, is uniquely certified that can assist you get the easiest effects! those international leaders during this quarter speak about the benefits and drawbacks of the whole variety of non-fusion technologies.and current the step by step, richly illustrated operative tips you want to in attaining optimum results! three hours of surgical video on DVD display how one can practice key systems, and entry to the entire contents of the ebook on-line lets you reference it comfortably from any computer.Select the easiest gadget and strategy for every patient!*cervical overall disc arthroplasty*lumbar overall disc arthroplasty*lumbar partial disc substitute: nucleus replacement*lumbar posterior dynamic stabilization: pedicle screw based*lumbar posterior dynamic stabilization: interspinous based*lumbar part replacementProduce optimum results with particular recommendation on. *advantages and downsides of every option*indications and contraindications*patient selection*interpretation of imaging studies*surgical anatomy and biomechanics*surgical techniques*tips and pearlsSee tips on how to practice every one procedure, due to. *step-by-step, full-color illustrations*more than three hours of surgical video clips on DVD, narrated through the specialists! entry to the full contents of the publication on-line permits you to practice fast searches, stick with hyperlinks to Medline and PubMed abstracts, and extra.
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Extra info for Motion Preservation Surgery of the Spine: Advanced Techniques and Controversies
Several designs have used the History and Evolution of Motion Preservation 15 concept of an articulating core and attempted shock absorption by using a compressible elastomer as the core material. Khvisuyk's38 design is composed of a silicon cushion between two metallic plates. The Downey prosthesis39 was similar and had two large bolts to screw it into the superior and inferior end plates. Another example is the AcroFlex, by DePuy Spine (Raynham, MA), shown in Figure 2–11. 40 It is designed for implantation in the lumbar spine.
CHAPTER 2 n F I G U R E 2–9. Erickson and Griffith device used a polymer core to decrease friction with the articulating superior end plate. whereas others, Bryan and Kunzler,34 used plate extensions that could be screwed into the anterior aspect of the superior and inferior vertebral bodies. Variations on the hard plate/hard core theme involved a core secured to one of the plates. Gordon's35 variation used a hemispheric bearing anchored to the inferior plate but articulating with the superior plate, similar to the ProDisc.
11 This concept was demonstrated by the Fernstrom ball implants, which have a very small end plate contact surface. A larger contact surface allows for wider load repartition and less stress on the end plates; however, this factor mandates that disc arthroplasty with rigid materials will likely always require an anterior approach. The complex role of the disc, providing both viscoelastic load distribution and articular motion, creates a difficult design challenge. Most designs used today, namely the CHARITÉ III and ProDisc II, have largely abandoned viscoelastic considerations and focused on motion preservation.