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The Isobar TTL and the Dynesys have Food and Drug Administration (FDA) approval as an adjunct to fusion, but to date none of these systems have been approved as a dynamic stabilizer (i.e., without fusion).20-24 The Dynesys system was the only device to undergo an FDA Investigational Device Exemptions (IDE) study as a dynamic stabilizer. 30 SECTION 1 History The most notable advancements in pedicle screw-rod based systems are the Graf ligmentoplasty system, the Isobar TTL Semi-rigid spinal system (Scient’X, West Chester, PA), and the Dynesys system (Zimmer Spine, Minneapolis, MN). This proof copy is the copyright property of the publisher and is confidential until formal publication. It is not allowed to publish this proof online or in print.
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A B ISBN: 978-0-5 PII: B978-0-5.00003-4 Author: Benzel & Steinmetz 00003 f0010 f0015 Benzel_0305_Chapter 3_main.indd 29 5:02:52 PM To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. Anteroposterior (A) and lateral (B) radiographs after surgical stabilization of a burst fracture of 元 with segmental sublaminar wire fixation to an angled rod using the technique described by Eduardo Luque. Anteroposterior (A) and lateral (B) radiographs after surgical stabilization of a burst fracture of 元 with Harrington rod internal fixation.
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History of Spinal Instrumentation: The Modern Era 29 3 Figure 3-1. SUMMARY OF KEY POINTS ISBN: 978-0-5 PII: B978-0-5.00003-4 Author: Benzel & Steinmetz 00003 c00003 p0010 u0015 u0020 u0025 p0035 s0010 p0040 p0045 p0050 p0055 p0060 p0065 p0070 Benzel_0305_Chapter 3_main.indd 28 5:02:51 PM To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. Since the early 2000s, there has been a greater interest in dynamic stabilization technologies and tools for minimally invasive surgery.Īn improved understanding of biomechanics and clinical experience with today’s instrumentation should promote further advancement in internal fixation and even better patient outcomes in the future.Surgeons are now able to select a specific type of implant that is best suited to address an individual patient’s problem. Since the 1970s, there has been an amazing increase in the variety of instrumentation available to provide internal spinal fixation.Internal fixation leads to higher fusion rates and provides more powerful means of correcting spinal deformity.The development of instrumentation for internal fixation of the spine has dramatically improved the surgeon’s ability to successfully provide surgical intervention for a wide variety of spinal disorders.The loss of normal lumbar lordosis was associated with “flat back syndrome.6,7” Hook dislodgement and rod breakage also proved to be troublesome complications.8,9 In addition, casting or bracing was generally required in the postoperative period, which proved to be difficult or impractical in some patients.10 In response to the difficulties encountered with Harrington rods, Eduardo Luque advanced a major concept in the mid1970s that quietly pushed forward the future direction of spinal instrumentation: segmental spinal fixation. Unfortunately, the use of distraction as the sole correction tool resulted in the loss of normal sagittal plane alignment. The use of a distraction system provided excellent correction of coronal plane deformities (scoliosis). Over the years, however, their widespread use led to recognition of the limitations. 3-1), degenerative disease,3 and metastatic disease.4,5 The system provided distraction rods as well as compression rods and hooks. The rod system, originally developed by Paul Harrington for the correction of spinal deformities, was soon used in the treatment of traumatic injuries1,2 (Fig. DORSAL THORACOLUMBAR INSTRUMENTATION In 1975, the Harrington rod represented the state of the art in spinal instrumentation.