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Introduction Spinal instability constitutes an important indication for surgical stabilization in a number of spinal pathologies. Since the time of the description of the ‘middle path regime’ by Tuli in 1975, spinal instability has constituted
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affected. It is thought to be triggered by a degenerate disc that becomes incompetent. The anteroposterior translational shear forces that arise from longstanding soft-tissue instability accelerate the degenerative changes observed in the facet joints until
Department of Orthopedic Surgery, Spine Unit, Centre Hospitalier de l’Université de Montréal (CHUM), Canada.
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protect neural elements and maintain/restore neurologic function; (2) to prevent or correct segmental collapse and deformity; (3) to prevent spinal instability and pain; (4) to permit early ambulation and return to function; and (5) to restore normal
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laminectomy or lamino-arthrectomy. Nevertheless, fusion is often associated with decompression to avoid posterior instability. Single anterior fusion for indirect decompression Local instability and slipping increases radicular compression; therefore
Clínica Universidad de los Andes, Santiago, Chile
Universidad Andrés Bello, Hospital del Trabajador, Facultad de Medicina, Santiago, Chile
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Sanatorio Güemes, Buenos Aires, Argentina
Hospital General de Agudos Dr. Teodoro Álvarez, Buenos Aires, Argentina
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Spine Unit, Department of Traumatology, Clínica Alemana, Santiago, Chile
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Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany
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( 4 ). The failure of the nonoperative treatment was reported in about 20% of the cases, probably due to missed mechanical instability. The torpid evolution of isolated cervical spine facet fractures can result in persistent cervical pain, subsequent
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= partial fracture with no instability including transverse fracture of the sacrum below S2; type B = fracture with horizontal instability; type C = fracture with vertical instability. In type B, the vertical opening of the posterior lesion can occur at the
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on the use of decompression alone to manage degenerative spondylolisthesis were published by Epstein 35 and Kristof, 36 with good to excellent outcomes in older patients without dynamic instability on lateral radiographs (82.0% and 73
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Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, UK
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Orthopaedics and Trauma has declared two major goals of diagnostics for the cervical spine: ‘precise morphologic detection and quantification of instability as a possible source of secondary pain syndromes, deformity or neurologic damage’, and ‘detection of
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leading to clinical symptoms, such as radiculopathy, stenosis and instability. 9 , 10 Nevertheless, there are a few reports considering reoperation rate as being the most reliable parameter to define ASD, despite clinical symptoms. 11 The incidence of
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which require reoperation. 25 , 47 , 62 , 100 Intraoperative death is the most serious complication caused by anaphylactic reaction during surgery due to cyst rupture; the organism is highly immunogenic. 85 Vertebral column instability is