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Normal, Fused, and Degenerative Cervical Spines: A Comparative Study of Three-Dimensional in Vivo Kinetics
Fei Liu, PhD1; Joseph S. Cheng, MD, MS1; Richard D. Komistek, PhD1; Mohamed R. Mahfouz, PhD1
1 1910 Blanding Street, Columbia, SC, 29201. E-mail address for F. Liu: lf_david@hotmail.com
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Note: The authors acknowledge Christy Hagewood for help in preparing the IRB submission and assisting with experiments, and they also thank John Kyle Mueller, Chris Little, and Christopher B. Carr for assisting with experiments.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2008 Nov 01;90(Supplement 4):85-89. doi: 10.2106/JBJS.H.00626
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Extract

With a complex system of intervertebral discs and adjoining ligaments and muscles, the cervical spine provides support and stability to the head, transfers the weight of the head to the trunk, and allows for complex physiological motions. The technique of anterior cervical discectomy decompression and fusion has been successfully used in the treatment of the degenerative cervical spine for decades1-3. However, it has been reported that 2.9% of fused cervical spines per year will require revision surgery at adjacent levels for the treatment of progressive spondylosis and that 25.6% of patients who undergo anterior cervical discectomy decompression and fusion will have new disease at an adjacent level within the first ten years after surgical treatment4. Also, prior in vitro studies have reported greater motions and increased load and intradiscal pressures along with a higher prevalence of degeneration at the segments adjacent to the level of the initial anterior cervical discectomy decompression and fusion as compared with those in a normal cervical spine4-6. The variations in the relative motions and forces occurring at the levels adjacent to the fused levels have been thought to be responsible for the further degeneration seen in the cervical spine.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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