Assuntos
Ácido 12-Hidroxi-5,8,10,14-Eicosatetraenoico/análise , Carcinoma de Células Escamosas/química , Ceratose Actínica/metabolismo , Neoplasias Cutâneas/química , Biópsia , Carcinoma de Células Escamosas/patologia , Celecoxib/farmacologia , Celecoxib/uso terapêutico , Quimioprevenção , Ciclo-Oxigenase 2/metabolismo , Inibidores de Ciclo-Oxigenase 2/farmacologia , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Glucuronosiltransferase/metabolismo , Humanos , Ceratose Actínica/patologia , Inibidores de Lipoxigenase/farmacologia , Inibidores de Lipoxigenase/uso terapêutico , Neoplasias Induzidas por Radiação/química , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/prevenção & controleRESUMO
Objective The objective of this study was to compare the relative stability in lumbar spondylolysis (SP) of a rigid anterior plate (with a novel compression slot) versus traditional posterior pedicle screw (PS) fixation. Summary of Background Data Arthrodesis has been a mainstay of treatment for symptomatic isthmic spondylolisthesis in adults. Posterior PS fixation has become a commonly used adjunct. Some have advocated anterior lumbar interbody fixation (ALIF) plate as an alternative. The relative stability afforded by ALIF in SP has not been well characterized, nor has the contribution afforded by a compression screw slot in an ALIF plate. Methods Calf spine segments were characterized in the normal state, after sectioning the pars (SP model), then after reconstruction with an interbody spacer and either PS/rods, or an ALIF plate, or both. Results ALIF plate conferred stability on the spondylolytic segment only comparable to that of the normal functional spinal unit (FSU). Posterior fixation was more stable than anterior fixation in all testing modes. Addition of an ALIF plate conferred a significant additional stability in those that already had posterior fixation. The utilization of an anterior compression screw conferred additional stability in extension testing only. Conclusions ALIF plate reconstruction in the setting of SP may not confer enough segmental stability to predictably encourage fusion beyond that of the uninstrumented intact FSU. The utilization of an integral compression screw in an ALIF plate may not confer clinically significant additional construct stability in SP.