Indications
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Segmental instability requiring fusion for stabilization
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Recurrent disk herniation
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Symptomatic spinal stenosis with a significant back pain component that would benefit from fusion
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Degenerative disk disease with a significant back pain component
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Spondylolisthesis that is progressive, is symptomatic, or requires decompression with a need to fuse spondylolisthetic level
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Correction of degenerative scoliosis requiring fusion segments
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Salvage for pseudarthrosis of a previous intertransverse fusion or arthroplasty
Planning and positioning
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Anteroposterior and lateral plain films or computed tomography (CT) scan to evaluate bony anatomy
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Dynamic (flexion-extension) x-rays to evaluate degree of motion or instability
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Magnetic resonance imaging (MRI) to evaluate neural elements and soft tissue (e.g., disk)
FIGURE 74-1:
The patient is placed in the prone position with chest rolls on a Jackson table.
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Fluoroscopy and neuromonitoring, including somatosensory evoked potentials or electromyography or both
Planning and positioning
