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January 12, 1994

Contempo: Instrumented Spinal Fusions

Author Affiliations

Durham Clinic Durham, NC

JAMA. 1994;271(2):105. doi:10.1001/jama.1994.03510260029020

To the Editor.  —In his review of the current issues in orthopedic surgery, Dr Morrey1 briefly reviewed issues involving instrumented spinal fusions.Morrey implies that "increasing caution" is being expressed with regard to indications as well as the use of instrumented spinal fusions. Two recent articles2,3 in Spine indicate the significant value of rigid pedicle screw instrumentation in improving the outcome of spinal fusion procedures. In a prospective, randomized study of lumbar fusions performed with and without instrumentation, Zbeblick2 indicated that fusion rates and clinical success were significantly higher with rigid instrumentation in 124 highly debilitated patients with spinal stenosis, degenerative disk disease, spondylolisthesis, and degenerative scoliosis.Steffee and Brantigan3 reported on the prospective study of 250 subjects enrolled in the Food and Drug Administration clinical trials to evaluate a rigid pedicle screw fixation system. The success rates for clinical improvement in all categories of patients

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