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Hybrid fixation caused less degeneration in the adjacent segment, but showed a higher rate of implant failure.
Although the hybrid fixation showed less progression of degeneration in the adjacent segment, there was a higher rate of implant failure.
Topping off has been reported to provide dynamic stabilization along with a consequent reduction of degeneration in the adjacent segment [ 8, 9].
The "topping off" technique has been reported to provide dynamic stabilization and to reduce degeneration in the adjacent segment [ 7, 8].
Additionally, a dorsal laminectomy adjacent performed to the fused segment, pre-existent IVD degeneration and pre-existent facet degeneration in the adjacent segment are also risk factors associated with the development of clinical ASP [ 41, 43].
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This implies that for certain segments only the first, the last, or both event positions have to be displaced in order to guarantee realistic velocities in the adjacent segments.
Type 1 had nearly half the amount of motion in the adjacent segments compared to that in type 3 under all given conditions, and had the least amount of increase in the adjacent segments among all the implanted models.
The facet loads in the adjacent segments (L2 3) had similar pressures in type 1 and type 2, while type 3 had higher pressures than the other types.
On the other hand, the stand-alone cage model had a similar load sharing distribution to a normal lumbar segment, and had relatively less motion in the adjacent segments compared to that for the PSF.
LSF itself causes changes in the biomechanics of the lumbar spine, which may also accelerate degenerative changes in the adjacent segments [ 13] and cause muscle atrophy, leading to fatty infiltration of the lumbar muscles, especially in the multifidus[ 14- 16].
Our results indicate that Wg transport in an anterior direction generates the normal expanse of naked cuticle within the segment and that movement of Wg in a posterior direction specifies diverse denticle cell fates in the anterior portion of the adjacent segment.
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