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2011年4月24日 星期日

DYNAMIC STABILIZATION?

 DYNAMIC STABILIZATION
Dynamic stabilization: A flexible rod in place of a solid metal rod.

 It means: you want to stabilize the lumbar spine (the segment which would have been fused), at the same time, you want to maintain mobilization (of the adjacent normal segment).
 Paradoxical, isn't it? No wonder the US FDA banned this fantastic, heavenly idea: thou shalt not have the best of both worlds.


Dynamic Stabilization:" I am screw, but I have a beautiful, wavy, flexible waist and can do mambo that no other screws can."
FDA: "You look like a screw, taste like a screw, smell like a screw, feel like a screw, so you must be a screw, you have to act like a screw. No mambo here, sorry."  
dynamic stabilization system implanted.


Europeans are more open-minded and optimistic than the die-hard American who can't enjoy the good things in life, as I see it.
 On the other hand, dynamic stabilization of nowadays seems to be a revived zombie (Graf system), or face changing .  


Semi-rigid device. Wider screw holes at each end of the plate which allow motions for upper and lower vertebrae.

The Mother of all Dynamic Stabilization. Graf Device: An elastic band looping around the screws.
  
The basic issue is still there: the pedicle screw. A screw is a screw is a screw. Period.
  Dynamic stabilization is intended to decrease the incidence of adjacent segment disease in which rigid pedicle screw instrumentation is the main culprit. If rigid is bad, then soft must be good, as long as the logic is as such simple. History showed that semi-rigid device failed, Graf system was long gone; are we expecting an almost-doomed-to-fail newly bottled good-old idea to do magic-- surgeons and patients both live happily thereafter forever?
  Screw caused problem cannot be solved by a new screw. In the end, history always repeats itself until we wake up.

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