136S Proceedings of the NASS 25th Annual Meeting / The Spine Journal 10 (2010) 1S–149S

treatment cohorts. VAS neck pain scores (on a 10 cm scale) decreased from

6.4 62.6 pre-op to 1.3 62.2 at 24 months for the investigational group, and

also decreased for the control group (6.4 62.7 pre-op to 2.0 62.7 at 24

months). Similar reductions in VAS scores for right and left arm pain were

also observed in both treatment groups from pre-op to 24 months. Average

range of motion (angulation) on flexion-extension for SECURE�-C patients

was 9.7� 65.7� at 24 months as compared to the ACDF patients’ 0.7� 60.7�

at 24 months for ACDF patients. Average range of motion (translation) on

flexion-extension for SECURE�-C patients was 1.3 60.8 mm at 24 months

as compared to 0.1 60.1 mm for ACDF patients at 24 months. Ninety three

percent of SEC patients were satisfied with their results at two years after

surgery as compared to 82% of the control patients. The rate of secondary

surgeries at the index level were higher for the ACDF group than the SEC

group for the overall IDE study; 9 ACDF devices were removed and/or

revised, compared to 4 SEC devices. There were no mechanical failures of

either the investigational or control devices.

CONCLUSIONS: Results from these sites suggest that the SECURE�-C

Cervical Artificial Disc may be used to treat symptomatic cervical disc

disease and could help reduce pain and improve function. Continued

follow-up from all study sites is needed to determine the overall safety

and efficacy of this treatment.

FDA DEVICE/DRUG STATUS: SECURE-C: Investigational/Not ap-

proved; ASSURE Cervical Plate: Approved for this indication.

doi: 10.1016/j.spinee.2010.07.349

P74. The Effect of Timing of Surgery on Recovery in Patients with

Metastatic Spinal Cord Compression (MSCC)

Sherief Elsayed, MB BCh MRCS (Eng), Vlasta Dvorak, MD, Nasir

A. Quraishi, FRCS (Orth); Queens Medical Centre, Nottingham, United

Kingdom

BACKGROUND CONTEXT: Metastatic spinal cord compression is an

emergent disorder which requires prompt management.

PURPOSE: To assess whether the timing of surgery is an important factor

in neurological outcome in patients with MSCC.

STUDY DESIGN/SETTING: Retrospective analysis.

PATIENT SAMPLE: All patients with MSCC presenting to our unit were

included in this study from October 2003 to December 2009. Patients were

divided into three groups - those who underwent surgery within 24 hours

(Group 1), those 24 hours to 48 hours (Group 2) and those greater than

48 hours (Group 3).

OUTCOME MEASURES: Neurological outcome (improvement in

Frankel score), complication rate and survival.

METHODS: Patients were divided into three groups - those who under-

went surgery within 24 hours (Group 1), those 24 hours to 48 hours (Group

2), and those greater than 48 hours (Group 3).

RESULTS: A total of 109 patients with MSCC were operated on in our

unit during this time. Mean age of patients was 61 years (range 7 - 86).

The number that had at least one grade of Frankel improvement was 21/

37 (57%) in group 1; 11/17 (65%) in group 2 and 20/49 (41%) in group

3, (p50.03). When patients treated less than 24 hours were compared with

those greater than 24 hours, the Frankel grade improvement approached

significance (p50.05). When we compared those who had surgery within

48 hours and those greater than 48 hours, the Frankel grade improvement

was highly significant (p50.009). There was no difference in survival or

complications between the groups.

CONCLUSIONS: Our results suggest that early surgical treatment in pa-

tients with MSCC gives a better neurological outcome but has no influence

on survival or complication rates.

FDA DEVICE/DRUG STATUS: This abstract does not discuss or include

any applicable devices or drugs.

doi: 10.1016/j.spinee.2010.07.350

All referenced figures and tables will be available at the Annual Mee

P75. XLIF Retrieval Experience for Different Prostheses Models:

Minimal Invasive Lateral Access for Success

Leonardo Oliveira, BSc1, Luis Marchi, MSc2, Etevaldo Coutinho, MD2,

Luiz Pimenta, MD, PhD2; 1Universidade Federal de Sao Paulo, Sao Paulo,

British Indian Ocean Territory; 2Instituto de Patologia da Coluna, Sao

Paulo, Brazil

BACKGROUND CONTEXT: Lumbar total disc replacement has been

widely performed with good results. On the other hand, new techniques

generate new problems also. Due to emergent issue of revision surgeries

and historical recurrent anterior approach complications (vessel injury,

blood loss, muscle damaging, adherence and neural risk), we implanted

a lateral (XLIF) removal with subsequent fusion for different prostheses,

including Charite, Phisio-L, Maverick and Secure-T.

PURPOSE: The purpose of the abstract is to present a minimal invasive

way to remove different failed total disc devices by lateral approach.

STUDYDESIGN/SETTING:Non randomized, single center clinical study.

PATIENT SAMPLE: 16 patients that presented with failed artificial lum-

bar disc prostheses requiring revision surgery by XLIF approach.

OUTCOME MEASURES: Analysis consists of clinical outcomes and

pain assessment by means of VAS responses and functional assessment

by means of ODI.

METHODS: The minimally invasive disruptive extreme lateral interbody

fusion (XLIF) access has been used for disc removal and level fusion using

XLIF cages standalone (2 cases), with supplemental lateral plates (1 case)

or pedicle screws (13 cases). Cases included L2/L3, L3/L4 and L4/L5

discs, within 9 cases with Charite (DePuy Spine), 2 with Maverick (Med-

itronic), 1 with Phisio-L (Nexgen), 1 with Triumph (Globus Medical) and 3

with Lateral Disc (NuVasive).

RESULTS: All patients were successfully revised with fusion procedures

by a minimally invasive XLIF approach without major surgical complica-

tions, just experiencing 1 case of iliac vein tear-repaired. Mean surgical

time was 115.7 minutes; mean blood loss was!50 ml and all were outpa-

tient surgeries. Outcome assessment (VAS and ODI) showed important

clinical improve.

CONCLUSIONS: Retrieval surgery in failed TDR is a demanding proce-

dure, often technically difficult, and carries an incidence of morbidity. The

XLIF procedure is a safe and effective strategy for minimally disruptive

LTDR removal at the L2-L3, L3-L4 and L4-L5 levels.

FDA DEVICE/DRUG STATUS: This abstract does not discuss or include

any applicable devices or drugs.

doi: 10.1016/j.spinee.2010.07.351

P76. Short Segment vs. Long Segment Pedicle Screw Fixation

for Treating Thoracolumbar Junction Burst Fractures

Todd W. Peters, MD1, Suresh R. Chinthakunta, MS2, Mir Hussain, BS2,

Saif Khalil, PhD2; 1Vail Summit Orthopaedics, Avon, CO, USA; 2Globus

Medical Inc., Audubon, PA, USA

BACKGROUND CONTEXT: Long segment posterior fixation (LSPF) is

commonly used for burst fracture treatment. Use of short segment posterior

fixation (SSPF) has historically resulted in unacceptable rates of failure of

fixation and loss of reduction. More recently, there has been renewed inter-

est in limiting the amount of motion segments fused by adding anterior

column support. One of these methods involves supplementing posterior

SSPF with anterior calcium phosphate (CaP) cement through a transpedic-

ular approach (Vertebroplasty/Kyphoplasty �).

PURPOSE: The current study is aimed at investigating the differences in

stability between LSPF and SSPF. To our knowledge there has been no

biomechanical study comparing the performance of these treatments, espe-

cially in regards to adding anterior CaP in human cadavers. Our hypothesis

is that there is no significant change in the biomechanical properties of

cadaveric spines treated with SSPF and CaP when compared to LSPF.

STUDY DESIGN/SETTING: An In-vitro cadaveric study

ting and will be included with the post-meeting online content.