{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:02:39Z","timestamp":1777658559881,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,2,11]],"date-time":"2015-02-11T00:00:00Z","timestamp":1423612800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>In vitro testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether long cervical and cervicothoracic fusions increase the intradiscal pressure at the adjacent caudal disk and to determine which thoracic end vertebra causes the least increase in the adjacent-level intradiscal pressure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A bending moment was applied to six cadaveric cervicothoracic spine specimens with intact rib cages. Intradiscal pressures were recorded from C7\u2013T1 to T9\u201310 before and after simulated fusion by anterior cervical plating and posterior thoracic pedicle screw constructs. The changes in the intradiscal pressure from baseline were calculated and compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No significant differences where found when the changes of the juxtafusion intradiscal pressure at each level were compared for the flexion, extension, and left and right bending simulations. However, combining the pressures for all directions of bending at each level demonstrated a decrease in the pressures at the T2\u2013T3 level. Exploratory analysis comparing changes in the pressure at T2\u2013T3 to other levels showed a significant decrease in the pressures at this level ( p\u2009=\u20090.005).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on the combined intradiscal pressures alone it may be advantageous to end long constructs spanning the cervicothoracic junction at the T2 level if there are no other mitigating factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1055\/s-0035-1546418","type":"journal-article","created":{"date-parts":[[2015,2,11]],"date-time":"2015-02-11T18:40:43Z","timestamp":1423680043000},"page":"282-286","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Biomechanical Determination of Distal Level for Fusions across the Cervicothoracic Junction"],"prefix":"10.1177","volume":"5","author":[{"given":"Ivan","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric B.","family":"Sundberg","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Iezza","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, California, United States"},{"name":"Redwood Orthopaedic Surgery Associates, Santa Rosa, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek P.","family":"Lindsey","sequence":"additional","affiliation":[{"name":"Bone and Joint Rehabilitation R&D Center, The Veterans Administration Health Care System, Palo Alto, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Daniel","family":"Riew","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University in St. Louis, Saint Louis, Missouri, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,2,11]]},"reference":[{"key":"bibr1-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199904000-00009"},{"key":"bibr2-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199210001-00014"},{"key":"bibr3-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31828ce774"},{"key":"bibr4-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1298610"},{"key":"bibr5-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-012-2613-4"},{"key":"bibr6-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-21-01-3"},{"key":"bibr7-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31826cb2d6"},{"key":"bibr8-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200211150-00003"},{"key":"bibr9-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.3171\/SPI-07\/09\/336"},{"key":"bibr10-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000180478.96494.88"},{"key":"bibr11-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000109983.12113.9B"},{"key":"bibr12-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31826cef01"},{"key":"bibr13-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31826d60fb"},{"key":"bibr14-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.3171\/2011.10.SPINE11116"},{"key":"bibr15-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000257577.70576.07"},{"key":"bibr16-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2011.07.010"},{"key":"bibr17-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199506000-00022"},{"key":"bibr18-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199812010-00007"},{"key":"bibr19-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199411001-00011"},{"key":"bibr20-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000190453.46472.08"},{"key":"bibr21-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2003.07.002"},{"key":"bibr22-s-0035-1546418","doi-asserted-by":"publisher","DOI":"10.3171\/2009.12.SPINE09123"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1055\/s-0035-1546418","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1055\/s-0035-1546418","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1055\/s-0035-1546418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:14:44Z","timestamp":1777446884000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1055\/s-0035-1546418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,11]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1055\/s-0035-1546418"],"URL":"https:\/\/doi.org\/10.1055\/s-0035-1546418","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,11]]}}}