{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T20:35:44Z","timestamp":1771706144633,"version":"3.50.1"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2008,1]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>An in vitro flexibility experiment was performed to compare the biomechanical stability of asymmetrical lumbar pedicle screw fixation (longer hardware attached ipsilaterally to a 1-sided lesion), short and long fixation, and fixation with and without interconnection to the involved vertebra.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Seven human cadaveric specimens (T12\u2013S1) were studied intact; after simulated unilateral lesions were created at L2\u20133 and L3-4, the segments were stabilized by 1) L2\u20134 unilateral fixation (L-3 excluded), 2) L2\u20134 bilateral fixation (L-3 included contralaterally), 3) L2\u20135 unilateral fixation (L-3 excluded), 4) L2\u20135 fixation ipsilateral (L-3 excluded) and L2\u20134 fixation contralateral (L-3 included), 5) L2\u20135 bilateral fixation (L-3 included contralaterally), and 6) L2\u20135 bilateral fixation (L-3 excluded). The testing order varied among specimens. Angular range of motion (ROM) and lax zone were recorded optically while loading to 6.0 Nm was created with nonconstraining pure moments.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Unilateral short fixation provided significantly worse stabilization than any other construct tested in all loading modes (p &lt; 0.05, repeated-measures analysis of variance). There was a mean 56% reduction in ROM across the lesion after adding 1 additional level rostrally and caudally. Asymmetrical long\/short stabilization provided similar stability to symmetrical long stabilization. Minimal additional stability was gained by including L-3 in the long bilateral fixation construct.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Unilateral fixation is inadequate for stabilizing a 2-level unilateral lesion. Bilateral fixation, whether symmetrical or asymmetrical, provides good stabilization for this injury. It is not important for stability to include the level of the lesion within the long construct contralaterally.<\/jats:p><\/jats:sec>","DOI":"10.3171\/spi-08\/01\/044","type":"journal-article","created":{"date-parts":[[2008,1,2]],"date-time":"2008-01-02T13:41:36Z","timestamp":1199281296000},"page":"44-51","source":"Crossref","is-referenced-by-count":52,"title":["Biomechanics of unilateral compared with bilateral lumbar pedicle screw fixation for stabilization of unilateral vertebral disease"],"prefix":"10.3171","volume":"8","author":[{"given":"Kemal","family":"Y\u00fccesoy","sequence":"first","affiliation":[{"name":"1Department of Neurosurgery, Dokuz Eyl\u00fcl \u00dcniversitesi, Izmir, Turkey;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Zafer","family":"Y\u00fcksel","sequence":"additional","affiliation":[{"name":"2Spinal Biomechanics Research Laboratory and"},{"name":"4Kahramanmara\u015f S\u00fct\u00e7\u00fc \u0130mam \u00dcniversitesi, Kahramanmara\u015f, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seungwon","family":"Baek","sequence":"additional","affiliation":[{"name":"2Spinal Biomechanics Research Laboratory and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Volker K. H.","family":"Sonntag","sequence":"additional","affiliation":[{"name":"3Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil R.","family":"Crawford","sequence":"additional","affiliation":[{"name":"2Spinal Biomechanics Research Laboratory and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0080044","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1097\/00007632-198912000-00019","volume":"14","author":"Ashman RB","year":"1989","journal-title":"Spine"},{"key":"b2-0080044","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1995.82.1.0011"},{"key":"b3-0080044","doi-asserted-by":"publisher","DOI":"10.1007\/BF01676569"},{"key":"b4-0080044","doi-asserted-by":"publisher","DOI":"10.1016\/S1529-9430(01)00116-4"},{"key":"b5-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000153703.80747.16"},{"key":"b6-0080044","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1097\/00007632-199408000-00003","volume":"19","author":"Craven TG","year":"1994","journal-title":"Spine"},{"key":"b7-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199510000-00005"},{"key":"b8-0080044","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/00007632-199703010-00020","volume":"22","author":"Crawford NR","year":"1997","journal-title":"Spine"},{"key":"b9-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199810000-00009"},{"key":"b10-0080044","doi-asserted-by":"publisher","DOI":"10.1016\/S0268-0033(98)00080-1"},{"key":"b11-0080044","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1136\/aim.22.3.152","volume":"22","author":"Daivajna S","year":"2004","journal-title":"Acupunct Med"},{"key":"b12-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199410000-00006"},{"key":"b13-0080044","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.134.3.7355209"},{"key":"b14-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199103001-00023"},{"key":"b15-0080044","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/00003086-197511000-00019","volume":"113","author":"Gore DR","year":"1975","journal-title":"Clin Orthop Relat Res"},{"key":"b16-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199304000-00002"},{"key":"b17-0080044","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-005-2816-8"},{"key":"b18-0080044","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1097\/00007632-198904000-00025","volume":"14","author":"Horowitch A","year":"1989","journal-title":"Spine"},{"key":"b19-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00002517-199203000-00006"},{"key":"b20-0080044","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1227\/00006123-198609000-00013","volume":"19","author":"Kjerulf TD","year":"1986","journal-title":"Neurosurgery"},{"issue":"3","key":"b21-0080044","doi-asserted-by":"crossref","first-page":"S84","DOI":"10.1097\/00007632-199103001-00014","volume":"16","author":"Krag MH","year":"1991","journal-title":"Spine"},{"key":"b22-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198409000-00007"},{"key":"b23-0080044","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/01241398-198601000-00009","volume":"6","author":"Letts M","year":"1986","journal-title":"J Pediatr Orthop"},{"key":"b24-0080044","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1097\/00007632-199610010-00009","volume":"21","author":"Lim TH","year":"1996","journal-title":"Spine"},{"key":"b25-0080044","first-page":"54","volume":"203","author":"Luque ER","year":"1986","journal-title":"Clin Orthop Relat Res"},{"key":"b26-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198909000-00003"},{"key":"b27-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199106001-00003"},{"key":"b28-0080044","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/00007632-199103000-00016","volume":"16","author":"Miki T","year":"1991","journal-title":"Spine"},{"key":"b29-0080044","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/BF00588079","volume":"36","author":"Motateanu M","year":"1994","journal-title":"Neuroradiology"},{"key":"b30-0080044","doi-asserted-by":"crossref","first-page":"2471","DOI":"10.1097\/00007632-199312000-00017","volume":"18","author":"Nagata H","year":"1993","journal-title":"Spine"},{"key":"b31-0080044","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1097\/00007632-200202010-00015","volume":"27","author":"Narlawar RS","year":"2002","journal-title":"Spine"},{"key":"b32-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198810000-00013"},{"key":"b33-0080044","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1097\/00007632-198810000-00014","volume":"13","author":"Panjabi MM","year":"1988","journal-title":"Spine"},{"key":"b34-0080044","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1227\/00006123-198204000-00011","volume":"10","author":"Reynolds AF","year":"1982","journal-title":"Neurosurgery"},{"key":"b35-0080044","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2004.04.007"},{"key":"b36-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199807150-00009"},{"key":"b37-0080044","doi-asserted-by":"publisher","DOI":"10.1080\/02688699844637"},{"key":"b38-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200007150-00017"},{"key":"b39-0080044","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.2.3.0298"},{"key":"b40-0080044","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199306150-00006"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/8\/1\/article-p44.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/8\/1\/article-p44.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T23:31:31Z","timestamp":1605310291000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/8\/1\/article-p44.xml"}},"subtitle":["Laboratory investigation"],"short-title":[],"issued":{"date-parts":[[2008,1]]},"references-count":40,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/spi-08\/01\/044","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2008,1]]}}}