{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:28:11Z","timestamp":1758817691171},"reference-count":26,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,10]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Despite the wide use of anterior cervical instrumentation in the management of multilevel cervical spondylosis, the incidences of pseudarthrosis and instrument-related failure remain high. The use of a dynamic implant may aid in the prevention of these complications. The purpose of this study was to evaluate the DOC dynamic cervical implant in the treatment of multilevel cervical spondylosis.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The authors evaluated 34 cases in which anterior multilevel cervical decompression and fusion were performed using the DOC Ventral Cervical Stabilization System. Postoperatively, and at each follow-up visit, the sagittal angle and the degree of subsidence that developed were measured. Fusion rates and clinical outcomes were also evaluated.<\/jats:p>\n<jats:p content-type=\"fine-print\">The mean postoperative sagittal angle was 14\u00b0 of lordosis. The mean change in the sagittal angle during the follow-up period was 0.4\u00b0 of lordosis. By 6 months postoperatively some subsidence had occurred in most patients, with no subsidence occurring in only 15%. By 3 months greater than or equal to 2 mm of subsidence was demonstrated in 61% of cases. The overall fusion rate was 91%. In the majority of patients (79%) symptoms were judged to be improved or resolved.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> The DOC dynamic cervical implant permitted controlled subsidence and prevented progression of kyphotic deformity. There was one construct failure (related to a motor vehicle accident) and an overall fusion rate of 91%. The DOC implant is a safe and effective cervical construct for multilevel spondylotic disease.<\/jats:p>","DOI":"10.3171\/spi.2002.97.3.0330","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:54:19Z","timestamp":1241711659000},"page":"330-336","source":"Crossref","is-referenced-by-count":7,"title":["Preliminary experience with the DOC dynamic cervical implant for the treatment of multilevel cervical spondylosis"],"prefix":"10.3171","volume":"97","author":[{"given":"Michael P.","family":"Steinmetz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Warbel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melvin","family":"Whitfield","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Bingaman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Biomechanics of Spine Stabilization.","first-page":"431","author":"Benzel","year":"2001"},{"key":"b2","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"206","DOI":"10.3171\/jns.1996.85.2.0206","article-title":"Anterior cervical interbody fusion using autogeneic and allogeneic bone graft substrate: a prospective comparative analysis.","volume":"85","author":"Bishop","year":"1996"},{"key":"b3","series-title":"Spine","doi-asserted-by":"publisher","first-page":"2040","DOI":"10.1097\/00007632-200008150-00007","article-title":"Three- and four-level anterior cervical discectomy and fusion with plate fixation: a prospective study.","volume":"25","author":"Bolesta","year":"2000"},{"key":"b4","series-title":"Spine","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1097\/00007632-198803000-00003","article-title":"Cervical stabilization by plate and bone fusion.","volume":"13","author":"Brown","year":"1988"},{"key":"b5","series-title":"J Spinal Disord","first-page":"202","article-title":"Anterior cervical fusion: outcome analysis of patients fused with and without anterior cervical plates.","volume":"9","author":"Connolly","year":"1996"},{"key":"b6","series-title":"Spine","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1097\/00007632-200004010-00005","article-title":"Anterior cervical plating reverses load transfer through multilevel strut-grafts.","volume":"25","author":"DiAngelo","year":"2000"},{"key":"b7","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"941","DOI":"10.2106\/00004623-199807000-00002","article-title":"Anterior cervical decompression and arthrodesis for the treatment of cervical spondylotic myelopathy. 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