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Updated: Jun 6, 2026

Sit-to-stand-and-walk from 120% Knee Height: A Novel Approach to Assess Dynamic Postural Control Independent of Lead-limb
Published on: August 30, 2016
[Dynamic posterior stabilization with the cosmic system]
1Orthopädische Abteilung, Landeskrankenhaus Feldkirch, Feldkirch, Österreich. orthopaedie@lkhf.at
Objective:
Stabilization of unstable motion segments with a stable but non-rigid implant system without an additional spondylodesis.
Indications:
Neurogenic claudication with instability; discogenic pain; in combination with a fusion (hybrid technique); elongation of a preexisting fusion; second recurrence of a herniated disk.
Contraindications:
Increased instability; correction and reduction; instrumentation of more than three levels.
Surgical Technique:
Muscle-sparing approach to the posterior lumbar spine under anteroposterior and lateral image control. Use of special instruments with a slotted sleeve connected to the screw head for rod implantation. Alternatively: conventional midline approach with detachment of muscles from the posterior spine.
Postoperative Management:
Mobilization on the day after surgery. Limited physical activities and no work load for 6 weeks.
Results:
In 139 patients (77 females, 62 males, average age 55 years) with a follow-up of 2 years, Oswestry score improved from 49.0% preoperatively to 22.5% and VAS (visual analog scale) from 7.3 preoperatively to 2.5 after 2 years. No change of the lordosis. Eleven revisions (7.9%). Two broken screws (0.3%) and 17 screws (2.5%) with a radiolucent halo.
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