Proceedings of the NASS 18 th Annual Meeting / The Spine Journal 3 (2003) 67S–171S 125S of 36 IDET procedures (25%). Success rates at 6-months and latest follow- up did not differ significantly between 1-level and 2-level treatments (p=0.285). No obese (n=3) patient had a successful outcome. Six of 33 patients (18%), all male, went on to spinal surgery within 12 months of failed IDET. Currently, 20 of 33 (61%) patients are still on active duty, while 8 of 33 (24%) patients were medically discharged specifically for their chronic low back pain. The remaining 5 soldiers have since separated or retired from the military. Despite the apparent low success rate, 73% (24 of 33 patients) reported they would undergo IDET again. DISCUSSION: This is a prospective case study of Intradiscal Electrother- mal Therapy (IDET) for the treatment of chronic discogenic low back pain (LBP) in an active duty population. Initial success, defined as 50% reduction in pain, at 6 months follow-up was 51%, whereas success at 24 month follow-up was only 24%. Further studies are needed to better define the role of IDET in the treatment of chronic discogenic LBP. CONCLUSIONS: At 6-month follow-up, the “success rate” from IDET was 51%; however, results diminished significantly with time (24% at 24 month follow-up). Additionally, one quarter of patients reported worsening of their symptoms and 18% went onto spinal surgery following IDET. Nonetheless, 61% of soldiers were able to continue on active duty and 73% would undergo the procedure again. Ultimately, long term prospective follow-up studies are needed to definitively determine the efficacy and role of IDET in the treatment of chronic discogenic low back pain. DISCLOSURES: Device or drug: intradiscal electrothermal therapy (IDET). Status: approved. CONFLICT OF INTEREST: Timothy Kuklo, MD, grant research sup- port: Medtronic Sofamor Danek. doi: 10.1016/S1529-9430(03)00301-2 P26. 3 to 6-year follow-up of stand-alone BAK cages implanted by a single surgeon Gavin Button, MS, MD 1 , Munish Gupta, MD 1 , Cinnie Barrett, RN, ONC 1 , Paul Cammack, MD 1 , Daniel Benson, MD 1 ; 1 University of California Davis Medical Center, Sacramento, CA, USA HYPOTHESIS: Controversy exists regarding the clinical success of stand- alone BAK cages for the treatment of low back degenerative disc disease and/or mild spondylolisthesis. The purpose of this study was to review the 3 to 6-year clinical outcomes of patients who underwent placement of stand-alone BAK cages by a single surgeon. METHODS: The charts of 46 consecutive patients who underwent anterior placement of BAK cages at one or two levels by a single surgeon over a three year period were retrospectively reviewed. Operative time, hospital length of stay, number of complications, and revision rate were determined. Patients were then contacted to determine their functional status(by Prolo and Oswestry scores), current pain level, and satisfaction with the procedure. RESULTS: Follow-up was available on 32 (70%) of 46 patients. At least 10 patients required revision surgery (9 for pseudarthrosis, 1 for improper cage placement). 10 patients had complications not requiring revision surgery. Four patients had an excellent outcome, 6 good, 4 fair, and 18 poor as assessed by the Prolo rating system. Nineteen patients were categorized to have at least “severe disability” according to the Oswestry outcome scale. 31% of contacted patients were dissatisfied with their outcome. DISCUSSION: This single-surgeon series of stand-alone BAK cages dem- onstrates significantly worse clinical outcomes than has been previously reported. Both revision and complication rates were found to be unaccept- ably high. A significant majority of patients had continued severe disability or poor outcomes as measured by two different rating scales. CONCLUSIONS: The use of stand-alone BAK cages for degenerative disc disease should be reconsidered given the large number of patients with unacceptable outcomes. DISCLOSURES: Device or drug: BAK cages. Status: approved. CONFLICT OF INTEREST: No conflicts. doi: 10.1016/S1529-9430(03)00302-4 P31. Posterior cervical stabilization/fusion using segmental screw-rod fixation: technique analysis and results in 52 patients Kaushik Das, MD 1,2 , Virany Hillard, MD 1,2 , Chiedozie Nwagwu, MD 1,2 , Ashok Anant, MD 1,2 , Raj Murali, MD 1,2 , Bennie Chiles, MD 1,2 ; 1 New York Medical College, Valhalla, NY, USA; 2 New York Medical College, New York, NY, USA HYPOTHESIS: Lateral mass plating is an established technique for stabili- zation/fusion of the subaxial cervical spine. Problems inherent in this tech- nique include, fixed slots in the plate to place the screws, and difficulty with bending the plate to accomodate distorted anatomy. These short coming can lead to misplaced screws, and often having to skip a level. We propose segmental screw-rod fixation improves the technique of posterior cervical stabilization by addressing some of these issues and is effective in main- taining long term alignment. METHODS: Records and radiographs of 52 patients (40 male, 12 female, mean age 49 years) undergoing stabilization/fusion of the posterior cervical spine over a 24-month period were reviewed. The initial postoperative alignment of the cervical spine was measured and recorded by drawing a parallel line along the endplate of the most cephalad fixated vertebrate and along the inferior endplate of the most caudal fixated vertebrate. A perpendicular line was made from each and the angle was recorded in degrees of kyphosis or lordosis. The results were compared to xrays done at 6 weeks , 3 months, 6 months and after more than 12 months. RESULTS: Indications for surgical stabilization/fusion were varied. Sixty- three percent (63%) had multi-level degenerative disease, 29% had post- traumatic instability, and 8% had metastatic tumors. In total, 376 screws were placed with no malpositions resulting in vertebral artery injury or neurologic deficit. Follow-up ranged from 6 to 27 months(mean 16 mos) During the follow up period there were no instances of screw migration/ breakage. The degrees of kyphosis or lordosis changed less than 5 degrees in all cases except one. That patient had breakdown of the vertebral body at the cephalad end of the construct. No other patient developed new clinical symptoms during the follow up period. No changes were seen in the alignment of the cervical spine in patients after 6 months. The small initial changes in the overall alignment were not associated with any clinical symptoms and most often occurred between initial xray and the 6 week xray. DISCUSSION: The screw-rod construct is a newer system that offers the biomechanical advantages of lateral mass screws yet addresses the potential shortcomings of plates especially in patients with complex spinal abnormali- ties. Most notably, screw-rod systems allow for the initial placement of screws, after which the rods are contoured to conform to the screws. Compression or distraction can be applied as needed to correct deformi- ties. Although the efficacy of first-generation screw-rod constructs has been demonstrated difficulties can occur when contouring a rod to attach to screws through a side loading fixed angle connectors. Second-generation systems, such as the one described in our series, address this issue by incorporating polyaxial connectors that allow a rod to be affixed to a screw at any medial-to-lateral orientation. Rods can much easily be contoured in both the sagittal and coronal plane when compared to plates. CONCLUSIONS: Posterior fixation of the cervical spine with lateral mass screws and rods is an effective technique that can be utilized to treat cervical spine instability caused by a variety of conditions.The advantages of the system include, the ability to place more points of fixation even in cases of distorted anatomy, restoration anatomical alignment in the sagittal and coronal planes, and a biomechanically stronger construct which main- tains cervical alignment. DISCLOSURES: No disclosures. CONFLICT OF INTEREST: No conflicts. doi: 10.1016/S1529-9430(03)00303-6 P36. Comparison of four tests of quadriceps strength in L3 or L4 radiculopathies James Rainville, MD 1 , Cristin Jouve, MD 1 , Janet Limke, MD 1 , Mark Finno, MD 1 ; 1 New England Baptist Hospital, Boston, MA, USA