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The desire to expose the spine for surgery by anterior approaches at any level between the head and the sacrum is not new. Spinal pathology is often located anterior to the spinal cord and nerve roots in the cervical and thoracic spine, and anterior to the peripheral nerves that emerge from the lumbosacral spine below the first lumbar ver tebra. To treat such pathology one prefers to expose the front of the spine directly and widely enough to eradicate the pathology and to have full control of bleeding throughout the procedure. The posterior elements of the spine are important for mechanical stability of the spine, and therefore for the protection of the neural and vascular structures in the spine that would be threatened by instability. Extensive eradication of pathology posterior to the spinal canal and the intervertebral foraminae, including the transverse processes, may leave no adequate bony bed for the surgical creation of a stabilizing osseous fusion. In such a situation, an anterior fusion procedure is the only viable alternative to a posterior or posterolateral fusion. In situations where it is critically important to obtain a stable fusion, as in tuberculosis of the spine, both an anterior and a posterior fusion operation at the same motion segments is, in almost every instance, a guarantee of a stable osseous fusion. One should know both approaches.
This new edition contains chapters on very complicated, large procedures such as the approaches to the sacrum and the pelvis, and also includes minimally invasive procedures like laparoscopic fusion. Minimally invasive surgery is the future of spinal surgery; this book is unrivaled in its coverage of these procedures. This edition also continues the tradition of presenting clearly enumerated and illustrated step-by-step surgical procedures for the spine. New to this edition are chapters on the anterior approach to clivus C1 & C2, transclavicular cervico-thoracic approach, transsternal approach to the cervico thoracic & upper thoracic spine, approaches to the sacrum & pelvis, and laparoscopic approaches. Other new features include: new material on large major resection of spinal cancer; the most modern endoscopic techniques ; and expanded laproscopic/MIS approaches. Contributors are top authorities in the field. Procedures are beautifully illustrated in full color.
In this comprehensive and original monograph, Professor Rene Louis presents in minute detail in one volume the gross anatomy, nerve supply, biomechanics, and microcirculation of the spine. He also presents the surgical approaches to the vertebral bodies and their contents. Professor Louis is a great anatomist and this book has been prepared from his personal observations, both anatomical and surgical. His studies have been meticulously conducted and contain much original research, for instance his work on the motion of the neural elements within the lumbar vertebral canal. The illustrations are neady all original and very often a photograph of the neural or vascular elements is presented alongside a drawing of a given important anatomical area. For all these reasons, this inspiring treatise makes a valuable contri bution to our knowledge of the spine and forms a basis for an under standing of the intricacies of surgical anatomy and approaches. It will be especially valuable to the spinal surgeon, but the medical student, the orthopedic resident (or registrar), and the anatomist will also find it extremely useful. Leon L. Wiltse, M.D.
Offering in-depth coverage of an often-neglected topic, Revision Lumbar Spine Surgery identifies clinical problems and discusses recent major advances in this challenging area. Dr. Robert F. Heary and a team of international experts share their knowledge and experience with even the most difficult lumbar cases, helping you provide optimal outcomes for your patients. You'll find authoritative guidance on indications, diagnosis, approaches, and follow-up, with a focus on the significant advances that have occurred over the past two decades in this fast-changing field. - Identifies the clinical problems related to unsuccessful back spine surgery as well as indications, diagnosis, and new treatment options and advances in this complex area. - Provides in-depth information on the multiple options that exist for most clinical situations: anterior, posterior, lateral, and combined anterior and posterior approaches. - Covers methods of fixation, the use of interbody grafting, and surgical planning related to scar tissues, bleeding, and spinal fluid leaks. - Discusses critical follow-up topics such as key clinical procedures, radiography, patient reported outcomes, and pain management. - Includes timely chapters on robotics, bone density issues, medical fitness concerns, instrumentation options, imaging considerations, and much more.
This video atlas covers a broad range of spinal surgical procedures. The volume includes a collection of high quality 3-to-8 minute videos of some of the most critical spine operations performed by internationally renowned expert surgeons. Key features of the book contents include: o Downloadable high quality video content with subtitles suitable for viewing on any display (A brief preview of the book content can be viewed at https://www.youtube.com/watch?v=SxMi4UFj7HA ) o Detailed descriptions of surgical indications, preoperative planning, patient positioning, surgical technique, complications, postoperative care and outcomes for each procedure o Full color images and illustrations highlighting different key stages of each surgical technique The video format allows skill development of its intended audience by conveying temporal and spatial details which often go unnoticed in photograph format. This volume will be of immense interest to both the novice and the experienced spinal surgeon as they can benefit from the visual guides presented in the book. It also serves as an ideal teaching tool for spine surgery units in medical schools.
The ultimate resource for learning and mastering minimally invasive spine surgery techniques An estimated 1.5 million instrumented spinal procedures are performed every year in the US. The majority of decompressions and about 50% of fusion procedures can be performed completely or partially using minimally invasive spine surgery (MISS) techniques. The full potential of MISS techniques has yet to be realized. Essential Step-by-Step Techniques for Minimally Invasive Spinal Surgery by internationally renowned MISS neurosurgeon Roger Härtl, spine-neurosurgeon Rodrigo Navarro-Ramirez, and an impressive group of global multidisciplinary contributors is the most comprehensive and detailed textbook written to date on this topic. The foundation of the book is built on six interacting principles critical to surgical success, and MISS in particular: Target, Technology, Technique, Teaching and Training, Testing, and Talent. The text starts with an opening chapter on the definition of MISS and introduction of these principles. Fifty-six subsequent chapters provide a comprehensive discussion on how to utilize an MISS approach for a full spectrum of spinal pathologies using nuanced variations specific to the operating surgeon. To ensure readers are well versed in all aspects of MISS, these chapters include painstaking details on indications, contraindications, pathoanatomy, operating room set-up, step-by-step techniques, and postoperative management. Key Highlights Contributions from master spine surgeons across the world provide a balanced global perspective on mastering and incorporating diverse techniques into practice Invaluable clinical pearls including tips/tricks and complication avoidance High-quality images, figures, anatomic drawings, and imaging studies illustrate relevant anatomic approaches and corridors and delineate why anatomic mastery is critical to MISS Twenty-five videos enhance the ability to learn and implement MISS approaches This is a must-have resource for practicing spine surgeons interested in MISS who wish to learn the latest techniques from master surgeons and achieve optimal patient outcomes. The text and videos also provide a robust training tool for senior-level orthopaedic and neurosurgery residents and spine fellows.
Best Evidence for Spine Surgery provides representative cases that help you determine the optimal surgical interventions for your patients. Drs. Rahul Jandial and Steven R. Garfin, and a balanced team of preeminent neurosurgeons and orthopaedists, address the trend toward a more collaborative approach between spine and orthopaedic surgery. This easy-to-read, evidence-based resource also features "Tips from the masters" for a quick review of important elements of diagnosis and treatment. Choose the best options for your patients using evidence that supports the optimal surgical intervention for each case. Apply a multi-disciplinary approach through coverage that reflects the changing nature of the specialty with chapters written by neurosurgeons and orthopaedists. Quickly review the most important elements of diagnosis through "Tips from the masters." Easily find the information you need with a consistent, case-based format that clearly presents evidence and techniques.
This book is a superbly illustrated guide to the latest endoscopic approaches employed in surgery to the lumbar spine. In the past, spinal endoscopic surgeries have been performed mainly in the treatment of lumbar disc herniation, but indications have now expanded owing to breakthroughs in surgical methods and instruments. Furthermore, in addition to the traditional percutaneous transforaminal approach, various other approaches are now feasible, including the posterior, paraspinal, transpedicular, and contralateral. This book describes and illustrates the full array of approaches in indications including lumbar central stenosis, lumbar foraminal stenosis, and lumbar disc herniation. Detailed guidance is also provided on endoscopic lumbar interbody fusion, covering the oblique, uniportal, and biportal approaches. Supplementary surgical videos further facilitate understanding and execution of the described procedures. Written by expert spinal endoscopy surgeons with extensive practical experience and a record of academic achievement, the book will be an ideal aid for spine surgeons at all levels of experience.
Spinal surgeons treat spinal trauma patients on a regular basis in their hospital emergency rooms. This well-illustrated, hands-on guide to the many surgical techniques required in these situations provides a solid basis for the management of spinal trauma.
Spinal osteotomy techniques have been dramatically applied as a standard method for severe and rigid spinal deformity. Although clinical results indicate that patients who undergo osteotomy procedures typically experience well deformity correction and ameliorate the clinical appearance, aggressive peri-operative risks and follow-up complications are not rare. More meticulous and standard indication selection, osteotomy plan design and complication prevention strategy and outcome evaluation are critically needed for surgeon majored in spine deformity. The book Spinal Osteotomy is divided into sections that focus on principles of spinal osteotomy, technical and case illustration and outcomes and complications as well as computer navigation and other latest techniques. Each section is heavily illustrated and clearly written for ease of understanding. Orthopedic surgeons, neurosurgeon residents and fellows who want to focus on spinal deformity correction will find this instructive and invaluable.