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Degenerative disorders of the cervical spine are among the more common reasons why patients seek medical attention or consult with a spine specialist. These conditions can lead to neck pain and/or neurological deficit that can significantly compromise an individual’s quality of life. Despite the regularity of these conditions, there remains both uncertainty and controversy regarding optimal management. No standard of care exists, however there are nuances related to a patients history, clinical presentation, and imaging that may make one approach more conducive to clinical success. This text is intended to serve as a comprehensive, up-to-date resource for clinicians involved in the management of patients with cervical degenerative disease. The text is divided into sections, organized in a clinically strategic manner. The initial chapters address the basics of cervical spine anatomy and biomechanics as well as the pathophysiology leading to various cervical degenerative disorders and the possible neurological sequelae. Subsequent chapters outline characteristics of the clinical presentation and the various diagnostic modalities to evaluate these patients. Key elements involved in the surgical-decision making process are covered, providing the necessary elements to establish a solid foundation for treatment planning. The final sections discusses specific procedures; including traditional approaches as well as more recent developments such as motion preservation surgery and minimally invasive techniques. The last section focuses on challenging clinical scenarios that require advanced surgical consideration. Individual chapters are organized with an introductory outline containing key chapter elements. Chapters focusing on specific pathological entities include discussions regarding pathophysiology, genetics, and risk factors. Those describing surgical procedures include a discussion on indications/contraindications, pre-operative planning, surgical technique, post-operative care, and complication avoidance. Chapter authors present their personal experience enhancing the information from current, evidence-based, referenced material. When appropriate, case presentations are added to provide a practical application of chapter’s key points. This text, based on relevant, up-to-date clinical information and the cumulative experience of current spine experts, offers physicians the necessary tools involved in the decision-making process to formulate the optimal treatment plan for an individual patient. In addition, identification of knowledge gaps will hopefully stimulate future research and the evolution of cervical spondylotic treatments.
Clinical research presents health care providers with information on the natural history and clinical presentations of disease as well as diagnostic and treatment options. In today's healthcare system, patients, physicians, clinicians and family caregivers often lack the sufficient scientific data and evidence they need to determine the best course of treatment for the patients' medical conditions. Initial National Priorities for Comparative Effectiveness Research(CER) is designed to fill this knowledge gap by assisting patients and healthcare providers across diverse settings in making more informed decisions. In this 2009 report, the Institute of Medicine's Committee on Comparative Effectiveness Research Prioritization establishes a working definition of CER, develops a priority list of research topics, and identifies the necessary requirements to support a robust and sustainable CER enterprise. As part of the 2009 American Recovery and Reinvestment Act, Congress appropriated $1.1 billion in federal support of CER, reflecting legislators' belief that better decisions about the use of health care could improve the public's health and reduce the cost of care. The Committee on Comparative Effectiveness Research Prioritization was successful in preparing a list 100 top priority CER topics and 10 recommendations for best practices in the field.
Cervical laminoplasty for the treatment of ossification of the posterior longitudinal ligament was developed and refined in Japan during the 1970s. Since that time, various cervical laminoplasty techniques have been further analyzed and modified, and have proven to be clinically successful. Until now cervical laminoplasty has been practiced primarily in Japan, and surgeons outside Japan had only limited access to the detailed English literature needed to make full use of the procedures. This book fills that gap in English information and provides a detailed, up-to-date guide to performing safe and effective cervical laminoplasty. Drawing on the latest knowledge from Japan, the book covers the history of cervical laminoplasty, surgical anatomy, basic procedures, modified procedures, possible complications, and perspectives on the future of expansive laminoplasty. This volume by leaders in the field is an excellent guide for all surgeons interested in laminoplasty.
Using illustrative clinical cases, this volume in the Problem-Based Learning series reviews key topics in Anesthesia frequently encountered in clinical practice and on examinations. It highlights practical issues that arise in the operating room and solutions for them. With real-world clinical cases and discussion questions that guide case progression, this book facilitates both individual and small-group learning. Each case is further broken down to include additional related subtopics for maximum yield. Evidence-based reviews and multiple-choice self-assessment questions follow each case, making this book ideal for continuing education in anesthesia for the generalist and specialist practitioner. Teachers and trainees in anesthesiology will take advantage of this book's features for targeted teaching, learning, and retention.
Quantitative MRI of the Spinal Cord is the first book focused on quantitative MRI techniques with specific application to the human spinal cord. This work includes coverage of diffusion-weighted imaging, magnetization transfer imaging, relaxometry, functional MRI, and spectroscopy. Although these methods have been successfully used in the brain for the past 20 years, their application in the spinal cord remains problematic due to important acquisition challenges (such as small cross-sectional size, motion, and susceptibility artifacts). To date, there is no consensus on how to apply these techniques; this book reviews and synthesizes state-of-the-art methods so users can successfully apply them to the spinal cord. Quantitative MRI of the Spinal Cord introduces the theory behind each quantitative technique, reviews each theory's applications in the human spinal cord and describes its pros and cons, and suggests a simple protocol for applying each quantitative technique to the spinal cord. - Chapters authored by international experts in the field of MRI of the spinal cord - Contains "cooking recipes—examples of imaging parameters for each quantitative technique—designed to aid researchers and clinicians in using them in practice - Ideal for clinical settings
The aim of this book is to provide clinicians and medical students with basic knowledge of the most common neurosurgical disorders. There is a vast array of signs and symptoms that every clinician should recognize as neurosurgical affectations, allowing them to identify when to refer the patient to a neurosurgeon. In this text, the editors intend to bridge the gap between clinical medicine and neurosurgery, making neurosurgical practice understandable to a wider medical public. The book provides a smooth transition from neuroanatomy, neurophysiology and neurological examination to neurosurgery, focusing more on the knowledge underlying neurosurgical practice rather than on surgical technique. The core of the book is composed of chapters discussing each of the most important medical conditions that deserve neurosurgical intervention, providing key information on diagnosis, clinical aspects, disease management, surgical procedures and prognosis. Moreover, complementary discussion of the frontiers and advances in neurosurgery are also covered. In this sense, this book has two main goals and intended audiences. First, and primarily, it is intended for clinicians in a wide array of non-surgical medical specialties (such as general practitioners, neurologists, pediatricians, oncologists and others) aiming to give an overview on important characteristics and initial management of the most prevalent disorders treated by neurosurgeons. Second, and to a lesser degree, it is intended to be used as a practical guide for medical students who are initiating their study in neurosurgical sciences. Fundamentals of Neurosurgery – A Guide for Clinicians and Medical Students intends to be a comprehensive guide for all non-neurosurgeons who want to broaden their knowledge of neurosurgery.
The earliest human known to have the capability of walking erect on two legs is Sahelanphropus, who lived 6 million years ago. The ability to stand erect led to required extensive changes in the human skeleton, including significant changes in the cervical spine. In modern humans, the cervical spine holds the head upright and gives it great mobility. The combination of great mobility in this spinal segment combined with the requirement that it carry significant weight makes the cervical spine susceptible to a wide variety of pathologies. The cervical spine not only supports the head upright, but acts as a channel for the full set of neural elements connecting the brain with all near and distant parts of the body; thus, pathologies involving the spinal column in this segment directly affect the cervical spinal cord and exiting nerve roots. Today, excellence in spine surgery requires a thorough understanding of spinal anatomy, relevant neurology, and biomechanics, as well as skilled use of a variety of surgical techniques. The surgeon must master the ability to effectively select from a wide and constantly changing variety of alternative instrumentations and surgical approaches. In addition, the trend towards reducing the invasiveness of surgical procedures has led to the use of smaller and smaller tools and smaller surgical incisions with more limited views of the relevant anatomy. As a result of the rapid pace of change, the choice of an optimal technique in any given situation is increasingly complex. In this book, we begin with a basic review of anatomy, neurology, neurophysiology, and biomechanics. We also discuss clinical and radiological assessment required for a differential diagnosis, and present a thorough discussion of the importance of sagittal alignment of the spine and the utility of gait analysis. We proceed with a thorough discussion of nontraumatic pathologies causing cervical myelopathy, beginning with the craniocervical junction down through the subaxial spine, in pediatric and adult populations. This discussion includes steps in the differential diagnosis for specific pathologies, surgical techniques and nuances, radiation-based treatment alternatives, and special topics ranging from the use of stem cells to robotics and endoscopic surgery.We have attempted to provide both fundamental and state-of-the-art knowledge and to share the rich experience of some of the leading spine surgeons worldwide, with the aim of enabling surgeons at all levels to advance their own capabilities for performing safe and successful procedures in this area of complex anatomy.
Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. This is an easily readable teaching tool focusing on fundamentals and basic principles and provides a homogeneous syllabus with a consistent didactic strategy. The chosen didactic concept highlights and repeats core messages throughout the chapters. This textbook, with its appealing layout, will inspire and stimulate the reader for the study of spinal disorders.
This is a quick-reference resource covering the most common acute orthopedic injuries. Including bulleted text and easy-to-follow algorithms, protocols, and images, this “pocket consultant” provides the most up-to-date information when you need it most. Organized anatomically for fast reference, each chapter is broken down into the most common and most serious injuries with tips on how to evaluate and treat adult and pediatric patients. Each injury pattern discussed includes a brief description covering what to ask, what to bring, what to request, what to test, what to look for, and how to further evaluate. The contributing authors are senior orthopedic surgery residents at a major Level-1 Trauma Center who have experience managing a high volume of orthopedic injuries and who have trained many young residents. Covering all aspects of acute care, The Orthopedic Consult Survival Guide is an indispensable tool for medical students, residents, fellows, attendings , and affiliated providers in orthopedic surgery, emergency medicine, and surgery caring for orthopedic patients in emergency rooms, urgent care centers, and primary practice settings.
Edited by internationally recognized pain experts, this book offers 73 clinically relevant cases, accompanied by discussion in a question-and-answer format.