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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.
Edited by internationally recognized pain experts, this book offers 73 clinically relevant cases, accompanied by discussion in a question-and-answer format.
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.
Navigate the unique clinical issues involved in treating athletes who have spinal injuries. A team of peerless authorities in sports medicine share their unparalleled expertise in Spine Injuries in Athletes, published in partnership with the AAOS. This unique and practical clinical reference culls today’s best approaches for managing these injuries, optimizing function, and ensuring quick but safe return to play whenever possible.
An essential information source for all healthcare providers treating patients with cervical, thoracic and lumbar spine disease.
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.
Interpretation Basics of Cone Beam Computed Tomography is an easy-to-use guide to Cone Beam CT technology for general dental practitioners and dental students. It covers normal anatomy, common anatomical variants, and incidental findings that practitioners must be familiar with when interpreting CBCT scans. In addition to functioning as an identification guide, the book presents and discusses sample reports illustrating how to use this information in day-to-day clinical practice. Organized by anatomical regions, the book is easy to navigate and features multiple images of examples discussed. It also includes a valuable section on legal issues surrounding this new technology, essential for informed and appropriate use.
It is difficult to know what the true incidence of metastatic spinal cord compression (MSCC) is in England and Wales because the cases are not systematically recorded. However, evidence from an audit carried out in Scotland between 1997 and 1999 and from a published study from Ontario, Canada, suggests that the incidence may be up to 80 cases per million population per year. This would mean around 4000 cases per year in England and Wales or more than 100 cases per cancer network per year. The Clinical Resource and Audit Group (CRAG) audit clearly showed that there were significant delays from the time when patients first developed symptoms until hospital doctors and general practitioners recognised the possibility of spinal cord compression and made the appropriate referral. The median times from the onset of back pain and nerve root pain to referral were 3 months and 9 weeks respectively. As a result, 48% of patients were unable to walk at the time of diagnosis and of these the majority (67%) had recovered no function at 1 month. Of those walking unaided at the time of diagnosis (34%), 81% were able to walk (either alone or with aid) at 1 month. The ability to walk at diagnosis was also significantly related to overall survival. At present, relatively few patients with malignant spinal cord compression in the UK receive surgery for the condition. But research evidence suggests that early surgery may be more effective than radiotherapy in a selected subset of patients.
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.