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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6011_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •The Comprehensive Treatment of the Aging Spine
- •Contributors
- •Preface
- •INTRODUCTION
- •GASTRULATION
- •SOMITE PERIOD
- •ASSOCIATED ANOMALIES
- •CONGENITAL SPINAL ANOMALIES
- •Defects of Formation
- •Defects of Segmentation
- •CONCLUSION
- •References
- •THE VERTEBRAE
- •Cervical Vertebrae
- •Thoracic Vertebrae
- •Lumbosacral Spine
- •INTERVERTEBRAL DISC
- •LIGAMENTS
- •Intraspinal Ligaments
- •THE NERVE ROOTS
- •THE INTERVERTEBRAL FORAMEN
- •INNERVATION OF THE SPINE
- •NUTRITIONAL SUPPORT FOR THE VERTEBRA AND DISC
- •MUSCULAR ANATOMY
- •PATHOLOGIC CHANGES IN AGING
- •Spinal Stenosis
- •Spondylolisthesis
- •Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- •Degenerative Scoliosis and Kyphosis
- •UPPER CERVICAL SPINE
- •NEURAL DEVELOPMENT
- •SACRUM AND CONUS MEDULLARIS DEVELOPMENT
- •References
- •INTRODUCTION
- •INTERVERTEBRAL Disk
- •VERTEBRAL BODIES
- •FACET JOINTS
- •MUSCLES AND LIGAMENTS
- •SUMMARY
- •References
- •NATURAL HISTORY OF THE DEGENERATIVE CASCADE
- •ANATOMY AND GENERAL MECHANISMS OF PAIN
- •PATHOGENESIS OF LUMBAR DEGENERATION
- •BIOCHEMICAL CHANGES
- •BIOMECHANICAL CHANGES
- •THE THREE STAGES OF INSTABILITY
- •CLINICAL INSTABILITY AND DIAGNOSTIC IMAGING
- •CONCLUSION
- •References
- •INTRODUCTION
- •PAST MEDICAL HISTORY
- •Congenital/Familial/Genetic
- •Occupational/Environmental/Psychological
- •Comorbidities
- •HISTORY
- •Origin of Pain
- •Neurological History
- •Past Surgical History
- •PHYSICAL EXAMINATION
- •Global Balance
- •Gait
- •Neurological
- •C5 Neurological Findings
- •C6 Neurological Findings
- •C7 Neurological Findings
- •C8 Neurological Findings
- •T1 Neurological Findings
- •Thoracic and Abdominal Neurological Findings
- •T12 to L3 Neurological Findings
- •L2 to L4 Neurological Findings
- •L4 Neurological Findings
- •L5 Neurological Findings
- •S1 Neurological Findings
- •S2-4 Neurological Findings
- •Vascular
- •Summary
- •INTRODUCTION
- •NUTRITION
- •OBESITY
- •EXERCISE
- •SUMMARY
- •References
- •INTRODUCTION AND OVERVIEW
- •UNDERSTANDING THE PATIENT’S PERSPECTIVE
- •WESTERN PERSPECTIVES ON THE PSYCHOLOGY OF AGING
- •WESTERN PERSPECTIVES ON MANAGING THE AGING PROCESS
- •EASTERN PERSPECTIVES ON MEDICINE AND PSYCHOLOGY
- •AYURVEDA: TRADITIONAL INDIAN MEDICINE
- •Magnetic Resonance Imaging and Modic Changes in 40-Year-Old Men and Women
- •References
- •AYURVEDIC PERSPECTIVES ON AGING
- •AYURVEDIC PERSPECTIVES ON MANAGING THE AGING PROCESS WITH RESPECT TO BONE
- •CONCLUSION
- •References
- •INTRODUCTION
- •AGING AND DEGENERATIVE CHANGES ON THE EFFECTS OF BIOMECHANICAL RANGE OF MOTION
- •ASSESSING ANATOMICAL CHANGES
- •OSTEOPOROSIS, AGING, AND BIOMECHANICAL PROPERTIES
- •BMD AND IMPLICATIONS ON INSTRUMENTED PROCEDURES
- •DUAL ENERGY X-RAY ABSORPTIOMETRY AND MECHANICAL STRENGTH
- •MODIC CLASSIFICATION OF VERTEBRAL ENDPLATE CHANGE
- •INTRODUCTION
- •BASIC SCIENCE
- •Aging of the Spine
- •Finite Element Analysis of CT Scans — Biomechanical Computed Tomography
- •CLINICAL PRACTICE GUIDELINES
- •CLINICAL CASE EXAMPLES
- •Comparing Teriparatide and Alendronate for Treatment of Osteoporosis
- •Alendronate Treatment in Rheumatoid Arthritic Patients
- •Assessing Risk of Vertebral Fracture in Postmenopausal Women
- •DISCUSSION
- •Acknowledgements
- •References
- •AN INTRODUCTION TO FUNCTIONAL DIAGNOSTICS OF THE SPINE
- •THE CURRENT STATE OF THE ART: DIAGNOSTIC EFFICACY OF TODAY’S FUNCTIONAL TESTING METHOD
- •Range of Motion (RoM) Measurements
- •Measurement Variability in Range of Motion (RoM) Measurements
- •Using Normative IVA Data to Detect Normal Motion, Hypomobility, and Hypermobility
- •Conclusions: Implications for the Practitioner Regarding the Clinical Application of RoM Measurements
- •TECHNOLOGICAL ADVANCES THAT IMPROVE THE DIAGNOSTIC EFFICACY OF SPINAL FUNCTIONAL TESTING
- •Reducing IVA Observer-Related Variability by Improving the Reliability of Image Analysis Techniques
- •Reducing the Subject-Related IVA Variability Introduced through Uncontrolled BendingDuring Imaging
- •NEW INSIGHTS INTO THE BIOMECHANICS OF THE AGING SPINE
- •Physiologic Variation in sIVA among Normal Subjects Is Very Low
- •Rethinking the Conventional Wisdom Regarding Intervertebral Hypomobility and Age
- •SUGGESTIONS FOR THE CLINICAL USE OF FUNCTIONAL TESTING METHODS
- •Suggestions Regarding the Clinical Use of the Current Standard of Care
- •Suggestions Regarding the Clinical Use of Recently Developed Methods for Conducting Functional Testing of the Spine
- •References
- •INTRODUCTION
- •PREMATURE AGING FACTORS
- •Biochemical
- •Biomechanical
- •Atherosclerosis
- •Lifestyle Factors
- •Smoking
- •Obesity
- •Genetic Factors
- •DISCUSSION
- •CLINICAL RELEVANCE
- •References
- •PHYSIOLOGY OF BONE REMODELING AND BONE TURNOVER
- •DIAGNOSIS OF OSTEOPOROSIS
- •EVALUATION FOR OSTEOPOROSIS
- •Screening for Osteoporosis with Bone Mineral Density Measurement
- •Laboratory Investigations for Osteoporosis
- •Evaluation for Secondary Osteoporosis
- •Assess for Risk of Falls and Fractures
- •TREATMENT IN OSTEOPOROSIS
- •Nonpharmacologic Treatment
- •Calcium and Vitamin D Supplementation
- •Pharmacologic Treatment
- •Antiresorptive Agents
- •Anabolic Agents
- •Pharmacologic Agents and Spinal Fusion
- •FUTURE DIRECTIONS
- •SUMMARY
- •References
- •CLINICAL CASE EXAMPLES
- •Clinical Case #1 (Degenerative Lumbar Spondylolisthesis)
- •Clinical Case #2 (Degenerative Cervical Spondylosis)
- •Clinical Case #3 (Atlantoaxial Instability)
- •BASIC SCIENCE
- •EPIDEMIOLOGY AND RISK FACTORS
- •PATHOPHYSIOLOGY
- •DEGENERATIVE MECHANICS
- •NATURAL HISTORY
- •CLINICAL PRACTICE GUIDELINES
- •Evaluation
- •Conservative Therapy
- •Operative Therapy
- •Neurological Decompression
- •Instrumented Spinal Fusion
- •Minimally Invasive Alternatives
- •CLINICAL CASE EXAMPLES
- •Discuss Treatment, Clinical Challenges, and Future Treatments
- •CONCLUSIONS AND DISCUSSION
- •References
- •CLINICAL CASE EXAMPLE
- •BASIC SCIENCE
- •CLINICAL PRACTICE GUIDELINES
- •Surgery
- •CONCLUSIONS AND DISCUSSION
- •Acknowledgments
- •References
- •PART ONE: UNDERSTANDING THE CONDITION
- •Pathophysiology
- •Epidemiology
- •Natural History
- •PART TWO: CLINICAL DECISION MAKING
- •Evaluation
- •Imaging Studies
- •Elderly
- •Multiple Comorbidities
- •Osteoporosis
- •Indications for Fusion
- •Lateral Listhesis
- •Axial Pain
- •Nonfusion Decision Making
- •PART THREE: MANAGEMENT
- •Nonsurgical
- •Surgical
- •Fusion Options with or without Instrumentation
- •Decompression and Noninstrumented Posterolateral Fusion
- •Fusion with Biologics
- •Decompression and Posterolateral Fusion with Instrumentation
- •Facet Fusion
- •Fusion with Transforaminal Lumbar Interbody Graft
- •Laminotomy or Interlaminar Fenestration
- •Foraminotomy
- •Restorative Laminoplasty
- •Minimally Invasive Techniques
- •Motion-Sparing Technologies
- •CONCLUSION
- •References
- •IMAGING OF DEGENERATIVE SPINE DISEASE
- •Intervertebral Disc Degeneration
- •Vertebral Marrow Changes and Osteophyte Formation
- •Facet Arthropathy
- •Spondylolisthesis and Segmental Instability of the Spine
- •Spinal Stenosis
- •SUMMARY
- •References
- •THE “DEGENERATIVE CASCADE”
- •THE FOCUS OF REHABILITATION
- •PATHOPHYSIOLOGIC BASIS FOR REHABILITATION
- •COMORBIDITY INFLUENCE ON REHABILITATION
- •PHYSIOLOGIC FACTORS OF SPINAL STABILIZATION
- •CORE STABILIZATION EXERCISES
- •References
- •CLINICAL CASE EXAMPLES
- •BASIC SCIENCE
- •CLINICAL PRACTICE GUIDELINES
- •Physician Evaluation and Prescription
- •Indications
- •Contraindications
- •Evidence Base
- •CONCLUSIONS AND DISCUSSION
- •References
- •EPIDURAL STEROID INJECTIONS
- •FACET JOINT PROCEDURES
- •SACROILIAC JOINT PROCEDURES
- •SPECIFIC DEGENERATIVE CONDITIONS
- •Degenerative Disc Disease
- •Degenerative Lumbar Spondylolisthesis
- •Degenerative Lumbar Spinal Stenosis
- •CONCLUSION
- •References
- •DESCRIPTION OF THE needle
- •OPERATIVE TECHNIQUES
- •Needle Insertion Techniques
- •Finger pressing insertion.
- •Pinching needle insertion.
- •Pinching skin insertion.
- •Tight skin insertion.
- •Needle Manipulation
- •Other Modalities and Techniques Related to Acupuncture and the Meridian System
- •Application of Meridian Theory in Spine-Related Pain Conditions
- •Hua Tuo Jia Ji Points
- •RESEARCH BACKGROUND OF BASIC SCIENCES AND CLINICAL OUTCOMES
- •COMPLICATIONS
- •CLINICAL PRESENTATION AND DISCUSSION
- •Case One
- •Case Two
- •Case Three
- •Case Discussions
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •TAI CHI
- •Clinical Practice Guidelines
- •FROM QI GONG TO ENERGY-BASED THERAPIES
- •Clinical Practice Guidelines
- •MIND-BODY THERAPIES
- •Mindfulness Meditation
- •Guided Imagery
- •Spirituality and Religiousness
- •BASIC SCIENCE
- •Attention and Pain
- •Regulation of the Autonomic Nervous System
- •Case Discussion
- •CONCLUSION
- •References
- •INTRODUCTION
- •NONOPIOID ANALGESIC AGENTS: ACETAMINOPHEN, NSAIDs, ASPIRIN
- •Acetaminophen
- •Cyclooxygenase Inhibitors (COX-2)
- •Aspirin
- •Flavocoxid (Limbrel®)
- •Opioid Analgesics
- •MUSCLE RELAXANTS AND ANTISPASTICITY MEDICATIONS
- •ANTIDEPRESSANTS
- •ANTICONVULSANTS
- •CONCLUSION
- •References
- •INTRODUCTION
- •CLINICAL AND BASIC SCIENCE
- •CONCLUSION
- •ACKNOWLEDGMENT
- •References
- •INTRODUCTION
- •REGIONAL ANATOMY OF THE CERVICAL SPINE
- •Osseous Components
- •Intervertebral Discs
- •Ligaments and Joints
- •Vascular Supply
- •PATHOPHYSIOLOGY OF CERVICAL SPONDYLOSIS
- •CLINICAL PRESENTATION OF CERVICAL SPONDYLOSIS
- •DIAGNOSTIC MODALITIES
- •Neuroradiology
- •Neurophysiology
- •NATURAL HISTORY OF CERVICAL RADICULOPATHY
- •TREATMENT AND DECISION-MAKING
- •POSTERIOR CERVICAL SURGICAL TECHNIQUES
- •ANTERIOR CERVICAL SURGICAL TECHNIQUES
- •SURGICAL OUTCOMES
- •COMPLICATIONS OF SURGERY
- •EMERGING TECHNOLOGIES: ARTIFICIAL Disc REPLACEMENT
- •CONCLUSION
- •References
- •INTRODUCTION
- •INDICATIONS/CONTRAINDICATIONS
- •CLINICAL PRESENTATION AND EVALUATION
- •DESCRIPTION OF THE DEVICES
- •OPERATIVE TECHNIQUES
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSION/DISCUSSION
- •References
- •INTRODUCTION
- •BIOMECHANICS OF THE CERVICAL SPINE
- •Cervical Motion and the Spinal Cord
- •Degenerative Processes in the Cervical Spine
- •MANAGEMENT OF THE PATIENT WITH CERVICAL KYPHOSIS
- •Patient Assessment
- •Imaging
- •Surgical Decision-Making
- •The Surgical Approach
- •Surgical Complications
- •CONCLUSIONS/DiskUSSION
- •References
- •INTRODUCTION
- •MECHANISM
- •DEFINITION OF CENTRAL CORD SYNDROME
- •INCIDENCE AND AGE
- •BASIC SCIENCE
- •Pathophysiology of Acute Traumatic Central Cord Syndrome (ATCCS)
- •Theory of Somatotopic Organization of Corticospinal Tracts (Neuroanatomical Theory)
- •Theory of Increased Upper Limb and Hand Functional Representation of CST (Functional Theory)
- •Neurological and Functional Recovery of Central Cord Syndrome in the Elderly
- •Imaging Modalities Used to Assess Cervical Spine Injury (Box 27-4)
- •MRI Findings in Traumatic SCI
- •Skeletal Injury
- •Extradural Compression
- •Cord Deformation and Signal Change within the Cord
- •TREATMENT
- •Clinical Challenges
- •Future Treatments
- •SUMMARY
- •References
- •OVERVIEW
- •ANATOMY
- •Occipital Bone
- •The Atlas
- •The Axis
- •Ligaments of the Craniocervical Junction
- •The Vertebral Artery
- •INJURIES OF THE CRANIOCERVICAL JUNCTION
- •Overview
- •Occipitocervical Instability
- •Occipitoatlantal Dislocation
- •Occipital Condyle Fractures
- •C1 Fractures and Transverse Ligament Injuries
- •C2 Fractures
- •Craniocervical Manifestations of Rheumatoid Arthritis
- •CONSERVATIVE MANAGEMENT OF OCCIPITOCERVICAL INJURIES IN THE AGING SPINE
- •SURGICAL APPROACHES AND TECHNIQUES
- •Ventral vs. Dorsal Approaches
- •Occipitocervical Fusion
- •Odontoid Screw
- •C1-2 Harms
- •C1-2 Transarticular Screws
- •C2 Laminar Screws
- •COMPLICATIONS
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •BASIC SCIENCE
- •ANKYLOSING SPONDYLITIS
- •DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS
- •BIOMECHANICS AND CLASSIFICATION OF SUBAXIAL SPINE FRACTURES
- •INSTRUMENTATION OF OSTEOPOROTIC LOWER CERVICAL AND UPPER THORACIC SPINE
- •CLINICAL PRACTICE GUIDELINES
- •CLINICAL CASE EXAMPLES: TREATMENT, CLINICAL CHALLENGES, AND FUTURE TREATMENTS
- •Case 1
- •Case 2
- •CONCLUSION
- •References
- •INTRODUCTION
- •BASIC SCIENCE
- •CLINICAL PRACTICE GUIDELINES
- •Risk Factors
- •Clinical Presentation
- •Laboratory and Imaging Studies
- •Treatment
- •CONCLUSIONS/DISCUSSION
- •References
- •INTRODUCTION
- •EPIDEMIOLOGY AND NATURAL HISTORY
- •PATHOPHYSIOLOGY
- •CLINICAL PRESENTATION
- •LABORATORY DATA
- •RADIOGRAPHIC ANALYSIS
- •Plain Radiographs
- •Magnetic Resonance Imaging
- •Computed Tomography
- •MANAGEMENT
- •Nonoperative Management
- •Surgical Indications
- •Preoperative Assessment
- •Operative Management
- •Atlantoaxial Subluxation
- •Cranial Settling
- •Subaxial Subluxation
- •Odontoid Resection
- •CONCLUSION
- •References
- •INTRODUCTION
- •INTRAMEDULLARY SPINAL TUMORS
- •General Information, Clinical Presentation, and Imaging
- •Ependymomas
- •Astrocytomas
- •Hemangioblastomas
- •OPERATIVE TECHNIQUES (See Figures 32-1 and 32-2)
- •Intramedullary Tumors
- •Postsurgical Management
- •INTRADURAL-EXTRAMEDULLARY SPINAL CORD TUMORS
- •General Information, Clinical Presentation, and Imaging
- •Nerve Sheath Tumors
- •Meningiomas
- •OPERATIVE TECHNIQUES
- •Intradural-Extramedullary Tumors
- •Spinal Schwannomas
- •Spinal Meningiomas
- •Postsurgical Management
- •EXTRADURAL SPINAL CORD TUMORS
- •General Information, Clinical Presentation, and Imaging
- •Operative and Postoperative Management
- •Spinal Metastatic Tumors
- •Primary Malignant Tumors
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •BASIC SCIENCE
- •SURGICAL INDICATIONS AND PREPARATION
- •RADIOLOGICAL EVALUATION
- •SURGICAL TECHNIQUES
- •Anterior Cervical Microforaminotomy
- •Transuncal Approach
- •Upper Vertebral Transcorporeal Approach
- •Lower Vertebral Transcorporeal Approach
- •Percutaneous Cervical Nucleoplasty
- •Percutaneous Endoscopic Discectomy
- •Microendoscopic Discectomy
- •DISCUSSION
- •Microsurgical Anterior Cervical Foraminodiscectomy
- •Percutaneous Cervical Nucleoplasty(PCN)
- •Percutaneous Endoscopic Cervical Discectomy
- •Microendoscopic Discectomy
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •BRIEF DESCRIPTION
- •INDICATIONS AND CONTRAINDICATIONS
- •DESCRIPTION OF THE DEVICE
- •BACKGROUND OF SCIENTIFIC TESTING AND CLINICAL OUTCOMES
- •CLINICAL PRESENTATION AND EVALUATION
- •OPERATIVE TECHNIQUE
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSIONS AND DISCUSSION
- •References
- •INTRODUCTION
- •HISTORY OF VERTEBROPLASTY
- •PATIENT SELECTION/INDICATIONS
- •Absolute Contraindications
- •Relative Contraindications
- •TECHNIQUE
- •Transpedicular Approach
- •Parapedicular (Transcostovertebral) Approach
- •Posterolateral Approach
- •Anterolateral Approach
- •Procedure
- •INJECTION MATERIALS
- •COMPLICATIONS
- •NEJM RANDOMIZED CONTROLLED TRIALS
- •Fracture Acuity
- •Enrollment
- •Control Group as an “Alternative Intervention”
- •Crossover
- •CONCLUSION
- •References
- •INTRODUCTION
- •VERTEBRAL BODY STENT
- •How to Restore and Maintain Vertebral Height
- •In Vitro Testing
- •Clinical Application
- •Indications
- •Surgical Technique
- •Clinical Experience
- •Results
- •DISCUSSION
- •References
- •INTRODUCTION
- •CLINICAL INDICATIONS AND CONTRAINDICATIONS
- •DESCRIPTION OF THE OSSEOFIX DEVICE
- •Biomechanical Studies
- •Results – Study 1
- •Results – Study 2
- •CONCLUSION
- •CLINICAL DATA
- •OPERATIVE TECHNIQUE
- •Step 1: Positioning.
- •Step 2: Creating an access channel into the vertebral body
- •Step 4: Cement delivery.
- •PITFALLS AND COMPLICATIONS OF THE PROCEDURE
- •TREATMENT ALTERNATIVES
- •DISCUSSION AND CONCLUSION
- •References
- •INTRODUCTION
- •INDICATIONS
- •CONTRAINDICATIONS
- •PRECAUTIONS
- •DESCRIPTION OF THE DEVICE
- •CLINICAL PRESENTATION AND EVALUATION
- •Material and Methods
- •RESULTS
- •OPERATIVE TECHNIQUE
- •DEPLOYMENT OF THE DISTRACTION SLEEVE
- •INJECTING PMMA BONE CEMENT
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSIONS AND DISCUSSION
- •References
- •INTRODUCTION
- •SYSTEM OVERVIEW
- •INDICATIONS
- •CONTRAINDICATIONS
- •BIOMECHANICAL TESTING
- •THE SHIELD KYPHOPLASTY SYSTEM SURGICAL TECHNIQUE
- •CLINICAL OUTCOMES
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •MATERIALS AND METHODS
- •The StabiliT Vertebral Augmentation System
- •In Vitro Evaluation of Height Restoration and Intravertebral Pressure in Three Minimally Invasive Procedures Using an Osteoporotic Cadaver Bone Model
- •RESULTS
- •RF KYPHOPLASTY CLINICAL EXPERIENCE WITH THE StabiliT VERTEBRAL AUGMENTATION SYSTEM
- •DISCUSSION
- •References
- •INTRODUCTION
- •INDICATIONS AND CONTRAINDICATIONS
- •DESCRIPTION OF THE DEVICE
- •BACKGROUND OF SCIENTIFIC TESTING AND CLINICAL OUTCOMES
- •CLINICAL PRESENTATION AND EVALUATION
- •OPERATIVE TECHNIQUE
- •Anesthesia
- •Position
- •Procedure
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSIONS AND DISCUSSION
- •References
- •INTRODUCTION
- •INDICATIONS AND CONTRAINDICATIONS
- •DESCRIPTION OF THE DEVICE
- •PRINCIPLES OF PROCEDURE
- •BACKGROUND OF SCIENTIFIC TESTING AND CLINICAL OUTCOMES
- •OPERATIVE TECHNIQUE
- •Anesthesia
- •Position
- •Surgical Procedure for the Crosstrees System
- •Transpedicular Approach
- •Extrapedicular Approach (Usually Recommended in Thoracic Spine)
- •Delivery of PMMA
- •POSTOPERATIVE CARE
- •CONCLUSIONS AND DISCUSSIONS
- •References
- •INTRODUCTION
- •INDICATIONS AND CONTRAINDICATIONS
- •DESCRIPTION OF THE DEVICE
- •BACKGROUND OF SCIENTIFIC TESTING AND CLINICAL OUTCOMES
- •CLINICAL PRESENTATION AND EVALUATION
- •OPERATIVE TECHNIQUE
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSIONS AND DISCUSSION
- •References
- •INTRODUCTION
- •INDICATIONS AND CONTRAINDICATIONS
- •Indications
- •Contraindications
- •DESCRIPTION OF THE DEVICE
- •BACKGROUND OF SCIENTIFIC TESTING AND CLINICAL OUTCOMES
- •OPERATIVE TECHNIQUE
- •Anesthesia
- •Position
- •PROCEDURE
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND CAUTIONS
- •CONCLUSION
- •References
- •INTRODUCTION
- •BASIC SCIENCE
- •CLINICAL PRACTICE GUIDELINES
- •Stable Thoracic Vertebral Fractures
- •CLINICAL CASE EXAMPLES
- •Thoracic Stabilization
- •Spinal Cord or Nerve Decompression
- •Deformity Correction
- •CONCLUSIONS/DISCUSSION
- •References
- •INTRODUCTION
- •Metastatic Tumors
- •Intradural Extramedullary Tumors
- •Intramedullary Spinal Cord Tumors
- •Primary Vertebral Column Tumors
- •BASIC SCIENCE
- •CLINICAL PRACTICE GUIDELINES
- •CLINICAL CASE EXAMPLES
- •DISCUSSION
- •References
- •INTRODUCTION
- •PATHOPHYSIOLOGY
- •Bacterial Pathogenesis
- •Pathogenesis of Tuberculosis
- •CLINICAL PRESENTATION
- •DIAGNOSTIC EVALUATION
- •Imaging
- •MANAGEMENT
- •Medical Therapy
- •Indications for Surgical Intervention
- •Surgical Management
- •Posterior Approach
- •Anterior Approach
- •Anterior Approach with Anterior Fixation
- •Single-Stage Anterior and Posterior Procedure
- •Two-Staged Anterior-Posterior Procedure
- •Use of Instrumentation
- •Graft Type
- •Minimally Invasive Surgery
- •Thoracoscopic Spinal Surgery
- •Percutaneous Technology
- •PROGNOSIS
- •CONCLUSION
- •References
- •INTRODUCTION
- •PATHOLOGY
- •CLINICAL PRESENTATION
- •DIAGNOSIS
- •TREATMENT
- •OTHER CAUSES FOR THORACIC SPINAL STENOSIS
- •Neoplasms
- •Synovial Cysts
- •PROGNOSIS
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •RADIOSURGERY
- •INDICATIONS FOR SPINAL RADIOSURGERY
- •TREATMENT DETAILS
- •TREATMENT OF SPINAL METASTASES
- •TREATMENT OF INTRADURAL EXTRAMEDULLARY LESIONS
- •TREATMENT OF INTRAMEDULLARY LESIONS
- •COMPLICATIONS
- •CONCLUSION
- •References
- •INTRODUCTION
- •Basic Science
- •Clinical Practice Guidlines
- •Basic Science
- •Clinical Practice Guidelines
- •Basic Science
- •Clinical Practice Guidelines
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •PATHOANATOMIC CHANGES
- •DEFINITION OF STENOTIC DEGENERATIVE DISEASE IN DEFORMITY
- •CLINICAL COMPLEX OF SYMPTOM PRESENTATION
- •ADULT SCOLIOSIS CLASSIFICATION
- •CONSIDERATIONS FOR NONSURGICAL OR SURGICAL MANAGEMENT
- •GOALS OF TREATMENT
- •SURGICAL PROCEDURES
- •OUTCOMES ASSOCIATED WITH SPINAL DEFORMITY TREATED WITH SURGICAL DECOMPRESSION
- •OPERATIVE TREATMENT OF DEGENERATIVE LUMBAR SCOLIOSIS ASSOCIATED WITH SPINAL STENOSIS
- •PRINCIPLES FOR SELECTING FUSION LEVELS IN ADULT SPINAL DEFORMITY WITH LUMBAR CURVES
- •SPINAL STENOSIS WITH SCOLIOSIS
- •RATE OF COMPLICATIONS IN SCOLIOSIS SURGERY
- •SUMMARY
- •References
- •INTRODUCTION
- •NATURAL HISTORY
- •Idiopathic Curves
- •Degenerative Curves
- •IMAGING EVALUATION
- •THE ROLE OF CONSERVATIVE MANAGEMENT
- •INDICATIONS FOR SURGERY
- •SURGICAL PLANNING
- •The Role of Decompression Only in Adult Scoliosis Surgery
- •The Role of Deformity Correction and Fusion
- •The Role of Deformity in the Clinical Presentation
- •SURGICAL TECHNIQUES
- •Posterior Instrumentation
- •Anterior Release or Anterior-Only Surgery
- •Extent of Fusion
- •Extension of Fusion to the Sacrum
- •The Role of Osteotomies and Spinal Column Shortening in Adult Deformity Patients
- •SUMMARY
- •References
- •INTRODUCTION
- •PATIENT EVALUATION
- •TREATMENT
- •SURGERY
- •SURGICAL TECHNIQUES
- •OSTEOPOROSIS AND SCOLIOSIS
- •COMPLICATIONS
- •OUTCOMES
- •References
- •INTRODUCTION: INTERSPINOUS SPACERS – HOW DO THEY WORK?
- •THE “EXTENSION STOPPERS”
- •X - Stop (Medtronic) (Figure 54-1)
- •Surgical Technique
- •Results
- •Summary
- •InSpace (Synthes, Paoli, PA, USA) (Figure 54-3)
- •Surgical Technique
- •Results
- •Summary
- •Other Implant Types (Figure 54-7)
- •Surgical Technique
- •Results
- •Summary
- •DYNAMIC/RIGID INTERSPINOUS STABILIZERS
- •Surgical Technique
- •Results
- •Summary
- •Surgical Technique
- •Results
- •Summary
- •Other Implants
- •CONCLUSION
- •References
- •INTRODUCTION
- •CLINICAL PRACTICE GUIDELINES
- •Indications
- •Contraindications
- •Osteopenia and Osteoporosis
- •Infection or Malignancy
- •Facet Joints
- •Scoliosis
- •Spondylolysis and Spondylolisthesis
- •Prior Abdominal Surgery
- •Obesity
- •Metal Allergy
- •Anatomic and Vascular Considerations
- •Psychosocial Factors
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •DEVICES
- •Interspinous Spacers
- •X-Stop (Kyphon)
- •Wallis (Zimmer Spine)
- •Diam (Medtronic)
- •ExtenSure (NuVasive)
- •In-Space (Synthes)
- •Facet Devices
- •Zyre (Quantum Orthopedics)
- •Fenix (Gerraspine AG)
- •Anatomic Facet Replacement System (Facet Solutions)
- •Total Facet Arthroplasty System (Archus)
- •Total Posterior System (Impliant)
- •Pedicle-Based Dynamic Rods
- •N-Hance (Synthes)
- •Stabilimax NZ (Applied Spine)
- •Dynesys (Zimmer Spine)
- •Dynamic TTL-Rod (Scient’x)
- •CD Horizon Legacy Peek Rod System (Medtronic)
- •DSS Spine Stabilization System (Paradigm)
- •Dynabolt (VertiFlex)
- •CLINICAL APPLICATION
- •Ligament
- •Facet
- •Canal
- •Osteopenia
- •CONCLUSION
- •References
- •INTRODUCTION
- •PEDICLE SCREWS IN THE OSTEOPOROTIC SPINE
- •Screw Placement
- •Undertapping Pedicle Screws
- •Transverse Connectors
- •Bone Cement
- •Expandable Screws
- •CONCLUSION
- •References
- •INTRODUCTION
- •BONE MORPHOGENETIC PROTEINS
- •OTHER BONE GRAFT ALTERNATIVES
- •Allograft
- •Demineralized Bone Matrix
- •Synthetic Materials (Ceramics)
- •Bone Marrow Aspirates
- •OTHER POTENTIAL APPLICATION OF BIOLOGICS IN THE AGING SPINE
- •Vertebral Body Augmentation in Vertebral Body Compression Fractures
- •Nonfusion Applications: Addressing Disc Degeneration Directly
- •CONCLUSION
- •References
- •INTRODUCTION
- •PATHOPHYSIOLOGY
- •TREATMENT OPTIONS AND GUIDELINES
- •SURGICAL RATIONALE
- •INDICATIONS FOR MISS DECOMPRESSIVE TECHNIQUES
- •Surgical Technique
- •POSTOPERATIVE MANAGEMENT
- •CLINICAL OUTCOMES AND COMPLICATIONS
- •EMERGING TECHNOLOGIES
- •References
- •INTRODUCTION
- •BASIC SCIENCE OF MINIMALLY INVASIVE SPINE SURGERY
- •CLINICAL PRACTICE GUIDELINES
- •Endoscopic Transforaminal Decompression for Unilateral Radiculopathy
- •Deformity Correction via Direct Lateral Anterior Interbody Fusion
- •Minimally Invasive Posterior-Only Approaches
- •Percutaneous Pedicle Screw Fixation
- •MIS Iliac Fixation
- •CONCLUSIONS AND DISCUSSION
- •References
- •INTRODUCTION
- •INDICATIONS AND CONTRAINDICATIONS
- •CLINICAL STUDY
- •PREOPERATIVE ASSESSMENT AND PLANNING
- •Operative Technique
- •Patient Positioning
- •Incision and Retroperitoneal Access
- •Transpsoas Access
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSION
- •References
- •INTRODUCTION
- •BASIC SCIENCE AND BIOMECHANICAL STUDIES
- •CLINICAL PRACTICE GUIDELINES
- •CLINICAL CASE EXAMPLES: TREATMENT AND FUTURE CHALLENGES
- •CONCLUSION
- •References
- •INTRODUCTION
- •FUNCTIONAL ANATOMY OF THE INTERVERTEBRAL Disc
- •CAUSES OF DEGENERATIVE DISC DISEASE
- •THERAPEUTIC BIOLOGIC STRATEGIES
- •Intradiscal Injection of a “Naked” Biologically Active Factor
- •Gene Therapy Approaches
- •Implantation of Mesenchymal Stem Cells
- •CONCLUSIONS
- •References
- •INTRODUCTION
- •INDICATIONS AND CONTRAINDICATIONS
- •DESCRIPTION OF THE DEVICE
- •CLINICAL PRESENTATION AND EVALUATION
- •OPERATIVE TECHNIQUE(S)
- •Anesthesia
- •Position
- •Procedure
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSIONS AND DISCUSSION
- •References
- •INTRODUCTION
- •INDICATIONS AND CONTRAINDICATIONS
- •Ideal Indications
- •Relative Indications
- •Patients with Poor Indications for Dorsal Ramus Rhizotomy
- •DESCRIPTION OF THE DEVICE
- •BACKGROUND OF SCIENTIFIC TESTING AND CLINICAL OUTCOMES
- •CLINICAL PRESENTATION AND EVALUATION
- •OPERATIVE TECHNIQUE
- •Anesthesia
- •Position
- •Procedure
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSIONS AND DISCUSSION
- •Anatomy of the Lumbar Dorsal Ramus
- •L1 to L4 Dorsal Rami
- •L5 Dorsal Ramus
- •References
- •INTRODUCTION
- •OVERVIEW OF THE ECONOMY AND HEALTHCARE
- •OVERVIEW OF SPINE CARE
- •BACK PAIN IN A CHANGING POPULATION
- •Osteoporosis
- •COMPENSATION
- •MEDICAL TOURISM
- •COST-EFFECTIVENESS
- •WHERE TO GO FROM HERE
- •References
- •INTRODUCTION
- •SPINAL ETIOLOGIES
- •Degenerative Disc and Congenital Disorders
- •Spinal Stenosis
- •Osteoporosis
- •Spinal Deformity (Scoliosis, Kyphosis)
- •Spinal Tumors
- •NANOMEDICINE AND THE AGING SPINE
- •Micro- and Nanoscale Smart Polymer Technologies
- •Nanocoatings
- •Biosensors and Biochips
- •THE POTENTIAL FOR MICRO/NANOTECHNOLOGY IN THE AGING SPINE
- •References
- •INTRODUCTION
- •INDICATIONS/CONTRAINDICATIONS
- •DESCRIPTION OF THE DEVICE
- •BACKGROUND OF SCIENTIFIC TESTING / CLINICAL OUTCOMES
- •CLINICAL PRESENTATION AND EVALUATION
- •OPERATIVE TECHNIQUE
- •POSTOPERATIVE CARE
- •COMPLICATIONS AND AVOIDANCE
- •CONCLUSION/DISCUSSION
- •References
- •INTRODUCTION
- •LASER DECOMPRESSION
- •OZONE CHEMODISCOLYSIS
- •CONCLUSION
- •References
- •HISTORICAL BACKGROUND
- •Tissue Response to Biomaterials
- •METALS
- •Metal Types
- •Titanium
- •Cobalt-Chrome
- •Stainless Steel (316L)
- •Tantalum
- •Corrosion
- •Distribution of Metal in Body Fluids
- •Mutagenesis
- •Carcinogenicity
- •Hypersensitivity
- •POLYMERS
- •Introduction
- •UHMWPE
- •PEEK
- •PLA and PGA
- •Implant Performance and Failure
- •UHMWPE
- •PEEK
- •PLA and PGA
- •HYDROGELS
- •Synthetic Hydrogels
- •Hydrolyzed Pan Hydrogels – Development and History
- •BIOLOGICS
- •Bone Graft
- •SUMMARY
- •References
- •Index
Index
475
Total Facet Arthroplasty SystemÔ (TFAS), 376, 377f
Total Posterior SystemÔ (TOPS), 377, 378f
Traditional Chinese medicine (TCM), 33. See also
Acupuncture
Transforaminal lumbar interbody fusion (TLIF), 402,
402f
Tuberculosis, spinal, 301
clinical presentation of, 303
indications for surgical intervention, 304
medical therapy, 304
pathogenesis, 303, 303f
Tumors, cervical spine
extradural, 192–197
chordoma, en bloc resection/treatment, 194–197
clinical presentation/imaging, 192–193
metastatic, 193–194
operative/postoperative management, 193–197
primary malignant, 194
IDEM, 191–192
clinical presentation/imaging, 191–192
meningiomas, 191–192
nerve sheath, 191
operative techniques, 192
postsurgical management, 192
schwannomas, 192
IMSCT, 188–189
astrocytomas, 189
clinical presentation/imaging, 188–189
ependymomas, 188–189
hemangioblastomas, 189
operative techniques, 189–191, 190f
postsurgical management, 191
overview, 188, 188b, 197
Tumors, etiology, 448
Tumors, primary vertebral column
benign, 289
malignant, 289
rarity of, 289
thoracic spine, 289
types of, 289
Tumors, thoracic spine. See also Stereotactic radiosurgery
basic science, 289
case 1: posterolateral approach, 290b–292b, 291f
case 2: anterior approach, 292b, 293f–294f
case 3: anterior/posterior combined approach, 294b–296b,
295f–297f
case 4: en bloc, 298f–299f, 298b–300b
clinical practice guidelines, 289–296
intervention effectiveness, 289
intervention indications, 289–290
radiation, 290
resection method, 290
stabilization, 290
surgical approaches, 290
vascular anatomy, 290
discussion, 296
IDEM, 288
neurofibromas, 288
schwannomas, 288
SRS treatment of, 322
types of, 288
IMSCT, 288–289
signs of, 289
SRS treatment of, 322–323
types of/treatment of, 288–289
metastatic, 288
SRS treatment of, 321–322, 324t
overview, 288–289, 288b
primary, 289
stenosis and, 315
U
UHMWPE. See Ultra high molecular weight polyethylene
Ultra high molecular weight polyethylene (UHMWPE),
463
Unilateral
microscopic hemilaminotomy, 389
radiculopathy decompression, 397–398, 397f
Upper cervical spine, embryology of, 5
V
Vata (wind/movement/flow humor), 34, 36
VBCFs. See Vertebral body compression fractures
VertebraeCrosstrees Percutaneous Vertebral Augmentation;
StabiliT Vertebral Augmentation System; oracic
vertebral fractures, treatment of; Tumors, primary
vertebral column
anatomy, 9–11
cervical, 10, 133, 134f
lumbosacral, 11
nutritional support for, 12
thoracic, 10–11
histological changes in, 17–18, 17f–18f
Vessel-X and, 270, 271f
Vertebral body augmentation, 385–386
Vertebral body compression fractures (VBCFs)Kiva
system; OptiMesh; OsseoFix device; Radiofrequency
kyphoplasty
age regarding, 218, 218f
introduction to, 218
osteoporosis, 260
Vertebral body stenting
advantages/disadvantages of, 231b
clinical applications, 221f–225f
41-year-old man, 230f
56-year-old woman, 221f–225f
72-year-old woman, 226f–227f
78-year-old man, 227f–229f
clinical experience, 221
indications, 218
results, 221–222
surgical technique, 220–221, 220f
consequences of height loss, 219f
how to restore/maintain vertebral height, 218
introduction, 218
kyphoplasty compared with, 219f
overview, 218, 218b
in vitro testing, 218
Vertebroplasty
complications, 216–217
contraindications
absolute, 215
relative, 215
history, 214
injection materials, 216
kyphoplasty compared with, 253–254
overview, 214, 214b, 217
patient selection/indications, 214–215
pitfalls of, 237
randomized controlled trials, 217
control group as “Alternative Intervention”, 217
crossover, 217
enrollment, 217
fracture acuity, 217
technique, 215–216
anterolateral approach, 215
parapedicular approach, 215
posterolateral approach, 215
procedure, 215–216
transpedicular approach, 215
Vessel-X
advantages/disadvantages, 279b
case studies, 272b–274b
case 1, 272f
case 2, 273f
case 3, 273f
case 4, 273, 274f
case 5, 274f
case 6, 275f
complications/avoidance, 278
contraindications, 269
indications, 269
instruments, 270f
operative technique, 272
anesthesia, 272
position, 272
origins of, 269, 270f
other techniques vs., 269, 271f
overview, 269, 269b, 278–279
pain relief, 270–272, 272f
Vessel-X (Continued)
postoperative care, 278
procedure, 275–277
bone access needle/precision drill, 275–276, 276f
cement delivery, 272f, 276, 276f
container, 275, 275f
final steps, 277, 278f
fluoroscopic imaging control, 277, 279f
luer connector tightening, 276, 276f
marker/guide wire, 275, 276f
pressure regarding, 275, 275f
pressure release, 273f, 277, 277f
testing/clinical outcomes background, 270–272, 271f–272f
vertebrae relief, 270, 271f
Vitamin D supplementation, 71
W
WallisÔ implant
device, 363, 363f
dynamic stabilization and, 374, 375f
as dynamic/rigid stabilizer, 363–364
results, 363
summary, 363–364
surgical technique, 363, 363f
Western perspectives
on management of aging, 32–33
on psychology of aging, 31–32
therapies used in, 32–33
WHO. See World Health Organization
Women, fracture risk in postmenopausal, 49
World Health Organization (WHO), 68–69, 69t
X
XLIF. See eXtreme Lateral Interbody Fusion
X-StopÔ
device, 358, 359f
dynamic stabilization and, 374, 375f
as extension stopper, 358–361
indications, 358
results, 358
summary, 358
surgical technique, 358, 359f
Y
YESS procedure
advantages/disadvantages, 434b
clinical presentation/evaluation, 431
complications/avoidance, 433–434
device description, 428, 429f
discussion, 434
operative techniques, 431–433
anesthesia, 431
position, 431
procedure, 431–433
overview, 427
postoperative care, 433
scientific testing/clinical outcomes, 428–431
micro vs. endoscopic diskectomy, 428–429,
429t–430t
range of conditions and, 429–431
Yoga
benefits of, 127
clinical/basic science, 127–129
defined, 127
exercises, 127–128, 128t
overview, 127, 127b, 129
postures, 128f–129f
principles of, 127
therapeutic use of, 128
types of, 127
Z
ZyreÔ, 376, 376f
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