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Surgical Techniques
for the Spine
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Surgical
the Spine
Thomas R. Haher , M.D.
Professor of Orthopaedic Surgery Department of Orthopaedic Surgery New York Medical College Valhalla, New York
Adjunct Professor of Civil Engineering The Cooper Union for the Advancement of
Science and Art
Chief of Spinal Surgery Lutheran Medical Center Brooklyn, New York
Andrew A. Merola, M.D.
Assistant Professor of Orthopaedic Surgery Director of Spinal Surgery Department of Orthopaedic Surgery
SUNY Downstate Medical Center
Brooklyn, New York
Thieme
New York / Stuttgart
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Thieme New York
333 Seventh Avenue New York, NY 10001
Consulting Medical Editor: Esther Gumpert Assistant Editor: Owen Zurhellen Director, Production and Manufacturing: Anne Vinnicombe Production Editor: David R. Stewart Marketing Director: Phyllis Gold Director of Sales: Ross Lumpkin Chief Financial Officer: Peter van Woerden President: Brian D. Scanlan Text Design: Michael Mendelsohn; Marsha Cohen Medical Illustrator: Anthony M. Pazos Compositor: primustype R. Hurler Printer: The Maple-Vail Book Manufacturing Group
Library of Congress Cataloging in Publication Data is available from the publisher
Copyright © 2003 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside of the narrow limits set
by copyright legislation, without the publisher’s written consent, is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage.
Important note: Medical knowledge is ever-changing. As new research and clinical experience
broaden our knowledge, changes in treatment and drug therapy may be required. The author of the material herein has consulted sources believed to be reliable in her efforts to provide information that is complete and in accord with standards accepted at the time of publication. However, in view of the possibility of human error by the author or publisher of the work herein, or changes in medical knowledge, neither the author nor the publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained by the use of such information. Readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this pub­lication is accurate and that changes have not been made in the recommended dose or in the contrain­dications for administration. This recommendation is of particular importance in connection with new and infrequently used drugs.
Some of the product names, patents, and registered designs referred to in this book are in fact regis­tered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be con­strued as a representation by the publisher that it is in the public domain.
Printed in The United States of America
54321
TNY ISBN 1-58890-026-6 GTV ISBN 3-13-124761-4
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To my wife Mary Jane and my sons Brendan and Brian.
Thomas R. Haher
To my wife Christine and my children Olivia and Nicholas.
Andrew A. Merola
In Memory of Laura B. Flawn, M.D., a vibrant young woman, whose contributions to orthopaedic
surgery will be greatly missed.
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Contents

FOREWORD xiii P
REFACE xv ONTRIBUTORS xvi
C
ECTION I. THE CERVICAL SPINE
S
1. O
CCIPITOCERVICAL JUNCTION:DECOMPRESSION AND FUSION 3
Michael F. O’Brien
2. ANTERIOR ODONTOID RESECTION 10
Dimos Bouramas and Alan Crockard
3. ODONTOID FIXATION 16
Pasquale X. Montesano and Christopher O. Neubuerger
4. C1-C2 FUSION (POSTERIOR SCREW FIXATION)23
Dieter Grob
5. FAR LATERAL APPROACH TO THE CERVICAL SPINE 27
Christopher J. DeWald
6. ANTERIOR CERVICAL CORPECTOMY 29
Eeric Truumees and Harry N. Herkowitz
7. MULTIPLE-LEVEL CERVICAL VERTEBRECTOMY (CORPECTOMY)
AND STABILIZATION USING CORTICAL BONE 36
Thomas S. Whitecloud III and Orderia Mitchell
8. CERVICAL LAMINOPLASTY 40
Kazumasa Ueyama, Po-Quang Chen, and Seiko Harata
9. POSTERIOR CERVICAL LAMINECTOMY AND FUSION 44
J. Paul Elliott and Anthony P. Dwyer
10. OPEN DOOR LAMINOPLASTY FOR THE TREATMENT OF CERVICAL SPONDYLOLYTIC MYELOPATHY 47
Joseph Riina and David G. Schwartz
11. POSTERIOR WIRING TECHNIQUES OF THE SPINE 52
Alexander R. Vaccaro and Kush Singh
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12. POSTERIOR CERVICAL PLATING TECHNIQUES 62
Jeffrey J. Wise and Howard S. An
13. ANTERIOR CERVICAL DISC SURGERY:TECHNICAL CHALLENGES 66
William Dillin
14. REVISION DISC SURGERY:TECHNICAL CHALLENGES 69
William Dillin
15. CERVICAL THORACIC FIXATION TECHNIQUES 72
Marshal D. Peris and William F. Donaldson
SECTION II. THE THORACIC SPINE
16. V
ERTEBROPLASTY AND KYPHOPLASTY IN THE TREATMENT OF
OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES 79
H. Claude Sagi and Hansen A. Yuan
17. THORACIC PEDICLE SCREWS: PEDICULAR APPROACH 86
Archibald H. von Strempel
18. EXTRAPEDICULAR SCREW PLACEMENT IN THE THORACIC SPINE 91
Peter Metz-Stavenhagen and Walter Morgenstern
19. THORACIC DISC DISEASE:RETROPLEURAL APPROACH 94
John M. Gorup and David H. Donaldson
20. VERTEBRAL CORPECTOMY FOR T HORACIC TUMOR OR INFECTION 97
Robert F. McLain and Ranjith R. Kuzhupilly
21. POSTERIOR TECHNIQUES FOR THORACIC DISC DISORDERS 101
Raj Murali
22. POSTERIOR COLUMN SHORTENING FOR SCHEUERMANN’S KYPHOSIS: AN INNOVATIVE ONE-STAGE TECHNIQUE 107
Alberto Ponte
23. ANTERIOR RELEASE AND POSTERIOR INSTRUMENTATION AND FUSION FOR SCHEUERMANN’S KYPHOSIS 114
Thomas G. Lowe
24. A NEW CLASSIFICATION SYSTEM OF ADOLESCENT
DIOPATHIC
Lawrence G. Lenke
SCOLIOSIS 118
25. ANTERIOR CORRECTION AND INSTRUMENTATION FOR THORACIC SCOLIOSIS 122
Thomas R. Haher and Andrew A. Merola
26. CONCAVE THORACOPLASTY FOR STIFF THORACIC SCOLIOSIS 128
Peter Metz-Stavenhagen and Walter Morgenstern
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27. CONVEX THORACOPLASTY 131
Randal R. Betz and Howard H. Steel
28. ANTERIOR THORACOPLASTY 135
Harry L. Shufflebarger
29. ANTERIOR CORRECTION OF THORACIC SCOLIOSIS USING THE KANEDA ANTERIOR SCOLIOSIS SYSTEM (KASS) 140
Kiyoshi Kaneda and Yasuhiro Shono
30. POSTERIOR SCOLIOSIS CORRECTION OF KING II CURVES:
OOKS AND RODS 145
H
Lawrence G. Lenke
31. POSTERIOR SCOLIOSIS CORRECTION:DOUBLE MAJOR CURVES 153
Keith H. Bridwell
32. POSTERIOR SCOLIOSIS CORRECTION:KING TYPE V/
OUBLE THORACIC CURVES 156
D
Keith H. Bridwell
33. POSTERIOR SCOLIOSIS CORRECTION:PEDICLE SCREWS 159
Se-Il Suk and Won-Joong Kim
34. ANTERIOR THORACOSCOPIC RELEASE FOR SPINAL DEFORMITY 165
Mark Weidenbaum and Mladen Djurasovic
35. THE ACCORDION PROCEDURE FOR MANAGEMENT OF RIGID THORACIC SCOLIOSIS 169
James E. Shook and Walter H. Burnham, Jr.
36. CORRECTION OF NEUROMUSCULAR PELVIC OBLIQUITY:
THE DOMINO TECHNIQUE 173
Baron S. Lonner
37. THORACIC VERTEBRECTOMY FOR CONGENITAL DEFORMITY 175
James W. Ogilvie
38. PREVENTION AND T REATMENT OF THE CRANKSHAFT PHENOMENON 179
John P. Lubicky
39. THORACIC SCOLIOSIS:VERTEBRAL RESECTION 182
Kirkham B. Wood
40. TECHNIQUE OF SUBLAMINAR WIRE PASSAGE 186
Vincent J. Devlin and Marc A. Asher
SECTION III. THE LUMBAR SPINE
41. H
OOK PATTERNS FOR THE PRESERVATION OF LUMBAR LORDOSIS 195
Joseph W. Dryer, Emile Cheung, and Gordon Lee Engler
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