Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6051_Библиотеки_им_академика_М_И_Перельмана

AOSpineMastersSeries

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AdultSpinalDeformities

SeriesEditor:

LuizRobertoVialle,MD,PhD

ProfessorofOrthopedics,SchoolofMedicine

CatholicUniversityofParanaState

Professor,NeurologicalSurgery

ChiefofSpinalSurgery

DirectoroftheAdvancedDeformityFellowship

WashingtonUniversitySchoolofMedicine

St.Louis,Missouri

KennethM.C.Cheung,MBBS(UK),MD(HK),FRCS,FHKCOS,FHKAM(Orth)

Head,DepartmentofOrthopaedics&Traumatology

JessieHoProfessorinSpineSurgery

TheUniversityofHongKong

QueenMaryHospital

NewYork,NY10001

ExecutiveEditor:WilliamLamsback

ManagingEditor:SarahLandis

Director,EditorialServices:MaryJoCasey

EditorialAssistant:HaleyPaskalides

ProductionEditor:BarbaraA.Chernow

InternationalProductionDirector:AndreasSchabert

VicePresident,EditorialandE-ProductDevelopment:VeraSpillner

InternationalMarketingDirector:FionaHenderson

InternationalSalesDirector:LouisaTurrell

President:BrianD.Scanlan

Adultspinaldeformities

Includesbibliographicalreferencesandindex.

ISBN978-1-62623-100-9(alk.paper)—ISBN978-1-62623-101-6(eISBN)

I.Vialle,LuizRoberto,editor.II.Lenke,Lawrence,1960–,editor.III.Cheung,KennethM.C.,editor.

IV.Title:Adultspinaldeformities.

[DNLM:1.SpinalDiseases—surgery.2.OrthopedicProcedures—methods.3.Spine—surgery.WE725]

RD768

617.4'71—dc23

2015001979

Copyright©2015byThiemeMedicalPublishers,Inc.

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carefullythemanufacturers’leafletsaccompanyingeachdrugandtocheck,ifnecessaryinconsultationwithaphysician

fromthestatementsmadeinthepresentbook.Suchexaminationisparticularlyimportantwithdrugsthatareeitherrarely

usedorhavebeennewlyreleasedonthemarket.Everydosagescheduleoreveryformofapplicationusedisentirelyat

the user’s ownrisk andresponsibility. Theauthors andpublishers request every user to report to the publishersany

discrepancies or inaccuracies noticed. If errors in this work are found after publication, errata will be posted at

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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

AOSpineMastersSeries

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

LuizRobertoVialle,MD,PhD

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ScottC.Wagner,DanielG.Kang,RonaldA.Lehman,Jr.,andLawrenceG.Lenke

2 Decision Making in Adult Deformity Surgery: Decompression Versus Short or Long

Fusion

KennethM.C.CheungandJasonP.Y.Cheung

3TheUseofOsteotomiesforRigidSpinalDeformities

StephenJ.LewisandSimonA.Harris

4IndicationsandTechniquesforSacral-PelvicFixationinAdultSpinalDeformity

KristenE.Jones,RobertA.Morgan,andDavidW.Polly,Jr.

5InstrumentationStrategiesinOsteoporoticSpine:HowtoPreventFailure?

AhmetAlanayandCaglarYilgor

RobertWaldropandSigurdBerven

9JunctionalIssuesFollowingAdultDeformitySurgery

HanJoKim,SravishtIyer,andChristopherI.Shaffrey,Sr.

ManabuIto,YuichiroAbe,andRemelAlingalanSalmingo

MichaelP.KellyandSigurdBerven

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istoquicklysynthesizethebestavailableevidenceandexpertopinioninthemanagement

ofspinepathologies.TheAOSpineMastersSeriesprovidesjustthat—eachvolumeinthe

compellingandsometimescontroversialtopicinspinecare.

The unique and efficient format of the Masters Series volumes quickly focuses the

attentionof thereaderon thecore informationcritical tounderstanding thetopic, while

encouragingthereadertolookfurtherintotherecommendedliterature.

Throughthisapproach,AOSpineisadvancingspinecareworldwide.

LuizRobertoVialle,MD,PhD

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physiciansandpatientsworldwideareawareofit.Withincreasinglongevity, thenormal

degenerationofthespinemayleadtovariousASDproblemssuchaslumbardegenerative

progress to symptomatic stages over adulthood. Clinical manifestations may include

progressivedeformity,potentialspinalimbalance,andspinalstenosis,withresultantaxial

or lower extremity symptomatology. Health-related quality-of-life assessments often

demonstrate severe adverse effects of ASD that can interfere with many aspects of

management of ASD, from evaluation to treatment, and including such issues as

patientselection forindicated surgicalinterventionone ofthe mainkeysto asuccessful

outcome.Pertinentissues,suchasbonedensityevaluationandpreoperativeoptimization,

must be addressed with the use of intraoperative adjuvants to ensure stable internal

fixation to the spinal column in patients requiring stabilization with or without

realignment. For patients with progressive deformity producing segmental, regional, or

globalmalalignment,variouscorrectivestrategiesarediscussedtosafelyrealignthespinal

columnusingvariousformsofspinalosteotomieswithadjuvantspinalinstrumentationto

secure the spinal segments in their realigned position. Spinal fixation techniques are

especially challenging when instrumenting the sacropelvic unit in long constructs. The

various forms of osteotomies utilized range from simple facet excisions to extremely

complex three-column osteotomies such as pedicle subtraction and vertebral column

treatingASDpatients.Thus,asinallareasofmedicine,thevaluepropositionoftreating

controversial and complicated clinical issues involved in the management of ASD