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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6052_Библиотеки_им_академика_М_И_Перельмана.pdf
268 Index
spinal canal (Continued)
thoracic, 17
trefoil, 149
variants, 149
spinal column, emergency room evaluation
of, in trauma patient, 85
spinal cord
compression
anterior spondylodiscitis and, in
rheumatoid arthritis, 235
by epidural rheumatoid granulation,
235
in rheumatoid arthritis, 231f
by tumor, 207t, 208, 217
diameter of, 4
dynamics, 11
function, 7
motor, 7
sensory, 7
internal structures of, 4–6, 6f
length of, 4
relationship to vertebral segments,
4, 5f, 5t
structure of, 4
tumor of, 46
vascularity of, 7–8
spinal cord injury, 12
annual incidence of, 85
cervical
anatomical distribution of, 95
epidemiology of, 95
evaluation of, 95
incidence of, 95
mechanism of injury in, 95
complete, 86
emergency room management of, 85–89
epidemiology of, 85
imaging of, 56, 88
incomplete, 86–88
intubation in, 86
methylprednisolone for, 95
pharmacological intervention for, 89, 89t
prehospital evaluation, 85
prognosis for, 88t, 89
secondary, 89
surgical treatment of, 89
treatment of, 89
spinal deformity
in adult, clinical presentation of, 46
in ankylosing spondylitis, 238
in child, clinical presentation of, 46
clinical presentation of, 46
inspection for, 47
kyphotic. See kyphotic spinal deformity
and scoliosis, 191
in thoracolumbar spine, 72–73
tumor and, 208
spinal dysraphism, skin and subcutaneous
findings in, 48
spinal fusion. See also atlanto-occipital
fusion; cervical spine, fusion;
lumbar spine, fusion; thoracic
spine, fusion
anterior, 80–81
anterior lumbar interbody, 163t, 164, 165f
factors affecting, 79
posterior, 80
posterior lumbar interbody, 162–164,
162 f, 163 t, 164f
transforaminal lumbar interbody, 162f,
163 t, 164, 164f, 165f
spinalis muscle, 21
spinal muscular atrophy
and kyphotic spinal deformity, 199
and scoliosis, 191
spinal nerve(s), 9–11, 12f
cervical, 9
intervertebral foramina for, 9
lumbar, 9
thoracic, 9
spinal stenosis
acquired, 148–149
and adult scoliosis, 188
central, 148
classification of, 148–149
congenital, 148
definition of, 148
degenerative, 148
disk degeneration and, 148
and disk herniation, combined, 148
epidemiology of, 148
foraminal, 148, 151–156
iatrogenic, 148
injection therapy for, 92
lateral recess, 148
lumbar, 144, 148–157, 174
central
decompression, 153, 154f–155f
dimensions of, 150
clinical findings in, 152
conservative treatment of, 153
differential diagnosis of, 153
dimensions of, 150–151, 151f
foraminal
decompression, 153–156
dimensions of, 151
Index 269
imaging of, 152–153
lateral recess
decompression, 153
dimensions of, 150
pathogenesis of, 149–152
physical findings in, 152
surgical treatment of
indications for, 153
techniques for, 153–156, 154f–155f
nerves affected by, 149
posttraumatic, 148
signs and symptoms of, 144
spine
cervical. See cervical spine
immobilization, prehospital, 85
lumbar. See lumbar spine
posterior innervation of, 12f
posterior musculature of, 13f
sacral. See sacrum
thoracic. See thoracic spine
spino-olivary tract, 6f
spinotectal tract, 6f
spinous process, 4
splenius capitis muscle, 13f, 15
splenius cervicis muscle, 15
spondylectomy, total, 212
spondyloarthropathy(ies), seronegative.
See seronegative
spondyloarthropathy(ies)
spondyloepiphyseal dysplasia, and
atlantoaxial instability, 247
spondylolisthesis
lumbar, 144, 150, 169–176
acquired, 170
biomechanics of, 74, 169
classification of, 169, 170t
congenital/dysplastic, 170, 170t
clinical findings in, 171, 171f
epidemiology of, 170
etiology of, 170
familial occurrence of, 169
treatment of, 171
definition of, 169
degenerative, 148, 149, 170, 170t
clinical findings in, 174
epidemiology of, 174
lumbar spinal fusion for, 156
nonoperative treatment of, 174–175
radiographic findings in, 174
and spinal stenosis, 174
surgical treatment of, 175–176, 175f
developmental, 170
epidemiology of, 169
hereditary factors and, 169
with high dysplasia, 170
iatrogenic, 170, 170t
isthmic, 159
clinical findings in, 172
epidemiology of, 171–172
familial occurrence of, 169
grading, 172
imaging of, 172
lumbar index in, 172
Meyerding classification of, 172
nonoperative treatment of, 172
radiographic measurements in, 172
slip angle in, 172, 173–174, 173f
surgical treatment of, 173–174
with low dysplasia, 170
neoplasia and, 176
pathological, 170, 170t, 17 6
postsurgical, 170, 170t
racial distribution of, 169
spina bifida and, 169
traumatic, 170, 170t, 17 6
treatment options in, 176t
and spinal deformity, 46
traumatic, of axis, 99–100, 99f. See also
hangman’s fracture
spondylolysis
definition of, 169
lumbar, 145
nerve root compression in, 150
spondylosis
cervical, 122
epidemiology of, 124t
physical findings in, 124t
thoracic, 132
Spurling’s sign, 46t, 122
SSEPs. See somatosensory evoked potentials
stability, spinal, 60
stellate ganglion, 23
stereognosis, spinal tracts for, 7
sternocleidomastoid muscle, 13f, 17, 23, 23f
sternohyoid muscle, 17
sterno-occipital-mandibular immobilized
brace, 69
sternothyroid muscle, 17
steroid(s)
epidural, 92
in lumbar disk disease, 145
injection therapy, for back and neck pain,
92
straight leg raise, 46t, 143
contralateral, 46t, 143
reverse, 46t, 143
270 Index
stress shielding, 76
strut graft(s)
for anterior cervical fusion, 80
for anterior thoracolumbar fusion, 80
subaxial subluxation, 235
in rheumatoid arthritis, 232
surgical stabilization in
indications for, 233
technique for, 234
suboccipital nerve, 21
superior culneal nerve, 12f
superior gluteal nerve, 11
superior intercostal artery, 7
superior lateral brachial cutaneous nerve,
12f
supraspinatus muscle, 13f
supraspinous ligament, 15, 17
Sygen, for spinal cord injury, 89t
sympathetic centers, of spinal cord, 11–12
sympathetic ganglion, 8f
sympathetic nerve(s), in midcervical spine,
23
syndesmophytes
in ankylosing spondylitis, 237
in enteropathic arthritis, 239
in Reiter’s syndrome, 238
T
tactile discrimination, spinal tracts for, 7
tectorial membrane, 15, 16f
tectospinal tract, 6f
temperature
perception, assessment of, 48
spinal tracts for, 6f, 7
tension signs, 42, 46t
teres major muscle, 12f, 13f
teres minor muscle, 12f, 13f
Texas Scottish Rite Hospital system, for
scoliosis, 185, 186
TGF. See transforming growth factor
third occipital nerve, 12f, 21
thoracic outlet syndrome, 127
thoracic spine
axial rotation, 61
biomechanics of, 69–70
costotransversectomy, 135–136
degenerative disorders, 132–136
clinical presentation of, 132
diagnosis of, 132
epidemiology of, 132
imaging of, 132, 134f, 13 5f
surgical treatment of, 135–136
treatment of, 133–136
flexion/extension, 61
fusion, 135–136
anterior, 72
instrumentation, 136
intervertebral foramina in, 9
kinematics, 61
lateral bending, 61
pedicle screws for, 72, 73f
range of motion, 61
spinal nerves, 9
stability, three-column concept of Denis,
70–72, 72f, 105, 105f
stenosis, 132
supporting structures of, 69–70
surgical approach to
anterior, 35–37
thoracoabdominal, 36–37
transthoracic, 35
posterior, 30–32
costotransversectomy, 32
posterolateral, 32
transpedicular, 30
thoracoscopic discectomy, 136
transpedicular instrumentation, 72, 73f
trauma, 70–72
vertebrae of, 17, 18f
thoracolumbar spine
anterior fusion, 72, 80–81
biomechanics of, 69–70
deformities, 72–73
extension, 48, 61
flexion, 48, 61
fractures, 104–110
instrumentation for, 72, 73f
stable, 106
surgical treatment of, 106
options for neurologically
compromised patients, 108–110
timing of, 106–107
types of, 72
immobilization of, external, 107
injury
anatomical distribution of, 104
associated injuries, 104
classification of, 105–106
compression-flexion, 107
distraction flexion, 107–108, 109f
epidemiology of, 104
evaluation of, 104–105
neurological, 104
radiological, 104–105
and neurological status, 107
and stability, 107
Index 271
torsional flexion, 108, 110f
vertical compression, 108
instability, 105–106
lateral bending, 48, 61
rotation, 48, 61
stability, three-column concept of Denis,
70–72, 72f, 105, 105f
supporting structures of, 69–70
surgical anatomy of, 17–21
surgical approach to, posterior, 30–33
trauma, 70–72
vascularity of, 7–8
three-joint complex, degenerative changes,
and spinal stenosis, 149
thyroid cancer
laboratory findings with, 205
metastases to spine, 206t
risk factors for, 206t
tirilazad mesylate, for spinal cord injury, 89t
TLIF. See transforaminal lumbar interbody
fusion
torticollis, 240, 244, 245
age at diagnosis, 246
clinical findings in, 247
differential diagnosis of, 247
pathogenesis of, 246
treatment of, 247
touch
crude, spinal tracts for, 7
deep, spinal tracts for, 6f
light
perception, assessment of, 48
spinal tracts for, 6f, 7
trachea, 23, 23f
transforaminal lumbar interbody fusion,
162 f, 163 t, 164, 164f, 16 5f
transforming growth factor , 82
and disk metabolism, 118
transition zone, of intervertebral disk, 115
transpedicular instrumentation, for
thoracolumbar fractures, 72, 73f
transverse ligament, 14, 15, 16f
rupture of, 63
anterior atlantodens interval in, 96
signs and symptoms of, 96, 97
treatment of, 96
transverse process, 4
trapezius muscle, 12f, 13f, 15
trauma
cervical spine, 95–103
emergency room management of, 85–89,
95
history-taking in, 46
imaging evaluation of, 88
in-field management of, 85, 95
management of, 46
neurological examination in, 86
thoracic, 70–72
thoracolumbar, 70–72
trigger point injections, 92
trigger point syndrome, 144
tuberculosis, spinal, 225
anterior involvement in, 225, 226f
central involvement in, 225, 226f
clinical presentation of, 225
differential diagnosis of, 225
epidemiology of, 225
kyphotic deformity in, 200–201, 201f
magnetic resonance imaging of, 225,
226f, 227f
peridiscal involvement in, 225, 226f
surgical treatment of, 225, 227f
tumor(s)
benign, 209t, 213f–215f
of bone, 46
benign, 209t, 213f
malignant, 210t, 216f
cervical spine, 126
diagnosis of, 212
differential diagnosis of, magnetic
resonance imaging for, 208t
history-taking for, 205
imaging of, 56, 207, 207t
intradural intramedullary, 212t, 213f
intraspinal, 211t, 213f
and kyphotic spinal deformity, 196
laboratory studies with, 206
and low back pain, 143, 159
and lumbar spondylolisthesis, 176
malignant, 210t, 216f
metastatic, 205, 206t
surgical approach for, 217
neurological examination with, 205
neurological status and, 212
pain with, 205
physical examination for, 205
radiation therapy for, 208
and scoliosis, 178
spinal cord, 46
and spinal deformity, 208
and spinal instability, 208
staging, 207, 212
surgery for
approaches for, 212–217
indications for, 208–212
risk stratification for, 212
272 Index
tumor(s), surgery for (Continued)
treatment of, 207–217
goals of, 207–208
tumor necrosis factor-alpha, and
intervertebral disk, 118, 142
two-point discrimination, spinal tracts for,
6f, 7
U
unilateral unsegmented bar, 182f
upper extremity, motor function, spinal
tracts for, 7
V
vacuum disk sign, 54f
ventral column, 6f
ventral commissure, 7
ventral ramus/rami, 11, 12f, 139
ventral spinocerebellar tract, 6f
ventral spinothalamic tract, 6f
vertebrae
anatomy of, 3–4
cervical, cross-sectional view of, 125f
number of, 3
posterior bony arch of, 3–4
vertebral artery, 14, 16f, 21
course of, 22f
vertebral body
anterior, 3
squaring of, in ankylosing spondylitis, 237
vertebral column
anatomy of, 3–4
curves of, 3
vestibulospinal tract, 6f
vibration sense, spinal tracts for, 6f, 7
Vitoss, 82
W
Waddell’s nonorganic findings, 143
Waddell’s sign, 51
WBC. See white blood cell count
Weinstein-Boriani-Biagini staging system,
for spinal tumors, 207
whiplash, 103
white blood cell count
in disk space infection, 224
in lymphoma, 206
in spinal infection, 206, 222t
white matter, of spinal cord, 4–6, 6f
whole person, definition of, 93
wide canal sign, 172
Wiltse spondylolisthesis classification, 169,
170 t
wry neck. See torticollis
X
X-Stop, 156
Z
Zielke rods, 185, 186