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Imaging of the Postoperative Spine, An Issue of Neuroimaging Clinics, E-Book

Imaging of the Postoperative Spine, An Issue of Neuroimaging Clinics, E-Book

Orlando Ortiz

(2014)

Abstract

Editor Orlando Ortiz and authors review important areas in Imaging of the Postoperative Spine. Articles will include: Post-operative spine imaging in cancer patients; Minimally invasive spine intervention; Post-vertebral augmentation spine imaging; Imaging of lumbar spine fusion; Motion sparing spine instrumentation; Imaging of spine surgery complications; Post-operative fluid collections; Emerging techniques of post-operative spine imaging, What the spine surgeon needs to know about post-operative spine; Post-operative spine infection evaluation; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Imaging of the\rPostoperative Spine i
copyright\r ii
Neuroimaging Clinics Of North America\r iv
Contributors v
Contents vii
Foreword xi
Preface\r xiii
Imaging of Lumbar Spine Fusion 269
Key points 269
Introduction 269
Indications 270
Primary versus secondary fusion 270
Use of hardware 271
Surgical methods 271
Intraoperative imaging 272
Postoperative imaging 272
Postoperative MR Imaging 272
Postoperative CT 274
Fusion assessment 274
MR Imaging 279
CT 280
CT Myelography 281
Long-term surveillance 281
Summary 283
References 283
Motion Preservation Surgery in the Spine 287
Key points 287
Lumbar total disc replacement 289
Cervical total disc replacement 291
Dedication 293
References 293
The Postoperative Spine 295
Key points 295
Introduction 295
Surgical techniques 295
Decompressive Procedures 295
Stabilization and Fusion Procedures 296
Surgical hardware 296
Plates and rods with transpedicular screws 296
Translaminar or facet screws 297
Interbody spacers 297
Fusion—surgical approaches 297
Additional Procedures 298
Vertebral body replacement (corpectomy) 298
Disc arthroplasty 298
Dynamic stabilization devices 298
Evaluation postsurgery 298
Evaluation Following Decompressive Procedures 298
Evaluation After Instrumentation 300
Adjacent segment disease 301
Foreign body 302
General complications 302
Summary 303
References 303
Postoperative Spine Complications 305
Key points 305
Introduction 305
Surgical approaches and specific related complications 306
Cervical Spine Approaches 306
Anterior cervical approach 306
Posterior cervical approach 306
Thoracic Approaches 308
Lumbar Approaches 308
Anterior lumbar approaches 308
Posterior lumbar approaches 308
Lateral and axial interbody fusion 308
Complications of hardware devices and instrumentation 308
Pseudarthrosis 311
Postoperative infection 311
Postoperative hematoma 312
Inflammatory changes and scarring 313
Arachnoiditis 313
Peridural Fibrosis 315
Pseudomeningocele, CSF leak, and intracranial hypotension 317
Complications related to bone graft, recombinant human bone morphogenic protein, and heterotopic bone 317
Recurrent disc herniation 320
Accelerated junctional/adjacent-level disease 321
Remote complications 322
Intracranial Hemorrhage 322
Ophthalmic Complications 322
Summary 322
References 322
Postoperative Spine Imaging in Cancer Patients 327
Key points 327
Introduction 327
Indications for postoperative imaging 328
Imaging protocols 328
MR Imaging 328
Computed Tomography 329
Nuclear Medicine 329
Imaging findings 329
Summary 334
References 334
Post-Vertebral Augmentation Spine Imaging 337
Key points 337
Introduction 337
Vertebral augmentation 337
Reasons for post-VA imaging 338
Post-VA Baseline Imaging 338
Post-VA Imaging for Suspected Complications 339
Cement leakage 339
Pain exacerbation 341
Iatrogenic injury, infection, and bleeding 341
Post-VA Imaging for Evaluation of New Symptoms 342
Post-VA imaging appearance 342
Signal Changes Resulting from the Cement Material 342
Signal Changes in Bone Marrow Surrounding Cement Material 343
Early changes (0–3 months) 343
Intermediate changes (3–6 months) 343
Late changes (6–12 months) 343
MR imaging and contrast enhancement 343
Bright rim sign 343
Changes in Vertebral Size and Morphology 345
Evaluation of new post-VA pain 346
Acknowledgments 346
References 346
Optimized Imaging of the Postoperative Spine 349
Key points 349
Introduction 349
CT 349
Fundamental Factors 349
kVp 350
Iterative reconstruction 350
Slice thickness 350
Advanced techniques 350
DECT 350
Methods 350
Dual Source Imaging 350
Fast Kilovolt Switching 353
Dual-Layer Detector (Sandwiched Layers) 353
Sequential Acquisition (Spin-Spin) 353
Quantum Counting 353
Output 354
MR imaging 355
Introduction 355
Managing Susceptibility 355
MR Imaging Advanced Techniques 356
Frequency Encoding Direction 356
Small Voxel Sizes 358
High Bandwidth 358
Fast/Turbo Spin Echo 359
Issues at 3 T 359
Multispectral imaging 361
Ultrashort time to echo 361
Fat Suppression 361
STIR 362
Chemical Shift Fat Suppression 362
Summary 363
References 363
Imaging and Management of Postoperative Spine Infection 365
Key points 365
Introduction 365
Radiography 365
Computed tomography 366
Ultrasonography 366
Magnetic resonance imaging 366
Nuclear medicine 366
Spondylodiskitis/epidural abscess 366
Paravertebral abscess 372
Summary 373
References 373
Radiologic Evaluation and Management of Postoperative Spine Paraspinal Fluid Collections 375
Key points 375
Introduction 375
Hematoma 377
Seroma 379
Pseudomeningocele 380
Abscess 385
References 388
Index 391