Additional Information
Book Details
Abstract
Minimally Invasive Percutaneous Spinal Techniques, by Daniel H. Kim, MD, FACS, Kyung Hoon Kim, MD, and Yong Chul Kim, MD, helps you apply methods of spinal pain relief that involve less risk and shorter recovery times. Focusing on the broad appeal of this goal for you and your patients, this volume will help surgeons and specialists in various areas of pain management provide less invasive alternatives and faster recovery procedures for those suffering with spinal injuries. Step-by-step techniques are well-illustrated in the book and demonstrated extensively online.
- Get accurate, step-by-step guidance by reviewing full-color, richly illustrated descriptions of various techniques.
- Make the most of extensive surgical videos demonstrating many of the procedures from the book on expertconsult.com.
- Reduce the risk associated with invasive spinal procedures by considering new perspectives on pain management techniques that can be used by specialists from various disciplines.
- Address the growing need for less invasive surgeries with shorter recovery times among a large and aging population with musculoskeletal problems.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Minimally Invasive Percutaneous Spinal Techniques | i | ||
| Copyright | ii | ||
| Dedication | iii | ||
| List of Contributors | iv | ||
| Preface | vi | ||
| Contents | vii | ||
| Video Table of Contents | ix | ||
| Chapter 1: Diagnosis and Treatment of Spinal Pain | 1 | ||
| Classifications Of Spinal Pain | 1 | ||
| Considerations For Diagnosis | 2 | ||
| Epidemiology Of Low Back Pain | 3 | ||
| Outcomes | 3 | ||
| Treatment of Acute Low Back Pain in Primary Care | 3 | ||
| Natural History of Low Back Pain | 3 | ||
| A General Assessment of Patients Reporting Low Back Pain | 3 | ||
| Relevant Medical History | 4 | ||
| Physical Examination | 4 | ||
| Related Anatomy And Physiology | 5 | ||
| Imaging Studies | 5 | ||
| Diagnostic Interventional Techniques | 8 | ||
| Facet or Zygapophyseal Joint Block | 10 | ||
| Safety and Complications | 11 | ||
| Provocative Discography | 13 | ||
| Chapter 2 Current Understanding of Spinal Pain and the Nomenclature of Lumbar Disc Pathology | 29 | ||
| General Pain Mechanism | 29 | ||
| Facet Joint Pain | 33 | ||
| Definition | 33 | ||
| Innervations | 33 | ||
| Intervertebral Disc | 34 | ||
| Distinguishing “Normal Aging” from Disease of the Intervertebral Disc | 36 | ||
| Altered Matrix Composition and Integrity | 36 | ||
| Reduced Cell Number | 37 | ||
| Nerve and Blood Vessel Ingrowth | 37 | ||
| Cytokines as Regulators of Disease Processes | 38 | ||
| Nomenclature And Classification Of Lumbar Disc Pathology | 39 | ||
| Classifications of Disc Herniation | 40 | ||
| Dorsal Root Ganglion | 41 | ||
| Sacroiliac Joint | 41 | ||
| Postlaminectomy Syndrome | 41 | ||
| Spinal Stenosis | 45 | ||
| References | 45 | ||
| Chapter 3 Radiologic Anatomy of the Spine | 46 | ||
| The Cervical Spine | 46 | ||
| Atlas (C1) | 46 | ||
| Axis (C2) | 46 | ||
| The Ligaments of the Atlas and Axis | 46 | ||
| C3 to C7 Vertebrae | 47 | ||
| Vertebral Bodies | 47 | ||
| Joints of von Luschka | 47 | ||
| Transverse Foramen | 47 | ||
| Pedicles | 48 | ||
| Laminae | 48 | ||
| Articular Processes | 48 | ||
| Spinal Canals | 48 | ||
| Epidural Space | 48 | ||
| Cervical Discs | 48 | ||
| Nerves of the Cervical Cord | 49 | ||
| Vertebral Arteries | 49 | ||
| Venous Plexus | 50 | ||
| The Thoracic Spine | 51 | ||
| Pedicles | 51 | ||
| Laminae | 51 | ||
| Spinous Process | 52 | ||
| Transverse Process | 52 | ||
| Articular Processes | 52 | ||
| Intervertebral Foramen | 52 | ||
| Spinal Canal | 52 | ||
| Conus Medullaris | 52 | ||
| The Lumbar Spine | 52 | ||
| Pedicles and Spinous Processes | 53 | ||
| Transverse and Accessory Processes | 53 | ||
| Articular and Mammillary Processes | 53 | ||
| Intervertebral Foramina | 54 | ||
| Spinal Canal | 54 | ||
| Meninges | 54 | ||
| Epidural Space | 55 | ||
| Ligaments of the Lumbar Spine | 55 | ||
| Nerves of the Lumbar Spine | 56 | ||
| Lumbar Venous Plexus | 56 | ||
| Lumbar Disc | 56 | ||
| Lumbar Arteries and Veins | 57 | ||
| References | 57 | ||
| Chapter 4 Imaging Diagnosis of the Degenerative Spine | 58 | ||
| Conventional Radiography (Plain Films) | 58 | ||
| Intervertebral Osteochondrosis | 58 | ||
| Spondylosis Deformans | 58 | ||
| Myelography | 58 | ||
| Computed Tomography | 58 | ||
| Discography | 60 | ||
| Magnetic Resonance Imaging | 61 | ||
| General Considerations In Degenerative Joint Disease | 61 | ||
| The Cervical Spine | 61 | ||
| Apophyseal (Facet) Joints | 61 | ||
| Uncovertebral Joints (Joints of von Luschka) | 61 | ||
| Intervertebral Disc | 61 | ||
| The Thoracic Spine | 62 | ||
| Apophyseal (Facet) Joints | 62 | ||
| Costal Articulation | 62 | ||
| Intervertebral Disc (Spondylosis, Senile Kyphosis) | 62 | ||
| The Lumbar Spine | 63 | ||
| Apophyseal (Facet) Joints | 63 | ||
| Intervertebral Disc | 65 | ||
| The Sacroiliac Joints | 67 | ||
| Disc Degeneration And Internal Disc Disruption | 69 | ||
| Disc Dehydration and Narrowing | 69 | ||
| Magnetic Resonance Imaging and Disc Degeneration | 69 | ||
| Degenerative Changes in Subchondral Marrow | 71 | ||
| Anular Fissure | 72 | ||
| Disc and Facet Degeneration and “Instability” | 74 | ||
| Disc Contour | 75 | ||
| Type and Position of Disc Herniation | 78 | ||
| Volume of Herniated Disc Material | 81 | ||
| Disc Herniation and Neural Compression | 81 | ||
| Disc Herniation and Signal Intensity | 82 | ||
| Special Considerations in the Cervical Spine | 82 | ||
| Special Considerations in the Thoracic Spine | 83 | ||
| Associated Degenerative Syndromes | 83 | ||
| Spinal Stenosis | 83 | ||
| Special Considerations in Stenosis | 86 | ||
| Degenerative Spondylolisthesis | 86 | ||
| The Cervical Spine and Spondylotic Myelopathy | 88 | ||
| Degenerative Scoliosis and Stenosis | 88 | ||
| Lumbar Foraminal Stenosis | 89 | ||
| Facet Joint Disease | 92 | ||
| Osteoarthritis of the Facet Joints | 92 | ||
| Synovial Cyst | 93 | ||
| Other Nondiscal Degenerative Processes | 95 | ||
| Instability | 95 | ||
| Interspinous Degenerative Changes | 96 | ||
| Diffuse Idiopathic Skeletal Hyperostosis | 98 | ||
| Ossification of the Posterior Longitudinal Ligament and of the Ligamentum Flavum | 98 | ||
| Scheuermann Disease, Thoracolumbar Osteochondrosis, and Juvenile Discogenic Disease | 101 | ||
| Schmorl Node | 102 | ||
| Scheuermann Disease (Juvenile Kyphosis) | 103 | ||
| References | 105 | ||
| Chapter 5 Epidural Blocks | 111 | ||
| The Mechanism Of Radiculopathy–Neuropathic Pain And The Action Of Epidural Steroid Injection | 112 | ||
| Possible Problems With Epidural Blockade | 113 | ||
| Recommendations For Use | 113 | ||
| The Contents Of The Epidural Space | 113 | ||
| Structures Encountered During Midline Insertion Of A Needle Into The Lumbar Epidural Space | 113 | ||
| Indications | 113 | ||
| Contraindications | 113 | ||
| Complications | 115 | ||
| Preoperative Preparation | 115 | ||
| Physical Examination | 115 | ||
| Imaging Diagnosis | 115 | ||
| Preoperative Medication | 117 | ||
| Instrumentation | 117 | ||
| Procedures | 117 | ||
| Cervical and Thoracic Epidural Block through the Interlaminar Midline Approach without Fluoroscopic Guidance | 117 | ||
| Thoracic Epidural Block through the Interlaminar Paramedian Approach without Fluoroscopic Guidance | 121 | ||
| Lumbar Epidural Block through the Interlaminar Midline Approach without Fluoroscopic Guidance | 121 | ||
| Caudal Epidural Block with Patient in the Prone Position | 121 | ||
| Caveats | 123 | ||
| References | 123 | ||
| Chapter 6 Transforaminal Epidural Block and Selective Nerve Root Block | 124 | ||
| Treatment Objectives | 124 | ||
| Chapter 7: Dorsal Root Ganglion Pulsed Radiofrequency Lesioning | 137 | ||
| Treatment Objectives | 137 | ||
| Indications | 137 | ||
| Contraindications | 137 | ||
| Complications | 137 | ||
| Preoperative Preparation | 137 | ||
| History Taking and Physical Examination | 137 | ||
| Imaging Diagnosis and Diagnostic Block | 138 | ||
| Electrophysiologic Study | 138 | ||
| Anatomy | 138 | ||
| Cervical Region | 138 | ||
| C2 Dorsal Root Ganglion | 138 | ||
| C3 through C8 Dorsal Root Ganglia | 138 | ||
| Thoracic Region | 139 | ||
| Lumbosacral Region | 139 | ||
| Instrumentation | 140 | ||
| Chapter 8: Medial Branch Block and Radiofrequency Lesioning | 149 | ||
| Treatment Objectives | 149 | ||
| Chapter 9: Atlantooccipital and Atlantoaxial Joint Block for Cervicogenic Headache | 164 | ||
| Cervicogenic Headache | 164 | ||
| Diagnostic Criteria for Cervicogenic Headache | 164 | ||
| Clinical Characteristics of Cervicogenic Headache | 164 | ||
| Sources of Pain | 164 | ||
| Atlantooccipital And Atlantoaxial Joint Pain | 165 | ||
| Related Anatomy And Physiology | 166 | ||
| The Atlantooccipital Joint | 166 | ||
| The Atlantoaxial Joint | 166 | ||
| Atlantooccipital And Atlantoaxial Joint Block | 166 | ||
| Indications | 166 | ||
| Complications | 167 | ||
| Preoperative Preparation | 167 | ||
| Procedure | 167 | ||
| References | 169 | ||
| Chapter 10: Sympathetic Nerve Block and Neurolysis | 170 | ||
| Preoperative Preparation | 170 | ||
| Instrumentation | 170 | ||
| Contraindications | 170 | ||
| Procedures | 170 | ||
| Stellate Ganglion | 170 | ||
| Anatomy | 170 | ||
| Indications | 171 | ||
| Technique | 171 | ||
| Stellate Ganglion Block | 171 | ||
| Pulsed Radiofrequency Lesioning or Radiofrequency Thermocoagulation of the Stellate Ganglion | 171 | ||
| Thoracic Sympathetic Ganglion | 172 | ||
| Anatomy | 172 | ||
| Indications | 172 | ||
| Techniques | 172 | ||
| Thoracic Sympathetic Block | 172 | ||
| Pulsed Radiofrequency Lesioning or Radiofrequency Thermocoagulation | 173 | ||
| Complications | 173 | ||
| Splanchnic Nerve | 173 | ||
| Anatomy | 173 | ||
| Indications | 173 | ||
| Contraindications | 173 | ||
| Techniques | 174 | ||
| Splanchnic Nerve Block | 174 | ||
| Pulsed Radiofrequency Lesioning or Radiofrequency Thermocoagulation | 174 | ||
| Radiofrequency Thermocoagulation | 175 | ||
| Pulsed Radiofrequency Lesioning | 175 | ||
| Complications | 175 | ||
| Celiac Plexus | 175 | ||
| Anatomy | 175 | ||
| Indications and Contraindications | 175 | ||
| Technique | 175 | ||
| Oblique Approach | 175 | ||
| A Single-Needle, Transaortic Approach | 175 | ||
| Complications | 176 | ||
| Lumbar Sympathetic Ganglion | 176 | ||
| Anatomy | 176 | ||
| Indications | 176 | ||
| Technique | 176 | ||
| Lumbar Sympathetic Block | 176 | ||
| Oblique Approach in the Prone Position | 177 | ||
| Oblique Approach in the Lateral Position | 179 | ||
| Radiofrequency Lesioning | 179 | ||
| Radiofrequency Thermocoagulation | 179 | ||
| Pulsed Radiofrequency Lesioning | 180 | ||
| Chemical Neurolysis | 180 | ||
| Chapter 11: Sacroiliac Joint Block and Neuroablation | 184 | ||
| Sacroiliac Joint Dysfunction | 184 | ||
| Indications | 185 | ||
| Complications | 185 | ||
| Sacroiliac Joint Injection | 185 | ||
| Neuroablation | 187 | ||
| Preoperative Preparation | 187 | ||
| Physical Examination | 187 | ||
| Anatomy | 188 | ||
| Procedures | 190 | ||
| Sacroiliac Joint Injection | 190 | ||
| Denervation of the Sacroiliac Joint | 190 | ||
| Postprocedural Management | 191 | ||
| References | 191 | ||
| Chapter 12: Paravertebral Block | 192 | ||
| Lumbar Paravertebral Block | 192 | ||
| Thoracic Paravertebral Block | 192 | ||
| Treatment Objectives | 193 | ||
| Indications | 193 | ||
| Lumbar Paravertebral Block | 193 | ||
| Thoracic Paravertebral Block | 193 | ||
| Contraindications | 193 | ||
| Complications | 193 | ||
| Anesthesia | 193 | ||
| Instruments | 194 | ||
| Procedures | 194 | ||
| Lumbar Paravertebral Block | 194 | ||
| Anatomy | 194 | ||
| Procedure | 196 | ||
| Single-Injection Technique | 196 | ||
| Continuous Technique | 196 | ||
| Continuous Infusion | 196 | ||
| Assessment of the Block | 196 | ||
| Thoracic Paravertebral Block | 196 | ||
| Anatomy | 196 | ||
| Procedures | 198 | ||
| Single-Injection Technique | 198 | ||
| Continuous Technique | 198 | ||
| Assessment of the Block | 198 | ||
| Postprocedure Care | 198 | ||
| References | 200 | ||
| Chapter 13: Intervertebral Discography | 202 | ||
| Concepts Of Discography | 202 | ||
| Terms Related to Discography | 202 | ||
| Mechanism of Disc Injection–Induced Pain | 202 | ||
| Concepts Of Internal Disc Disruption | 202 | ||
| Indications | 203 | ||
| Contraindications | 203 | ||
| Complications | 203 | ||
| Preoperative Preparation | 204 | ||
| Procedures | 204 | ||
| Cervical Discography | 204 | ||
| Thoracic Discography | 205 | ||
| Lumbar Discography | 206 | ||
| Related Anatomy And Physiology | 206 | ||
| Interpretation Of Discography | 207 | ||
| Scoring System for Response to Disc Stimulation | 207 | ||
| Other | 208 | ||
| Postoperative Follow-Up | 208 | ||
| Caveats | 209 | ||
| References | 213 | ||
| Chapter 14: Epiduroscopic Adhesiolysis | 214 | ||
| Treatment Objectives | 214 | ||
| Preoperative Preparation | 214 | ||
| History and Physical Examination | 214 | ||
| Imaging Diagnosis | 214 | ||
| Other Studies and Issues | 214 | ||
| Indications | 214 | ||
| Contraindications | 215 | ||
| Complications | 215 | ||
| Instrumentation | 215 | ||
| Instruments | 215 | ||
| Solutions | 216 | ||
| Procedure | 216 | ||
| Postprocedural Management | 217 | ||
| Epiduroscopic Findings | 218 | ||
| References | 220 | ||
| Chapter 15: Spinal Cord Stimulation | 221 | ||
| Treatment Objectives | 221 | ||
| Indications | 221 | ||
| Contraindications | 221 | ||
| Complications | 221 | ||
| Preoperative Preparation | 222 | ||
| Radiologic Anatomy | 222 | ||
| Instrumentation | 222 | ||
| Procedure | 223 | ||
| Implantation of the Trial Lead | 223 | ||
| Preparation for Implantation of the Trial Lead | 223 | ||
| Initial Lead Placement | 227 | ||
| Intraoperative Test Stimulation | 227 | ||
| Completion of Trial Procedure | 229 | ||
| Implantation of the Pulse Generator | 230 | ||
| Avoiding Complications | 232 | ||
| Postprocedural Management | 233 | ||
| Effects of Body Position on Stimulation | 233 | ||
| Discharging the Patient | 233 | ||
| References | 238 | ||
| Chapter 16: Implantation of Intrathecal Drug Delivery Systems | 239 | ||
| Indications | 239 | ||
| Contraindications | 239 | ||
| Instrumentation | 239 | ||
| Preoperative Preparation | 241 | ||
| Procedure | 241 | ||
| Step 1: Pump Preparation | 241 | ||
| Step 2: Implant Procedure | 242 | ||
| Postprocedural Management | 244 | ||
| Program The Pump | 245 | ||
| Complications | 245 | ||
| Chapter 17: Intradiscal Therapies | 250 | ||
| Intradiscal Electrothermal Therapy | 250 | ||
| Mechanisms of Action | 250 | ||
| Indications and Contraindications | 250 | ||
| Indications | 250 | ||
| Contraindications | 251 | ||
| Related Anatomy and Pathophysiology | 251 | ||
| Procedure | 251 | ||
| Postoperative Care and Follow-Up | 252 | ||
| Complications | 252 | ||
| Limitations | 252 | ||
| Nucleoplasty | 253 | ||
| Indications and Contraindications | 255 | ||
| Indications | 255 | ||
| Contraindications | 255 | ||
| Procedure | 255 | ||
| Limitations | 257 | ||
| Percutaneous Discectomy | 257 | ||
| Indications and Contraindications | 257 | ||
| Indications | 257 | ||
| Contraindications | 257 | ||
| Precaution | 257 | ||
| Potential Complications | 257 | ||
| Benefits | 257 | ||
| Procedure | 258 | ||
| Limitations | 258 | ||
| References | 258 | ||
| Chapter 18: Kyphoplasty | 259 | ||
| Treatment Objectives Of Kyphoplasty | 259 | ||
| Indications | 259 | ||
| Contraindications | 259 | ||
| Complications | 259 | ||
| Preoperative Preparation | 259 | ||
| Radiologic Anatomy For Kyphoplasty | 260 | ||
| Methods Of Kyphoplasty | 260 | ||
| Instrumentation | 260 | ||
| Operating Room Setup | 260 | ||
| Kyphoplasty Kit | 261 | ||
| Bone Cement | 261 | ||
| Other Equipment | 262 | ||
| Anesthesia | 262 | ||
| Procedure | 263 | ||
| Inserting the Tools into the Fractured Vertebral Body | 263 | ||
| Placing and Inflating the Bone Tamp | 265 | ||
| Mixing the Cement and Filling the Void | 265 | ||
| Postoperative Management | 265 | ||
| Potential Adverse Results | 265 | ||
| References | 269 | ||
| Chapter 19: Unipedicular Approach for Percutaneous Vertebroplasty | 270 | ||
| Preoperative Prepations | 270 | ||
| Preoperative Examination and Medications | 270 | ||
| Indications | 270 | ||
| Contraindications | 270 | ||
| Complications | 270 | ||
| Instrumentation | 272 | ||
| Procedure | 272 | ||
| Related Anatomy And Physiology | 274 | ||
| Postoperative Care And Follow-Up | 274 | ||
| Key Points | 274 | ||
| References | 276 | ||
| Chapter 20: Percutaneous Sacroplasty | 277 | ||
| Indications | 277 | ||
| Possible Complications | 277 | ||
| Procedure | 277 | ||
| Postoperative Follow-Up | 277 | ||
| Related Anatomy And Physiology | 277 | ||
| Caveat | 277 | ||
| Reference | 286 | ||
| Chapter 21: Anterior Endoscopic Cervical Discectomy | 287 | ||
| Instrumentation | 289 | ||
| Procedure | 289 | ||
| Related Anatomy And Physiology | 291 | ||
| Postprocedural Management | 294 | ||
| Complications | 295 | ||
| Future Directions | 299 | ||
| References | 299 | ||
| Acknowledgement | 300 | ||
| Chapter 22 : Anterior Endoscopic Cervical Microdecompression of Disc and Foramen | 301 | ||
| Treatment Objectives | 301 | ||
| Indications | 301 | ||
| Contraindications | 301 | ||
| Advantages | 301 | ||
| Instrumentation | 302 | ||
| Procedure | 302 | ||
| Anesthesia | 302 | ||
| Patient Positioning | 303 | ||
| Fluoroscopy and Neurophysiologic Monitoring | 303 | ||
| Localization and Point of Entry | 303 | ||
| Surgical Technique | 303 | ||
| Postoperative Managment | 307 | ||
| Complications | 308 | ||
| Conclusion | 308 | ||
| References | 309 | ||
| Chapter 23: Percutaneous Endoscopic Cervical Discectomy and Stabilization | 311 | ||
| Indications And Contraindications | 311 | ||
| Preoperative Preparation | 311 | ||
| Instrumentation | 312 | ||
| Equipment | 312 | ||
| Anesthesia and Other Medications | 312 | ||
| Procedure | 312 | ||
| Discectomy | 313 | ||
| Percutaneous Cervical Stabilization Using the Cervical B-Twin Expandable Holder | 317 | ||
| Postprocedural Management | 318 | ||
| Caveats | 319 | ||
| References | 319 | ||
| Chapter 24: Endoscopy-Assisted Thoracic Microdiscectomy | 320 | ||
| Treatment Objective Of Endoscopy-Assisted Thoracic Discectomy | 320 | ||
| Indications | 320 | ||
| Contraindications | 320 | ||
| Advantages | 320 | ||
| Instrumentation | 321 | ||
| Preoperative Preparation | 322 | ||
| Anesthesia | 322 | ||
| Patient Positioning | 322 | ||
| Fluoroscopy and Neurophysiologic Monitoring | 322 | ||
| Procedure | 322 | ||
| Localization and Point of Entry | 322 | ||
| Surgical Technique | 322 | ||
| Postoperative Management | 325 | ||
| Complications | 326 | ||
| Conclusion | 327 | ||
| References | 327 | ||
| Chapter 25: Posterolateral Endoscopic Thoracic Discectomy | 328 | ||
| Indications And Contraindications | 328 | ||
| Indications | 328 | ||
| Contraindications | 328 | ||
| Preoperative Preparation | 328 | ||
| Physical Examination | 328 | ||
| Imaging Diagnosis | 329 | ||
| Medications | 329 | ||
| Complications | 329 | ||
| Instrumentation | 329 | ||
| Procedure | 331 | ||
| Anesthetics and Other Medications | 331 | ||
| C-Arm–Guided Percutaneous Endoscopic Thoracic Discectomy using a Rigid Working Channel Scope | 331 | ||
| Real-time Computed Tomography-Guided Percutaneous Endoscopic Thoracic Anuloplasty Using the LASE System | 333 | ||
| References | 335 | ||
| Chapter 26: Selective Percutaneous Posterolateral Endoscopic Lumbar Nuclectomy | 336 | ||
| Indications | 336 | ||
| Contraindications | 336 | ||
| Complications | 337 | ||
| Preoperative Prepations | 337 | ||
| Physical Examination | 337 | ||
| Imaging Diagnosis | 337 | ||
| Medications | 337 | ||
| Related Anatomy And Physiology | 338 | ||
| Instrumentation | 338 | ||
| Procedure | 341 | ||
| Postoperative Care And Follow-Up | 346 | ||
| Caveats | 346 | ||
| Chapter 27: Full-Endoscopic Interlaminar Lumbar Discectomy and Spinal Decompression | 351 | ||
| Advantages | 351 | ||
| Disadvantages | 352 | ||
| Indications | 352 | ||
| Contraindications | 353 | ||
| Preoperative Preparation | 353 | ||
| Examination | 353 | ||
| Informed Consent | 353 | ||
| Procedure | 353 | ||
| Complications | 356 | ||
| Postprocedural Management | 357 | ||
| Conclusion | 357 | ||
| References | 359 | ||
| Chapter 28: Posterior Lumbar Foraminal Decompression | 360 | ||
| Anatomical And Technical Considerations | 361 | ||
| Indications | 361 | ||
| Radiologic Diagnosis | 362 | ||
| Operating Room Setup And Anesthesia | 362 | ||
| Procedure | 363 | ||
| Postprocedural Management | 365 | ||
| Conclusion | 366 | ||
| References | 366 | ||
| Chapter 29: Percutaneous Transforaminal Lumbar Interbody Stabilization | 367 | ||
| Advantages | 367 | ||
| Indications | 367 | ||
| Contraindications | 367 | ||
| Complications | 367 | ||
| Preoperative Preparation | 367 | ||
| Patient Symptoms | 367 | ||
| Imaging Diagnosis | 367 | ||
| Instrumentation | 367 | ||
| Anesthesia | 368 | ||
| Procedure | 369 | ||
| Postprocedural Management | 370 | ||
| References | 373 | ||
| Chapter 30: Percutaneous Pedicle Screw Fixation | 374 | ||
| Advantages | 374 | ||
| Indications | 374 | ||
| Contraindications | 374 | ||
| Preoperative Preparation | 374 | ||
| Procedures | 374 | ||
| Procedure for Percutaneous Pedicle Screw in General | 375 | ||
| Procedure for Use of the Sextant System | 377 | ||
| Patient Positioning and Operating Room Setup | 377 | ||
| Fluoroscopy for Percutaneous Pedicle Screw Fixation | 377 | ||
| Procedure for Percutaneous Pedicle Screw Fixation | 377 | ||
| Limitations of the Sextant System | 379 | ||
| Modified Methods Allow for these Limitations | 380 | ||
| Complications | 381 | ||
| References | 384 | ||
| Chapter 31: Percutaneous Translaminar Facet Pedicle Screw Fixation | 388 | ||
| Indications And Contraindications | 388 | ||
| Instrumentation | 388 | ||
| Procedures | 388 | ||
| Preoperative Measurement of Laminar Angles | 388 | ||
| Intraoperative Measurement of Caudal Angle | 388 | ||
| Insertion of the Translaminar Facet Screw | 388 | ||
| Postoperative Management | 391 | ||
| Conclusions | 391 | ||
| References | 394 | ||
| Chapter 32: Percutaneous Lumbar Restabilization Via a Posterolateral Approach | 395 | ||
| Indications And Contraindications | 395 | ||
| Patient Selection | 395 | ||
| Complications | 395 | ||
| Procedure | 395 | ||
| Patient Position | 395 | ||
| Anesthesia | 397 | ||
| Instrumentation | 397 | ||
| Surgical Procedure | 397 | ||
| Postoperative Care And Follow-Up | 401 | ||
| References | 404 | ||
| Chapter 33: Interspinous Spacer | 405 | ||
| Indications And Contraindications | 406 | ||
| Presurgical Treatments | 406 | ||
| Related Anatomy And Physiology | 406 | ||
| Preoperative Preparations | 406 | ||
| Assessment | 406 | ||
| Diagnostic Testing | 406 | ||
| Informed Consent and Preoperative Planning | 407 | ||
| Procedures And Technique | 407 | ||
| References | 411 | ||
| Chapter 34: Lateral Percutaneous Interspinous System for the Treatment of Lumbar Stenosis | 413 | ||
| Indications | 413 | ||
| Contraindications | 414 | ||
| Advantages | 414 | ||
| Disadvantages | 414 | ||
| Surgical Technique | 414 | ||
| Postoperative Care | 414 | ||
| Clinical Series | 414 | ||
| Methods | 414 | ||
| Results | 414 | ||
| Key Points | 416 | ||
| Conclusion | 416 | ||
| References | 421 | ||
| Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique | 422 | ||
| Presurgical Treatments | 423 | ||
| Preoperative Preparations | 423 | ||
| Assessment | 423 | ||
| Diagnostic Testing | 423 | ||
| Indications And Contraindications | 424 | ||
| Informed Consent And Preoperative Planning | 424 | ||
| Related Anatomy And Physiology | 424 | ||
| Procedures And Technique | 424 | ||
| Fluoroscopic Pedicle Targeting | 425 | ||
| Percutaneous Approach | 426 | ||
| Mini-Open Approach | 428 | ||
| Postoperative Care | 429 | ||
| Key Points | 434 | ||
| Acknowledgement | 434 | ||
| References | 434 | ||
| Chapter 36: Transaxial Anterior Lumbar Interbody Fusion Using the Axia Lif System | 435 | ||
| Potential Complications | 435 | ||
| Presacral Anatomy | 435 | ||
| AxiaLIF at One Level | 435 | ||
| Procedure | 435 | ||
| Patient Positioning | 435 | ||
| Approach | 435 | ||
| Radial Discectomy | 436 | ||
| Fixation | 436 | ||
| Distraction and Dynamic Decompression | 437 | ||
| Closure and Postoperative Care | 437 | ||
| Treatment Alternatives | 437 | ||
| Percutaneous Axial Lumbar Interbody Fusion | 438 | ||
| Case Series [16, 17] | 438 | ||
| AxiaLIF at Two Levels | 441 | ||
| Advantages | 441 | ||
| Indications | 441 | ||
| Contraindications | 441 | ||
| Warnings | 441 | ||
| Precautions | 441 | ||
| Preoperative | 441 | ||
| Intraoperative | 441 | ||
| Postoperative | 441 | ||
| Preoperative Planning | 442 | ||
| Patient Preparation | 442 | ||
| Operating Room Setup | 442 | ||
| Procedure | 442 | ||
| Step 1: Access and Trajectory | 442 | ||
| Step 2: Discectomy at L5-S1 | 443 | ||
| Step 3: Bone Grafting at L5-S1 | 448 | ||
| Step 4: Advance Access to L4-L5 | 449 | ||
| Step 6: Bone Grafting at L4-L5 | 451 | ||
| Step 7: Implant Selection and Delivery | 451 | ||
| L4-L5 Implant Selection | 451 | ||
| L4-L5 Implant Delivery | 453 | ||
| L5-S1 Implant Selection | 454 | ||
| L5-S1 Implant Placement | 454 | ||
| Step 8: Graft Material | 455 | ||
| Step 9: Plug Insertion | 455 | ||
| Step 10: Finish and Close | 456 | ||
| Potential Complications and Management | 456 | ||
| Case Series [19] | 456 | ||
| Conclusion | 457 | ||
| Tips and Tricks | 457 | ||
| Preoperative | 457 | ||
| Intraoperative | 457 | ||
| Postoperative | 458 | ||
| References | 458 | ||
| Chapter 37: Lateral Interbody Fusion Using the Xlif System | 459 | ||
| Preoperative Planning | 459 | ||
| Indications | 459 | ||
| Instrumentation | 459 | ||
| Surgical Technique | 460 | ||
| Patient Preparation | 460 | ||
| Patient Positioning | 460 | ||
| Incision Placement and Dissection | 461 | ||
| Preparing the Disc | 463 | ||
| Device Implantation | 463 | ||
| Closure | 464 | ||
| Case Series | 464 | ||
| Conclusion | 464 | ||
| References | 464 | ||
| Chapter 38: Outcome Measurements for Minimally Invasive Percutaneous Spine Techniques | 465 | ||
| Various Outcome Scales | 465 | ||
| Back-Specific Function Measures | 466 | ||
| Generic Health Status Measures | 469 | ||
| Pain | 470 | ||
| Work Disability | 472 | ||
| Patient Satisfaction | 473 | ||
| References | 474 | ||
| Index | 475 |