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Surgical Management of Spinal Deformities E-Book

Surgical Management of Spinal Deformities E-Book

Thomas J. Errico | Baron S. Lonner | Andrew W. Moulton

(2008)

Additional Information

Abstract

A who’s who in this challenging field brings you state-of-the-art approaches to the full range of surgical management options—including reconstructive procedures—for the pediatric and adult patient with spinal deformity. Experts discuss the course of treatment for patients in different age groups and take into consideration the extent of the curve at the time of diagnosis and during follow-up, the patient’s stage of bone growth, the amount of pain and deformity associated with the condition, and the patient’s willingness and ability to withstand surgery. Plus, a section on general information such as practical surgical anatomy, imaging, applied biomechanics, and instrumentation helps you approach each patient more effectively.

  • Emphasizes technical skills and surgical decision making, including pearls, pitfalls, and illustrative case studies, offering you expert advice on technically challenging surgeries.
  • Provides the very latest information on minimally invasive endoscopic and mini-open approaches to broaden your surgical options and minimize post-operative complications.
  • Discusses peri-operative considerations, including anesthesia, blood loss management, bone graft and fusion enhancement, neural monitoring, and complications, keeping you prepared for any event.
  • Presents full-color line artwork of surgical procedures as well as diagnostic and clinical photographs for superb visual guidance.
  • Offers a consistent format throughout and a full-color design for ease of reference.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Surgical Management of Spinal Deformities iii
Copyright Page iv
Table of\rContents xvii
Dedication v
Contributors vii
Preface xiii
Acknowledgments xv
SECTION I: General Introduction/Principles 1
CHAPTER 1. Introduction to Spinal Deformity 3
CLINICAL PRESENTATION 4
DEFORMITY ANALYSIS 4
INTERPRETING DEFORMITY 6
TREATMENT PRINCIPLES 8
EVALUATING THE IMPACT OF DEFORMITY 10
CONCLUSION 11
REFERENCES 12
SUGGESTED READINGS 12
CHAPTER 2. Clinically Relevant Spinal Anatomy 13
THE OCCIPUT 13
THE ATLAS 13
THE AXIS 13
THE SUBAXIAL SPINE (C3 to C7) 18
THE THORACIC SPINE 23
THE LUMBAR SPINE 26
THE SACRUM 30
AUTOGENOUS GRAFT 33
LIGAMENTS 38
MUSCLES 40
REFERENCES 42
SUGGESTED READINGS 42
CHAPTER 3. Radiologic Imaging of Spinal Deformities 45
SCOLIOSIS 45
LUMBAR INSTABILITY AND SPONDYLOLISTHESIS 51
KYPHOSIS 55
LORDOSIS 57
REFERENCES 57
SUGGESTED READINGS 58
CHAPTER 4. Spinal Deformity in the Clinical Setting 61
HISTORY 61
PHYSICAL EXAMINATION 64
IMAGING 66
FURTHER EVALUATION 68
SUMMARY 69
REFERENCES 69
SUGGESTED READINGS 69
CHAPTER 5. Biomechanics of Spinal Instrumentation 71
IMPLANT MECHANICS 71
THE AMERICAN SOCIETY FOR TESTING AND MATERIALS MODEL 76
SUGGESTED READINGS 85
SECTION II: Pediatric Deformity 87
CHAPTER 6. Infantile and Juvenile Idiopathic Scoliosis 89
INFANTILE IDIOPATHIC SCOLIOSIS 89
JUVENILE SCOLIOSIS 91
TREATMENT OPTIONS 91
REFERENCES 96
SUGGESTED READINGS 96
CHAPTER 7. Adolescent Idiopathic Scoliosis 97
OVERVIEW 97
EVALUATION 97
CLASSIFICATION 98
TREATMENT OPTIONS 102
SUMMARY 104
REFERENCES 118
SUGGESTED READINGS 118
CHAPTER 8. Scheuermann's Kyphosis 119
OVERVIEW 119
EVALUATION 120
TREATMENT OPTIONS 121
CONCLUSION 124
REFERENCES 127
SUGGESTED READINGS 127
CHAPTER 9. Congenital Scoliosis 129
ETIOLOGY 129
CLASSIFICATION OF CONGENITAL SCOLIOSIS 129
RATE OF PROGRESSION 130
NATURAL HISTORY 131
ASSOCIATED ANOMALIES 131
PATIENT EVALUATION 131
TREATMENT 132
SUMMARY 135
REFERENCES 140
SUGGESTED READINGS 140
CHAPTER 10. Cerebral Palsy and Other Neuromuscular Disorders in Children 143
DEFINITIONS 143
GENERALITIES OF NEUROMUSCULAR CONDITIONS 144
PATIENT APPEARANCE 146
TIMING OF SURGICAL INTERVENTION 147
CHRONIC NUTRITIONAL AND VOLUME RESERVE DEFICIENCY 147
FALSE CURVATURE 148
FORCES 150
KINDS: CODES, WORDS, AND TONES 151
CONCLUSION 155
REFERENCES 155
SUGGESTED READINGS 155
CHAPTER 11. Operative Treatment of Neuromuscular Spinal Deformity 157
CLINICAL PRESENTATION AND EVALUATION 157
NONOPERATIVE CARE 158
OPERATIVE CARE 159
PREOPERATIVE AND PERIOPERATIVE CONCERNS 160
SURGICAL TECHNIQUE 160
POSTOPERATIVE CARE 161
COMPLICATIONS 162
OUTCOMES 162
REFERENCES 164
SUGGESTED READINGS 165
CHAPTER 12. Spinal Surgery in Connective Tissue Disorders 167
MARFAN SYNDROME 167
EHLERS-DANLOS SYNDROME 171
STICKLER SYNDROME 171
OSTEOGENESIS IMPERFECTA 171
REFERENCES 177
SUGGESTED READINGS 177
CHAPTER 13. Pediatric Infections of the Spine 179
DISCITIS AND OSTEOMYELITIS 179
TUBERCULOSIS 186
DISC SPACE CALCIFICATION 188
PYOMYOSITIS 188
REFERENCES 193
SUGGESTED READINGS 193
CHAPTER 14. Pediatric Neoplasms of the Spine 195
EPIDEMIOLOGY OF SPINE TUMORS 195
GENERAL APPROACH TO DIAGNOSIS 195
CLASSIFICATION 195
TREATMENT 203
REFERENCES 209
SUGGESTED READINGS 209
CHAPTER 15. Neurofibromatosis 211
CERVICAL SPINE DEFORMITIES 212
THORACOLUMBAR DEFORMITIES 212
SPINAL CANAL PATHOLOGY 223
ACKNOWLEDGMENT 231
REFERENCES 231
SUGGESTED READINGS 231
CHAPTER 16. Spinal Deformity in Skeletal Dysplasia 233
OVERVIEW 233
EVALUATION 233
CLASSIFICATION 233
DIAGNOSTIC PROCEDURES 241
SUMMARY 241
ACKNOWLEDGMENT 258
REFERENCES 258
SUGGESTED READINGS 259
CHAPTER 17. Isthmic and Dysplastic Spondylolisthesis 261
EPIDEMIOLOGY AND BIOMECHANICS 261
CLINICAL PRESENTATION AND NATURAL HISTORY 263
IMAGING 263
NONOPERATIVE MANAGEMENT 264
OPERATIVE MANAGEMENT 265
REFERENCES 275
SUGGESTED READINGS 275
CHAPTER 18. Myelomeningocele Spinal Deformities 277
EPIDEMIOLOGY 277
CLASSIFICATION 277
SYMPTOMATOLOGY 278
CLINICAL EVALUATION 278
SPECIFIC WORKUP BEFORE SURGERY 278
SPECIFIC TREATMENTS 279
CONCLUSIONS 283
REFERENCES 292
SUGGESTED READINGS 292
CHAPTER 19. Spinal Cord Injury 295
PEDIATRIC SPINAL POSTTRAUMATIC DEFORMITY 295
ADULT SPINAL POSTTRAUMATIC DEFORMITY 297
REFERENCES 303
SUGGESTED READINGS 303
SECTION III: Adult Deformity 305
CHAPTER 20. Adult Idiopathic Scoliosis and Degenerative Scoliosis 307
ADULT IDIOPATHIC SCOLIOSIS 307
DEGENERATIVE ADULT SCOLIOSIS 333
COMPLICATIONS IN ADULT IDIOPATHIC SCOLIOSIS AND DEGENERATIVE SCOLIOSIS 335
SUMMARY 337
SUGGESTED READINGS 342
CHAPTER 21. Degenerative Spondylolisthesis 343
OVERVIEW 343
EVALUATION 343
RADIOLOGIC IMAGING 343
TREATMENT OPTIONS 344
SURGICAL INDICATIONS 344
CONCLUSIONS 345
SUGGESTED READINGS 349
CHAPTER 22. Osteoporosis 351
INTRODUCTION AND EPIDEMIOLOGY 351
PATHOPHYSIOLOGY AND PATHOMECHANICS 351
CLINICAL PRESENTATION AND EVALUATION 353
NONOPERATIVE CARE 356
SURGICAL MANAGEMENT IN OSTEOPOROTIC PATIENTS 360
REFERENCES 370
SUGGESTED READINGS 371
CHAPTER 23. Adult Neoplasia 373
OVERVIEW 373
CLASSIFICATION 373
TREATMENT OPTIONS 374
REFERENCES 379
SUGGESTED READINGS 379
CHAPTER 24. Inflammatory Arthropathies 381
ANKYLOSING SPONDYLITIS 381
RHEUMATOID ARTHRITIS 386
REFERENCES 396
SUGGESTED READINGS 396
CHAPTER 25. Revision Deformity Surgery 399
OVERVIEW 399
CLASSIFICATION 399
TREATMENT OPTIONS 402
SPECIAL COMPLICATIONS: HOW TO AVOID AND TREAT 403
SUMMARY 407
REFERENCES 416
SUGGESTED READINGS 416
SECTION IV: Perioperative Considerations 419
CHAPTER 26. Anesthesia for Spine Surgery and Management of Blood Loss 421
PREOPERATIVE EVALUATION 421
INDUCTION AND INTRAOPERATIVE MANAGEMENT ISSUES 425
POSITIONING 426
THORACIC PROCEDURES 427
POSTOPERATIVE VISUAL LOSS 428
BLOOD TRANSFUSION IN THE SPINE SURGERY PATIENT 429
CONCLUSION OF THE SURGICAL PROCEDURE AND TRANSFER TO THE POSTANESTHESIA CARE UNIT 430
REFERENCES 431
SUGGESTED READINGS 431
CHAPTER 27. Bone Graft and Fusion Enhancement 433
EXTRACELLULAR MATRIX 433
BONE ARCHITECTURE 433
OSTEOINDUCTION 433
OSTEOCONDUCTION 433
OSTEOGENESIS 434
AUTOGRAFT 434
ALLOGRAFT 435
CERAMICS 435
COLLAGEN 437
OSTEOINDUCTIVE MATERIALS 438
DEMINERALIZED BONE MATRIX 438
BONE MORPHOGENETIC PROTEINS 438
REFERENCES 447
SUGGESTED READINGS 447
CHAPTER 28. Complications in Spinal Deformity Surgery 449
PATIENT PREPARATION: COMPLICATIONS, EXPECTATIONS, CONSENT PROCESS, AND DOCUMENTATION 449
COMMON COMPLICATIONS 449
CONCLUSION 468
REFERENCES 471
SUGGESTED READINGS 473
CHAPTER 29. Neuromonitoring for Scoliosis Surgery 475
INTRODUCTION TO INTRAOPERATIVE SPINAL CORD AND NERVE ROOT MONITORING 475
THE STAGNARA WAKE-UP TEST 475
THE SOMATOSENSORY EVOKED POTENTIAL 476
THE TRANSCRANIAL MOTOR EVOKED POTENTIAL 481
INTRAOPERATIVE ELECTROMYOGRAPHY 483
THE IMPORTANCE OF PREOPERATIVE BASELINE DATA 487
TECHNIQUES FOR IMPROVING THE QUALITY OF NEUROMONITORING DATA 489
PREPARING THE PATIENT FOR NEUROMONITORING 489
CONCLUDING COMMENTS 489
ACKNOWLEDGMENTS 493
SUGGESTED READINGS 493
CHAPTER 30. A Modified Anterior Muscle-Sparing Retroperitoneal Approach to the Lumbar Spine: Technique and Outcomes 495
LUMBOSACRAL SPINE EXPOSURE: ANTEROLATERAL APPROACH 495
LUMBOSACRAL SPINE EXPOSURE: ANTERIOR APPROACH 496
VASCULAR INJURIES 499
RESULTS 500
SUMMARY 500
CONCLUSIONS 501
SUGGESTED READINGS 501
CHAPTER 31. Thoracic Exposures for Spinal Deformity Surgery 503
OVERVIEW 503
CLASSIFICATION 503
ROLE OF THE THORACIC SURGEON IN ANTERIOR SPINE SURGERY 507
REFERENCES 510
SUGGESTED READINGS 511
SECTION V: The Future of Spinal Deformity Surgery 513
CHAPTER 32. Future Developments in Spinal Deformity Surgery 515
REFERENCES 519
SUGGESTED READINGS 519
Index 521