By Rahul Jandial MD PhD, Steven R. Garfin MD
Best proof for backbone surgical procedure offers consultant situations that assist you verify the optimum surgical interventions in your sufferers. Drs. Rahul Jandial and Steven R. Garfin, and a balanced workforce of preeminent neurosurgeons and orthopaedists, deal with the craze towards a extra collaborative strategy among backbone and orthopaedic surgical procedure. This easy-to-read, evidence-based source additionally positive aspects "Tips from the masters" for a fast evaluation of vital components of prognosis and remedy and on-line entry at www.expertconsult.com with totally searchable textual content and downloadable images.
- Choose the simplest strategies on your sufferers utilizing facts that helps the optimum surgical intervention for every case.
- Access the totally searchable textual content on-line at www.expertconsult.com, besides a downloadable picture gallery and a video library demonstrating nuances of key techniques.
- Apply a multi-disciplinary procedure via insurance that displays the altering nature of the distinctiveness with chapters written through neurosurgeons and orthopaedists.
- Quickly assessment crucial parts of prognosis via "Tips from the masters."
- Easily locate the data you wish with a constant, case-based structure that in actual fact offers facts and techniques.
Best facts for backbone surgical procedure is the ideal source for any general practitioner attracted to studying in regards to the most sensible proof on situations for which there's debate concerning the surgical administration. details offered encompasses a thorough evaluation of literature, method, and instances as offered by means of preeminent backbone surgeons. details is gifted from a balanced panel of orthopaedic and neurological surgeons, to articulate a collaborative process that has been the traditional evolution within the educational environment. This identify offers a consultant case and the facts for the optimum surgical intervention for that case, inside a layout that makes crucial components obtainable and appealing.
Read Online or Download Best Evidence for Spine Surgery: 20 Cardinal Cases PDF
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Postoperative neurologic improvement was greater in those with higher JOA scores and younger age at surgery. In a retrospective review of surgical techniques to treat cervical spondylotic myelopathy, Mummaneni and co-workers32 discussed the Level III evidence that laminectomy alone can be associated with late deterioration and that C2 C2 C7 C7 K-line (+) K-line (−) FIGURE 3-10 The K-line is a line connecting the midpoint of the spinal canal behind C2 and the midpoint of the canal behind C7. K-line (+) is when the line does not intersect the OPLL and thus indicates lordotic alignment.
Disk protrusion at other levels or at more than one level at any given time is rare. Other potential causes of sciatica include spondylosis, infection, neoplasm, and vascular disease. Although their clinical presentations may be similar, the management and prognosis of each of these conditions differs from that of a herniated disk and is not within the scope of this chapter. To properly evaluate a patient presenting with a lumbosacral radiculopathy, it is important to understand the anatomy of the lumbar spine, with particular attention to the relationships of the lumbar intervertebral spaces and foramina, nerve roots, and pedicles.
Tips from the Masters 3-4 • Avoid complete facetectomy to prevent iatrogenic destabilization and assess foraminal decompression with a right-angled nerve probe. Instrumented fusion, using lateral mass screws in the subaxial cervical spine, generally accompanies laminectomy. Starting points for the screws should be 1 mm medial to the coronal and sagittal midpoints (Figure 3-7, A). A 2-mm bur is used to initiate the starting points, which should be in line with each other. 5-mm drill with a 12- to 14-mm stop is used to drill the holes to orient the screws 30 degrees laterally and 15 to 30 degrees cephalad (Figure 3-7, B and C ).