Advances in spine surgery:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2002
|
| Schriftenreihe: | The orthopedic clinics of North America
33,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XI S., S. 291 - 469 zahlr. Ill. |
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| 650 | 4 | |a Spinal Diseases |x surgery | |
| 650 | 4 | |a Spinal Fusion | |
| 650 | 4 | |a Spinal Injuries |x surgery | |
| 650 | 4 | |a Spine |x Surgery | |
| 650 | 4 | |a Spine |x Wounds and injuries | |
| 650 | 4 | |a Spine |x surgery | |
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| adam_text | ADVANCES IN SPINE SURGERY ¦ . /¦ ¦; ¦•¦;.¦¦¦. ¦ ¦
CONTENTS
Preface xi
Frank P. Cammisa, Jr, Harvinder S. Sandhu, and Federico P. Girardi
Cervical Spine
Rheumatoid Arthritis of the Cervical Spine: Current Techniques for Management 291
Adrian T. H. Casey, H. Alan Crockard, Jean Pringle, Michael F. O Brien, and
John M. Stevens
Rheumatoid arthritis affects multiple joints with varying degrees of destruction. Later
stages of the disease may involve severe mechanical degeneration superimposed on the
hypermobile spine. The disease may also have systemic consequences, both vascular and
pulmonary. Side effects from the numerous medications used to treat the inflammation,
especially steroids, may also result in systemic problems. This article discusses whether
and when rheumatoid arthritis of the cervical spine should be treated surgically. The
authors suggest an algorithm that can be used to navigate through the numerous details
which must be considered to formulate a reasonable surgical plan. Although arthritis
patients are frail, an aggressive surgical solution applied in a timely fashion may yield
better results than an incomplete or inappropriate surgical solution applied too late.
Advances in the Management of Acute Spinal Cord Injury 311
Thomas T. Lee and Barth A. Green
The goal of treatment of spinal cord injury is to preserve residual neurological function,
avoid secondary injury, and restore spinal alignment and stability. In the future, treat¬
ment of spinal cord injury patients may involve neurotrophic factor infusion, neural
tissue/cellular transplantation, and other innovative techniques, but the present treat¬
ment protocols seek to minimize secondary injury and allow natural recovery of the
injured neural tissues. This article outlines the current management of a patient with an
acutely injured spinal cord.
Bone Grafting, Implants, and Plating Options for Anterior Cervical Fusions 317
D. Greg Anderson and Todd J. Albert
Anterior cervical surgery bec ime widely used in the mid TWOs as a method of treatment
for cervical disc disease. Since that time, the indications for anterior cervical surgery
have expanded to include degenerative conditions causing radiculopathy and myelopa
thy, treatment of cervical kyphosis, decompression and stabilization of cervical trauma,
VOLUME 33 • NUMBER 2 . APRIL 2(102 v
and resection and reconstruction of anterior cervical neoplasms. Success rates for anteri¬
or cervical surgery are generally high, however problems such as graft extrusion or col¬
lapse, bone graft donor site morbidity, and pseudarthrosis continue to
present challenges. This article reviews surgical techniques, bone grafting and plating
options currently in use, and discusses emerging technology that may play an expanded
role in anterior cervical surgery.
Surgical Options for the Treatment of Cervical Spondylotic Myelopathy 329
Matthew J. Geek and Frank J. Eismont
Cervical spondylotic myelopathy is a disorder of the cervical spine stemming from
compression of the cervical spinal cord by spondylotic degeneration, often in a congen
itally narrowed canal. Surgical options include the anterior approach, either anterior
cervical discectomy and fusion or corpectomy and strut grafting, or the posterior
approach, either laminectomy or laminoplasty. Techniques, results, and complications
are discussed.
Lumbar Spine
Intervertebral Fixation: Clinical Results with Anterior Cages 349
J. Kenneth Burkus
Threaded, cylindrical cages used for intervertebral fusion are a new and distinct class of
segmental spinal fixation devices. These devices are not intradiscal spacers that require
additional segmental stabilization. They are designed as stand alone, intervertebral
implants that function as an instrumented anterior interbody fusion. Clinical outcomes
of anterior lumbar surgery can be improved by using interbody fusion devices to restore
anatomic disc space height, increase rates of fusion, and recreate the normal sagittal
contour of the lumbar spine.
Transf oraminal Lumbar Interbody Fusion 359
Alan Moskowitz
Different methods of spinal fusion have been in use since 1911. Over the years, there
have been differences among physicians as to appropriate procedures to employ for var¬
ious spinal problems. This article describes a procedure known as transforaminal lum¬
bar interbody fusion (TLIF). TLIF enables load sharing and provides for anterior column
support, as well as providing a posterior tension band. It is a unilateral approach to the
spine that does not expose or manipulate the dura, and provides the benefits of a 360°
fusion without doing an anterior approach. It restores the normal anatomy of the motion
segment and maintains normal lumbar lordosis, allowing patients to be mobilized quickly
and resume activities early.
Advances in Posterior Lumbar Interbody Fusion 367
Brian Brislin and Alexander R. Vaccaro
Since Cloward s initial description of the posterior lumbar interbody technique, there
have been numerous adaptations and innovations. The introduction of metallic cage
implants has revolutionized this approach in the treatment of symptomatic axial low
back pain. An understanding of the biomechanical advantages of various cage devices
vi CONTENTS
and the surgical technique involved is critical to their safe use in clinical practice. Newer
methods of accessing the posterior interbody space will also be discussed.
Computerized Frameless Stereotactic Image Guidance in Spinal Surgery 375
Andrew A. Sama, Safdar N. Khan, Federico P. Girardi, and Frank P. Cammisa, Jr
Clinical applications of computerized frameless stereotactic image guided spinal surgery
continue to evolve. This article discusses several limiting factors regarding the use of this
technology. It discusses the benefits of stereotaxy, which are better realized when there is
a distortion of normal anatomy because of previous surgery or severe deformity. The
three dimensional model helps the surgeon navigate the rotated and translated
vertebrae. The technology can also be helpful when performing a posterior lumbar inter¬
body fusion, to determine the orientation and depth of placement of the allograft or
the cage.
Revision Strategies for Lumbar Pseudarthrosis 381
Mohammad Etminan, Federico P. Girardi, Safdar N. Khan, and Frank P. Cammisa, Jr
Lumbar spinal fusions are performed for a variety of indications including degenerative
disorders, deformity, trauma, infection, and neoplasms of the spine. The number of
lumbar spine fusion procedures performed annually has risen dramatically in recent
years, particularly for the treatment of degenerative conditions. Unfortunately, lumbar
fusions are not always successful. The rates of successful technical and clinical outcomes
range from 16% to 95%. On average at least 15% of attempted spinal fusions result
in pseudarthrosis. Pseudarthrosis is defined as the failure to obtain a solid bony fusion
in an attempted spinal fusion one year after surgery. This article reviews the patho
physiology and operative management of pseudoarthrosis of the lumbar spine.
Complications and Strategies for Salvage of Intervertebral Fixation Devices 393
Stephen E. Heim and Jean Jacques Abitbol
The recent evolution of interbody fixation devices, known as threaded interbody fusion
cages, is a significant new form of segmental fixation for application to the lumbar and
lumbosacral spine. This article discusses the construction, biomechanics, and use of
these devices, which serve as carriers for autogenous graft material while restoring
segmental stability to the involved motion segment. The biomechanics of these devices
greatly surpasses those of the interbody spacers used historically. Interbody spacers have
traditionally been utilized as a component of an overall construct that also employed
segmental posterior instrumentation. Threaded interbody cages, on the other hand, are
able to confer a degree of stability to the diseased motion segment as stand alone
constructs.
Current Concepts in Anterior Surgery for Thoracolumbar Trauma 403
Adam J. Mariotti and Ashish D. Diwan
Our goals in writing this article are to facilitate understanding of issues related to (1) why
anterior fixation for thoracolumbar fractures are .in important tool for managing these
injuries, (2) when to perform these as a single procedure, or in combination with other
procedures such as vertebrectomy .ind/or posterior stabilization and fusion, (3) to appre¬
ciate the biomechanical and design related issues of available systems, and (4) what the
clinical outcomes are following these procedures.
CONTENTS vii
Minimally Invasive Techniques
Laparoscopic Approaches to Fusion of the Lumbosacral Spine: Latest Techniques 413
Stephen E. Heim and Anthony Altimari
This article discusses clinical decision making and patient selection for interbody cage
anterior fusion procedures. The laparoscopic application of lumbar fusion cages is
described.
Anterior Endoscopic Correction of Scoliosis 421
George D. Picetti III, Janos P. Ertl, and H. Ulrich Bueff
Treatment of scoliosis has undergone significant evolution over the past 40 years. Recent
biological approaches to bone pathology and fractures enable the use of less invasive
techniques that take advantage of the body s natural healing potential. This article
describes a technique that builds on these ideas to offer a less invasive treatment for
spinal deformity. The technique for endoscopic treatment of scoliosis is under continuous
development, but initial results appear to equal those utilizing an open approach.
Surgical times have been decreased and fusion and correction rates have improved. The
technique allows the surgeon to perform a minimally invasive anterior approach with
minimal disruption of the local biology. Additional benefits realized are decreased oper¬
ative time, blood loss, rehabilitation, pain, and shortened hospital stays. Endoscopic
treatment shows great promise in the management of scoliosis curves; however, it
is a technically demanding procedure requiring cross training skills in endoscopic
discectomy, scoliosis management, and comfort with the anterior approach anatomy.
Minimally Invasive Options for the Treatment of Osteoporotic Vertebral 431
Compression Fractures
Joseph M. Lane, Catherine E. Johnson, Safdar N. Khan, Federico P. Girardi, and
Frank P. Cammisa, Jr
The recent introduction of vertebroplasty and kyphoplasty provide minimally invasive
methods to alleviate symptoms from vertebral fractures. While both methods are
successful in addressing fracture related pain, only the kyphoplasty can partially restore
structural alignment and height.
Tissue Engineering Perspectives
Gene Therapy for Spinal Applications 439
Chisa Hidaka, Safdar N. Khan, James C. Farmer, and Harvinder S. Sandhu
Gene therapy is a novel treatment modality in which nucleic acids, usually deoxyri
bonucleic acid (DNA), are transferred to and expressed in target cells for therapeutic
effect. Originally conceived of for the treatment of genetic diseases, gene therapy has
been developed and clinically tested in other areas such as cancer, cardiovascular dis¬
ease, and orthopaedics. A safety study in rheumatoid arthritis was the first to use gene
therapy for a non lethal disease. This article reviews spine related applications of gene
therapy. The majority of studies have used adenovirus (Ad) vectors for gene transfer, so
this article will review aspects of this vector which make it particularly attractive for use
in and around the spine. Experimental studies indicate that gene therapy has great
potential for spine fusion, as well as intervetebral disc and spinal cord regeneration.
viii CONTENTS
Bone Morphogenetic Proteins: Relevance in Spine Surgery 447
Safdar N. Khan, Harvinder S. Sandhu, Joseph M. Lane, Frank P. Cammisa, Jr,
and Federico P. Girardi
Bone morphogenetic proteins (BMPs) are low molecular weight glycoproteins that play
a vital role in the development and maturation of skeletal tissue. Bone morphogenetic
protein induced mesenchymal cell recruitment and differentiation leads to the formation
of chondroblasts and osteoblasts leading to the formation of de nova bone.
Overwhelming pre clinical and clinical evidence has suggested a promising role for
BMPs for anterior and posterolateral spinal fusion. Strength of this approach lies in the
potential ability of these growth factors to reverse inhibitory conditions common in the
clinical setting and enabling predictable fusion. However, several issues related to carri¬
ers, costs, and dosages still need to be consecutively addressed. Gene therapy techniques
producing in vivo osteoinductive factors and utilizing minimally invasive approaches
are attractive options being developed for the future.
Index 465
CONTENTS
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| spelling | Advances in spine surgery Frank P. Cammisa ... guest ed. Philadelphia [u.a.] Saunders 2002 XI S., S. 291 - 469 zahlr. Ill. txt rdacontent n rdamedia nc rdacarrier The orthopedic clinics of North America 33,2 Chirurgie (geneeskunde) gtt Wervelkolom gtt Spinal Diseases surgery Spinal Fusion Spinal Injuries surgery Spine Surgery Spine Wounds and injuries Spine surgery Wirbelsäulenchirurgie (DE-588)4190003-0 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Wirbelsäulenchirurgie (DE-588)4190003-0 s DE-604 Cammisa, Frank P. Sonstige (DE-588)131980920 oth The orthopedic clinics of North America 33,2 (DE-604)BV000001089 33,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009922843&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Advances in spine surgery The orthopedic clinics of North America Chirurgie (geneeskunde) gtt Wervelkolom gtt Spinal Diseases surgery Spinal Fusion Spinal Injuries surgery Spine Surgery Spine Wounds and injuries Spine surgery Wirbelsäulenchirurgie (DE-588)4190003-0 gnd |
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| title | Advances in spine surgery |
| title_auth | Advances in spine surgery |
| title_exact_search | Advances in spine surgery |
| title_full | Advances in spine surgery Frank P. Cammisa ... guest ed. |
| title_fullStr | Advances in spine surgery Frank P. Cammisa ... guest ed. |
| title_full_unstemmed | Advances in spine surgery Frank P. Cammisa ... guest ed. |
| title_short | Advances in spine surgery |
| title_sort | advances in spine surgery |
| topic | Chirurgie (geneeskunde) gtt Wervelkolom gtt Spinal Diseases surgery Spinal Fusion Spinal Injuries surgery Spine Surgery Spine Wounds and injuries Spine surgery Wirbelsäulenchirurgie (DE-588)4190003-0 gnd |
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