By John Rhee
Operative suggestions in backbone surgical procedure presents full-color, step by step reasons of all operative systems in backbone surgical procedure. It includes 19 chapters from the backbone part and 10 chapters from the pediatric component to Dr. Sam W. Wiesel’s Operative suggestions in Orthopaedic surgical procedure, in addition to 18 new chapters masking complex systems. Written by means of specialists from best associations around the globe, this beautifully illustrated quantity specializes in mastery of operative concepts and in addition presents an intensive knowing of the way to pick the easiest method, tips on how to steer clear of issues, and what results to expect.
The uncomplicated structure is perfect for speedy preoperative overview of the stairs of a process. each one technique is damaged down step-by-step, with full-color intraoperative pictures and drawings that reveal the best way to practice each one strategy. huge use of bulleted issues and tables permits speedy and straightforward reference.
Each medical challenge is mentioned within the related layout: definition, anatomy, actual checks, pathogenesis, ordinary heritage, actual findings, imaging and diagnostic experiences, differential prognosis, non-operative administration, surgical administration, pearls and pitfalls, postoperative care, results, and problems.
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Additional info for Operative Techniques in Spine Surgery
PEARLS AND PITFALLS Physical examination • The Hoffman reflex can indicate spinal cord compression but can be positive in normal individuals. Patient position • Slight cervical flexion facilitates exposure and closure by eliminating redundant posterior skin folds and decreases overlap of lamina (laminar shingling) for improved identification of adjacent levels. Opening side • If foraminotomies are planned, then the opening side should be made over the ipsilateral side of compression. If asymmetric compression is present, it may be beneficial to open the more affected side.
The superior end of the graft is inserted first and then the inferior end is gently tamped into position. ANTERIOR CERVICAL PLATING • • Plating is performed as noted during anterior cervical discectomy and fusion. Standalone plated multilevel corpectomies (three or more disc levels) have been reported to be associated with high failure rates. Consideration should be given in such cases to supplemental posterior fixation. 5 PEARLS AND PITFALLS Limits of corpectomy • The uncinates should be used as boundaries to prevent injury to the vertebral arteries while achieving wide enough cord decompression.
Chapter 4 CERVICAL LAMNOPLASIY: OPEN AND FRENCH DOOR OPENING THE LAMINOPLASTY • • A Proceeding from caudal to cranial, a nerve hook or curved curette is used to elevate the lamina on the ope~ ing side. Division of the residual ligamentum flavum and epidural veins proceeds from Cl to C7. A Kerrison rongeur can be used to divide ligamentous attachments, and bipolar forceps are used for cauterization of epidural veins. The laminae are then opened sequentially. This can be done with the assistance of a curved microcurette to • • raise the opening side and gently bend open each lamina hinge.