Operative Techniques: Spine Surgery

4th Edition - June 11, 2024
Editors: Alexander R. Vaccaro, Eli M. Baron
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 9 3 8 1 9 - 8
eBook ISBN:
9 7 8 - 0 - 4 4 3 - 1 0 4 5 3 - 4

Part of the superbly illustrated Operative Techniques series, Spine Surgery, 4th Edition, brings you up to speed with must-know surgical techniques in today’s technically… Read more

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Part of the superbly illustrated Operative Techniques series, Spine Surgery, 4th Edition, brings you up to speed with must-know surgical techniques in today’s technically demanding spine surgery. Step-by-step, evidence-based guidance walks you through both common and uncommon situations you’re likely to see in your practice, including trauma-related cases. Concise, detailed text accompanies the excellent visuals to provide a comprehensive, practical tool ideal for orthopaedic and neurosurgery residents, fellows, and practicing surgeons.

Cover image
Title page
Table of Contents
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Copyright
Dedication
Contributors
Foreword to the First Edition
Preface
Video Contents
Section I Cervical Spine
Section II Thoracic Spine
Section III Lumbar Spine
Section I: Cervical Spine
Procedure 1. Closed Cervical Skeletal Tong Placement and Reduction Techniques
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 2. Halo Placement in the Adult and Pediatric Patient
ADULT PATIENT
PEDIATRIC PATIENT
EVIDENCE
Procedure 3. Anterior Odontoid Resection: The Transoral Approach
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
EVIDENCE
Procedure 4. Odontoid Screw Fixation
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
EVIDENCE
EVIDENCE
Procedure 5. Anterior C1-C2 Arthrodesis: Lateral Approach of Barbour and Whitesides
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 6. Anterior Cervical Corpectomy/Diskectomy
INDICATIONS
EXAMINATION/IMAGING
SURGICAL ANATOMY
SET-UP AND POSITIONING
PROCEDURE
POSTOPERATIVE CARE
CERVICAL CORPECTOMY
EVIDENCE
Procedure 7. Anterior Resection of Ossification of the Posterior Longitudinal Ligament
INTRODUCTION
INDICATIONS
EXAMINATION/IMAGING
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 8. Cervical Total Disk Replacement
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 9. Occipital-Cervical Fusion
INDICATIONS
EXAMINATION/IMAGING
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 10. C2 Translaminar Screw Fixation
INDICATIONS
EXAMINATION/IMAGING
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 11. C1-C2 Posterior Fusion Harms and Magerl Techniques
C1-C2 POSTERIOR FUSION
INDICATIONS
EXAMINATION
IMAGING
POSITIONING
C1-C2 POSTERIOR SEGMENTAL SCREW AND ROD FIXATION (HARMS TECHNIQUE)
POSTERIOR C1-C2 TRANSARTICULAR FACET SCREWS (MAGERL TECHNIQUE)
EVIDENCE
Procedure 12. Cervical Spine: Lateral Mass Screw Fixation
INTRODUCTION
INDICATIONS
SURGICAL ANATOMY (FIG. 12.2)
PATIENT POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE
EVIDENCE
Procedure 13. Cervical Pedicle Screw Fixation
OVERVIEW
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
SURGICAL PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
SUMMARY
EVIDENCE
Procedure 14. Cervical Osteotomy Techniques
INDICATIONS/CONTRAINDICATIONS
PREOPERATIVE PLANNING
SURGERY
CERVICOTHORACIC PEDICLE SUBTRACTION OSTEOTOMY
MIDCERVICAL EXTENSION OSTEOTOMY
POSTOPERATIVE MANAGEMENT
CONCLUSION
EVIDENCE
Procedure 15. Posterior Cervical Laminoplasty
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 16. Posterior Cervical Foraminotomy, Microdiskectomy
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 17. Subaxial Cervical Trauma Classification and Treatment
INTRODUCTION
MECHANISTIC CLASSIFICATION SYSTEMS
MORPHOLOGIC CLASSIFICATION SYSTEMS
TREATMENT
CONCLUSIONS
EVIDENCE
Section II: Thoracic Spine
Procedure 18. Anterior Thoracic Diskectomy and Corpectomy
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS AND EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EXPECTED OUTCOMES
EVIDENCE
Procedure 19. Anterior Thoracolumbar Spinal Fusion via Open Approach for Idiopathic Scoliosis
INDICATIONS
POSITIONING
PORTALS/EXPOSURES
PROCEDURE: THORACOLUMBAR SPINE FUSION VIA AN OPEN APPROACH USING SINGLE-ROD INSTRUMENTATION
PROCEDURE: THORACOLUMBAR SPINE FUSION VIA AN OPEN APPROACH USING DUAL-ROD
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 20. Operative Management of Scheuermann Kyphosis
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
PROCEDURE 21. Resection of Intradural Intramedullary or Extramedullary Spinal Tumors
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
PROCEDURE 22. Endoscopic Image-Guided Thoracic Diskectomy
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
SURGICAL OUTCOMES
COMPLICATIONS AND AVOIDANCE
EVIDENCE
PROCEDURE 23. Adolescent Idiopathic Scoliosis: Lenke Classification and Surgical Indications
INTRODUCTION
LENKE ADOLESCENT IDIOPATHIC SCOLIOSIS AIS CLASSIFICATION SYSTEM
VALIDATION OF THE LENKE ADOLESCENT IDIOPATHIC SCOLIOSIS CLASSIFICATION SYSTEM
SURGICAL INDICATIONS BASED ON THE LENKE ADOLESCENT IDIOPATHIC SCOLIOSIS CLASSIFICATION SYSTEM
CONCLUSION
EVIDENCE
PROCEDURE 24. Posterior Thoracolumbar Fusion Techniques for Adolescent Idiopathic Scoliosis
INDICATIONS
SURGICAL ANATOMY
POSITIONING
EXPOSURE
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
PROCEDURE 25. Complete Vertebral Resection for Primary Spinal Tumors
INDICATIONS
SURGICAL ANATOMY
POSITIONING
EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
PROCEDURE 26. Hybrid Therapy for Metastatic Spine Tumors in the Context of the NOMS Decision Framework
INDICATIONS
Examination/Imaging
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
EVIDENCE
PROCEDURE 27. Surgical Treatment of Spinal Arachnoid Cysts and Arachnoid Web
INDICATIONS
Examination/Imaging
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
PROCEDURE 28. Surgical Management of Adult Syringomyelia
INDICATIONS
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
PROCEDURE 29. Surgical Treatment of Dural Arteriovenous Fistulas and Arteriovenous Malformations
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
PROCEDURE 30. Adult Scoliosis: Classification and Treatment
CLASSIFICATION OF ADULT SCOLIOSIS
INDICATIONS
INDICATIONS
CONCLUSION
EVIDENCE
Procedure 31. Spinopelvic Balance: Preoperative Planning and Calculation
INTRODUCTION
PREOPERATIVE MEDICAL CONSIDERATIONS
PREOPERATIVE RADIOGRAPHIC ANALYSIS
RADIOGRAPHIC ANALYSIS
CONSIDERATIONS WITH PREDICTING POSTOPERATIVE SAGITTAL MEASUREMENTS
SAGITTAL PLANE CORRECTION TECHNIQUES: BASIC PRINCIPLES
INTERBODY GRAFTING OR PROSTHESIS PLACEMENT
OSTEOTOMIES
CONCLUSIONS
EVIDENCE
Section III: Lumbar Spine
Procedure 32. Sacropelvic Fixation
INDICATIONS
NEUROMUSCULAR SCOLIOSIS
DEGENERATIVE SPINAL DEFORMITIES
SPONDYLOLISTHESIS (HIGH GRADE)
SACRECTOMY
TRAUMA
BIOCHEMICAL CONSIDERATIONS
Examination/Imaging
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE A: S1 PEDICLE SCREWS
PROCEDURE B: SACRAL ALAR SCREWS
PROCEDURE C: ILIOSACRAL SCREWS
PROCEDURE D: GALVESTON RODS
PROCEDURE E: ILIAC SCREWS (ILIAC BOLTS)
PROCEDURE F: TRANSILIAL BAR
PROCEDURE G: S2 ALAR ILIAC SCREWS (S2AI)
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 33. Posterior Far Lateral Diskectomy
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 34. Pedicle Subtraction Osteotomy for Fixed Sagittal Imbalance
INDICATIONS
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
ADDITIONAL STEPS
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 35. Spondylolysis Repair
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
INSTRUMENTATION/IMPLANTATION
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 36. Surgical Treatment of High-Grade Spondylolisthesis
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE A: SACRAL DOME OSTEOTOMY
PROCEDURE B: TRANSACRAL SCREW/FIBULAR DOWEL
PROCEDURE C: GAINES PROCEDURE
EVIDENCE
Procedure 37. Interspinous Process Motion-Sparing Implant
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE (COFLEX INTERSPINOUS DEVICE)
PROCEDURE (SUPERION INTERSPINOUS DEVICE)
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 38. Vascular Exposure for Anterior Lumbar Interbody Fusion
INDICATIONS
SURGICAL ANATOMY
POSITIONING (Fig. 38.3)
PROCEDURE (Fig. 38.4)
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 39. Transforaminal Lumbar Interbody Fusion
INDICATIONS
POSITIONING
SURGICAL ANATOMY
PORTALS AND EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
ACKNOWLEDGMENTS
EVIDENCE
Procedure 40. The Transpsoas Approach for Thoracolumbar Interbody Fusion
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 41. Antepsoas Approach for Lumbar Interbody Fusion
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
ADDITIONAL STEPS
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 42. Lumbar Total Disk Arthroplasty
INDICATIONS
TREATMENT OPTIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 43. Kyphoplasty
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 44. Minimally Invasive Exposure Techniques of the Lumbar Spine
INDICATIONS
SURGICAL ANATOMY
POSITIONING
GENERAL ASPECTS TO POSTERIOR TUBULAR RETRACTO SURGERY
RADIATION
TUBULAR MICRODISCECTOMY AND DECOMPRESSION TECHNIQUES
SPINAL FUSION
TRANSFORAMINAL LUMBAR INTERBODY FUSION
ANTERIOR LUMBAR INTERBODY FUSION
LATERAL TRANSPSOAS INTERBODY FUSION
PERCUTANEOUS PEDICLE SCREW INSTRUMENTATION
MINI-OPEN
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 45. Hemivertebrae Resection
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE A: LATERAL-POSTERIOR LUMBAR HEMIVERTEBRAE RESECTION AND CORRECTION WITH SEGMENTAL ANTERIOR INSTRUMENTATION
PROCEDURE B: HEMIVERTEBRA RESECTION AND FUSION: ANTERIOR AND POSTERIOR
PROCEDURE C: POSTERIOR HEMIVERTEBRAE RESECTION AND CORRECTION
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 46. Lumbar Internal Laminectomy
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 47. Cortical Screw Fixation in the Lumbar Spine
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 48. Spinal Navigation: Setup and Workflow
INDICATIONS
SURGICAL ANATOMY
POSITIONING
REFERENCE FRAME
PROCEDURE
EVIDENCE
Procedure 49. Robotically Assisted Spinal Surgery: Setup and Workflow
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 50. Virtual and Augmented Reality in Spinal Surgery: Setup and Workflow
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
ADDITIONAL STEPS: CLOSURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 51. Thoracolumbar Trauma Classification and Surgical Treatment
BACKGROUND
EVIDENCE
Procedure 52. Sacral Fixation: Iliosacral Screws and Sacral Fixation
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE A: SACROILIAC STYLE SCREWS
PROCEDURE B: POSTERIOR ILIOSACRAL PLATING: TENSION BAND PLATING
PROCEDURE C: DIRECT DORSAL-SACRAL PLATING
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 53. Sacroiliac Joint Fusion
INDICATIONS
CONTRAINDICATIONS
SURGICAL ANATOMY
POSITIONING
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Surgical Management of Sacroiliac Joint Pain
Randomized Controlled Trials
Prospective Cohort Studies
Case Series
Procedure 54. Endoscopic Lumbar Diskectomy and Foraminotomy: Indications and Techniques
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
TRANSFORAMINAL APPROACH
INTERLAMINAR PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Procedure 55. Awake Spinal Surgery: Indications and Technique
INDICATIONS
SURGICAL ANATOMY
POSITIONING
PORTALS/EXPOSURES
PROCEDURE
POSTOPERATIVE CARE AND EXPECTED OUTCOMES
EVIDENCE
Index
Confidence is ClinicalKey

Alexander R. Vaccaro

Dr. Vaccaro has served as the president of Rothman Orthopaedics since 2014 and is the Richard H. Rothman Professor and Chairman in the Department of Orthopaedic Surgery and Professor of Neurosurgery at Thomas Jefferson University in Philadelphia, Pennsylvania. He was the recipient of the Leon Wiltse award given for excellence in leadership and clinical research for spine care by the North American Spine Society (NASS) and is the past President of Cervical Spine Research Society (CSRS), the American Spinal Injury Association and the Association for Collaborative Spine Research. He is currently a member of the American Academy of Orthopaedic Surgeons (AAOS) Board of Directors. He has over 900 peer-reviewed and 200 non-peer reviewed publications. He has published over 372 book chapters and is the editor of over 63 textbooks and co-editor of OKU-Spine I and editor of OKU-8. Dr. Vaccaro also serves as Co-Director of the Regional Spinal Cord Injury Center of the Delaware Valley.

Affiliations and expertise

Richard H. Rothman Professor and Chairman, Department of Orthopaedic Surgery, Professor of Neurosurgery, Sidney Kimmel Medical Center of Thomas Jefferson University, Co-Director, Delaware Valley Spinal Cord Injury Center, President, Rothman Orthopaedics, Philadelphia, Pennsylvania

Eli M. Baron

Dr. Eli M. Baron is a Clinical Neurosurgery Associate Professor and a board certified neurosurgeon at the Cedars-Sinai Spine Center. Dr. Baron graduated the State University of New York at Binghamton with Summa Cum Laude in biological sciences. Afterwards he earned his medical degree at Temple University School of Medicine where he also completed a preliminary surgery year and a neurological surgery residency. He performed additional trainings in orthopaedic spine surgery at the famous Thomas Jefferson University Hospital in Philadelphia, Pennsylvania and a combined neurosurgical/orthopaedic spine fellowship at the Cedars-Sinai Spine Center. Dr. Baron is a prolific researcher and has published extensively in the fields of spine surgery and neurological surgery. He is the author and co-author of over 60 articles and book chapters on a wide range of subjects, all related to spinal disorders and spine surgery.

Affiliations and expertise

Co-Medical Director, Spine Trauma Surgery, Associate Professor, Neurosurgery, Mark Goodson Building

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