
Revision Lumbar Spine Surgery
- 1st Edition - March 3, 2021
- Imprint: Elsevier
- Editor: Robert F. Heary
- Language: English
- Hardback ISBN:9 7 8 - 0 - 3 2 3 - 7 1 2 0 1 - 9
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 7 1 2 0 2 - 6
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 7 1 2 0 3 - 3
Offering in-depth coverage of an often-neglected topic, Revision Lumbar Spine Surgery identifies clinical problems and discusses recent major advances in this challenging ar… Read more

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Identifies the clinical problems related to unsuccessful back spine surgery as well as indications, diagnosis, and new treatment options and advances in this complex area.
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Provides in-depth information on the multiple options that exist for most clinical situations: anterior, posterior, lateral, and combined anterior and posterior approaches.
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Covers methods of fixation, the use of interbody grafting, and surgical planning related to scar tissues, bleeding, and spinal fluid leaks.
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Discusses critical follow-up topics such as key clinical procedures, radiography, patient reported outcomes, and pain management.
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Includes timely chapters on robotics, bone density issues, medical fitness concerns, instrumentation options, imaging considerations, and much more.
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Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.
Neurosurgeons
- Cover image
- Title page
- Table of Contents
- Any screen, Any time, Anywhere
- Copyright
- List of Contributors
- Foreword
- Preface
- Acknowledgments
- 1. Anatomy and Physiology/Biology of Bone
- Abstract
- Chapter Outline
- Anatomy
- Lumbar Spine Alignment
- Load Transmission
- Fusion Types and Area
- Basic Bone Biology
- Bone Grafting Area and Volume Available in Different Approaches
- Pain Generator Identification in Previously Fused Patients
- Implant Removal
- Looking for Pain Generators Outside of the Spine
- Summary and Conclusion
- References
- 2. The Role of Osteoporosis and Bone Diseases in Revision Spine Surgery
- Abstract
- Chapter Outline
- Introduction
- Adverse Consequences of Poor Bone Health
- Epidemiology of Poor Bone Health in Spine Surgery
- Bone Health Evaluation in Revision Spine Surgery
- Preoperative Bone Health Optimization
- Conclusion
- References
- 3. Medical Fitness Evaluation
- Abstract
- Chapter Outline
- Introduction
- Overall Wellness
- Comorbidities
- Conclusion
- References
- 4. Indications
- Abstract
- Chapter Outline
- Background
- Adjacent Segment Pathology
- Pseudarthrosis
- Implant Failure
- Flatback Syndrome
- Residual Stenosis or Recurrent Disc Herniation
- Complications (Wound Healing Issues/Infection)
- Conclusions
- References
- 5. Imaging Considerations (Magnetic Resonance, Computed Tomography, Myelography, Plain)
- Abstract
- Chapter Outline
- Introduction
- Magnetic Resonance Imaging
- Computed Tomography
- Myelography
- Conventional Radiography
- References
- 6. Dural Scarring and Repair Issues
- Abstract
- Chapter Outline
- Background
- Revision Lumbar Spine Surgery
- Dural Tears During Lumbar Spine Surgery
- Our Approach to Revision Lumbar Surgery (and Management of Durotomy)
- Conclusion
- Illustrative Case
- References
- 7. Decompression
- Abstract
- Chapter Outline
- Introduction
- Diagnosis and Indications for Surgery
- Outcome Measures
- Adjacent Segment Stenosis
- Revision Lumbar Laminectomy
- Revision Lumbar Discectomy
- Minimally Invasive Revision Microdiscectomy
- Conclusion
- References
- 8. Disc Herniation (Primary, Recurrent, Residual)
- Abstract
- Chapter Outline
- Introduction
- Anatomy
- Clinical Presentation
- Imaging
- Operative Management
- Risk Factors for Recurrent Disc Herniations
- Evaluation of Recurrent Disc Herniation
- Management of Recurrent Disc Herniation
- Conclusion
- References
- 9. Instrumentation Options
- Abstract
- Chapter Outline
- Introduction
- Considerations
- Posterior Instrumentation
- Anterior Instrumentation
- Conclusions
- References
- 10. Autograft/Allograft/Cage/Bone Morphogenetic Protein
- Abstract
- Chapter Outline
- The Use of Autograft and Allograft in Revision Lumbar Spine Surgery
- References
- 11. Minimally Invasive Surgery and Navigation
- Abstract
- Chapter Outline
- Introduction
- Revision Decompression Without Fusion
- Revision Fusion
- Navigation in Revision Surgery
- Conclusion
- References
- 12. Anterior Lumbar Fusion
- Abstract
- Chapter Outline
- Introduction
- Anterior Lumbar Interbody Fusion for Lumbar Pseudarthrosis
- Anterior Lumbar Interbody Fusion for Correction of Sagittal Deformity
- Other Relative Indications: Recurrent Disc Herniations, Spondylolisthesis/Instability, Adjacent Segment Disease, and Degenerative Disc Disease
- Risks and Complications
- Authors’ Preferred Technique
- Conclusion
- References
- 13. Revision Transforaminal Lumbar Interbody Fusion
- Abstract
- Chapter Outline
- Introduction
- Pseudarthrosis, Subsidence, and Cage Migration
- Adjacent Segment Stenosis, Recurrent Lumbar Disc Herniation/Revision Discectomy, or Instability After Previous Decompressive Surgery
- Open Versus Minimal Invasive Operative Considerations
- Complications
- References
- 14. Lateral Lumbar Interbody Fusion
- Abstract
- Chapter Outline
- Introduction
- Anatomical Considerations
- Brief Surgical Technique
- Surgical Indications and Lateral Lumbar Interbody Fusion Revision Surgery
- Conclusion
- References
- 15. Anterior-Posterior Surgeries
- Abstract
- Chapter Outline
- Introduction
- Indications for Staged Anterior-Posterior Lumbar Spine Surgery
- Operative Techniques and Considerations
- Representative Case
- References
- 16. Unilateral Versus Bilateral Strut Placement in Revision Spine Surgery
- Abstract
- Chapter Outline
- Introduction
- Complications in Posterior and Transforaminal Lumbar Interbody Fusions
- Reoperation in Lumbar Spine Surgery
- Single Versus Double Cage
- Clinical Case
- Conclusion
- References
- 17. Robotics for Revision Spine Surgery
- Abstract
- Chapter Outline
- Introduction
- Robotics as an Emerging Technology
- Technique
- Pros and Cons
- Complications and Pitfalls
- Future Directions
- Case Examples
- References
- 18. Pedicle Subtraction Osteotomy
- Abstract
- Chapter Outline
- Introduction
- Patient Selection and Operative Indications
- Operative Planning
- Choosing Proximal and Distal Fixation Levels for Lumbar Pedicle Subtractive Osteotomy
- Surgical Technique
- Complications and Strategies to Reduce Their Occurrence
- Conclusion
- References
- 19. Vertebral Column Resection
- Abstract
- Chapter Outline
- Introduction
- Surgical Considerations and Indications
- Deformity Assessment
- Radiological Evaluation
- Surgical Technique
- Posterior-Only Vertebral Column Resection Technique
- Anterior-Posterior Vertebral Column Resection Technique
- Postoperative Management
- Conclusion
- Disclosures
- References
- 20. Revision Lumbar Deformity Surgery
- Abstract
- Chapter Outline
- Introduction
- Patient Assessment
- Approach Considerations
- Sagittal Considerations
- Coronal Considerations
- Complications
- Conclusion
- References
- 21. Postoperative Considerations
- Abstract
- Chapter Outline
- Introduction
- Postoperative Drains
- Perioperative Antibiotic Prophylaxis
- Postoperative Venous Thromboembolism Prophylaxis
- Spinal Orthoses
- Physical Therapy
- Summary
- References
- 22. Adjacent Segment Disease After Fusion
- Abstract
- Chapter Outline
- Definitions
- Biomechanical Pathogenesis of Adjacent Segment Disease
- Incidence
- Risk Factors
- Association With Patient-Reported Outcomes
- Prevention of Adjacent Segment Disease
- Clinical Evaluation and Diagnosis
- Nonoperative Management
- Operative Management
- References
- 23. Pseudarthrosis/Nonunion
- Abstract
- Chapter Outline
- Introduction
- Lumbar Pseudarthrosis Definition, Epidemiology, and Diagnosis
- Imaging Modalities to Assess Pseudarthrosis
- Mechanical Biology of Bone Healing and Fusion
- Patient Risk Factors for Pseudarthrosis
- Bone Graft Materials
- Summary
- References
- 24. Iatrogenic Spinal Instability: Causes, Evaluation, Treatment, and Prevention
- Abstract
- Chapter Outline
- Introduction
- Epidemiology
- Diagnosis
- Treatment
- Prevention
- Summary
- References
- 25. Advances in Spinal Cord Stimulation
- Abstract
- Chapter Outline
- Introduction
- Why Spinal Cord Stimulation?
- What Therapy Is More Cost-Effective?
- How Are the Best Outcomes Achieved?
- The Surgical Procedure
- Special Surgical Situations
- The Device Is in, Now What?
- What Is Subparesthesia Stimulation?
- Conclusions
- Conflicts of Interest
- References
- Index
- Confidence is ClinicalKey
- Edition: 1
- Published: March 3, 2021
- Imprint: Elsevier
- No. of pages: 224
- Language: English
- Hardback ISBN: 9780323712019
- eBook ISBN: 9780323712026
- eBook ISBN: 9780323712033
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