Table Of ContentSpinal Neurosurgery
ii
NEUROSURGERY BY EXAMPLE
Key Cases and Fundamental Principles
Series edited by: Nathan R. Selden, MD, PhD, FACS, FAAP
Volume 1: Peripheral Nerve Surgery, Wilson and Yang
Volume 2: Surgical Neuro- Oncology, Lonser and Elder
Volume 3: Spinal Neurosurgery, Harrop and Maulucci
Spinal Neurosurgery
Edited by
James S. Harrop, MD, FACS
Professor, Departments of Neurological and Orthopedic Surgery
Director, Division of Spine and Peripheral Nerve Surgery
Neurosurgery Director of Delaware Valley SCI Center
Thomas Jefferson University
Philadelphia, Pennsylvania
and
Christopher M. Maulucci, MD, FACS
Associate Professor of Neurological Surgery
Director of Spine Surgery
Tulane University
New Orleans, Louisiana
1
iv
1
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America.
© Oxford University Press 2019
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by license, or under terms agreed with the appropriate reproduction
rights organization. Inquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above.
You must not circulate this work in any other form
and you must impose this same condition on any acquirer.
Library of Congress Cataloging- in- Publication Data
Names: Harrop, James S., editor. | Maulucci, Christopher M., editor.
Title: Spinal neurosurgery / edited by James S. Harrop, Christopher M. Maulucci.
Description: New York, NY : Oxford Unversity Press, [2019] | Includes bibliographical references.
Identifiers: LCCN 2018029143 | ISBN 9780190887773 (pbk.)
Subjects: | MESH: Spine— surgery | Spinal Diseases— surgery | Spinal
Injuries—s urgery | Neurosurgical Procedures— methods
Classification: LCC RD533 | NLM WE 727 | DDC 617.4/ 71059— dc23
LC record available at https:// lccn.loc.gov/ 2018029143
This material is not intended to be, and should not be considered, a substitute for medical or other professional
advice. Treatment for the conditions described in this material is highly dependent on the individual
circumstances. And, while this material is designed to offer accurate information with respect to the subject
matter covered and to be current as of the time it was written, research and knowledge about medical and health
issues is constantly evolving and dose schedules for medications are being revised continually, with new side
effects recognized and accounted for regularly. Readers must therefore always check the product information
and clinical procedures with the most up-to-date published product information and data sheets provided by
the manufacturers and the most recent codes of conduct and safety regulation. The publisher and the authors
make no representations or warranties to readers, express or implied, as to the accuracy or completeness of this
material. Without limiting the foregoing, the publisher and the authors make no representations or warranties as
to the accuracy or efficacy of the drug dosages mentioned in the material. The authors and the publisher do not
accept, and expressly disclaim, any responsibility for any liability, loss or risk that may be claimed or incurred as a
consequence of the use and/or application of any of the contents of this material.
9 8 7 6 5 4 3 2 1
Printed by WebCom, Inc., Canada
Contents
Series Editor’s Preface vii
Contributors ix
1. Odontoid Fracture Type II 1
Daniel Tarazona and Alexander R. Vaccaro
2. Cervical Fracture Dislocation 11
Jason Liounakos, G. Damian Brusko, and Michael Y. Wang
3. Occipitocervical Dislocation 21
Alexander B. Dru and Daniel J. Hoh
4. Central Cord Injury 31
Bizhan Aarabi, Charles A. Sansur, David M. Ibrahimi, Mathew Kole, and Harry Mushlin
5. Atlantoaxial Instability 41
Jonathan M. Parish and Domagoj Coric
6. Basilar Invagination and Cranial Settling 49
Benjamin D. Elder and Jean- Paul Wolinsky
7. Cervical Myelopathy: Lordosis 63
Randall J. Hlubek and Nicholas Theodore
8. Cervical Myelopathy: Kyphosis 71
Mario Ganau, So Kato, and Michael G. Fehlings
9. Ossification of the Posterior Longitudinal Ligament: Cervical 81
Todd D. Vogel, Hansen Deng, and Praveen V. Mummaneni
10. Cervical Radiculopathy Due to Central Disc: ACDF/ Arthroplasty 93
Mazda K. Turel and Vincent C. Traynelis
11. Cervical Radiculopathy: Lateral Disc Foramintomy 101
Michael Karsy, Ilyas Eli, and Andrew Dailey
12. Thoracic Disc Herniation 109
Derrick Umansky and James Kalyvas
13. Thoracolumbar Burst Fractures 123
Omaditya Khanna, Geoffrey P. Stricsek, and James S. Harrop
14. Thoracic Cord Compression: Extradural Tumor 133
Tej D. Azad, Anand Veeravagu, John K. Ratliff, and Atman Desai
v
vi
Contents
15. Spinal Cord Tumor: Intramedullary 141
Rajiv R. Iyer and George I. Jallo
16. Spinal Cord Tumor: Intradural Extramedullary 149
Michael A. Galgano, Jared Fridley, and Ziya Gokaslan
17. Radiation- Sensitive Spine Tumor 159
Adam M. Robin and Ilya Laufer
18. Cauda Equina Syndrome 175
Emily P. Sieg, Justin R. Davanzo, and John P. Kelleher
19. Lumbar Stenosis 183
Miner N. Ross and Khoi D. Than
20. L4– L5 Degenerative Spondylolisthesis 191
Rani Nasser, Scott Zuckerberg, and Joseph Cheng
21. Isthmic Spondylolisthesis 199
Evan Lewis and Charles A. Sansur
22. Lumbar Degenerative Scoliosis 207
Michael LaBagnara, Durga R. Sure, Christopher I. Shaffrey, and Justin S. Smith
23. Flat Back Deformity 215
Yusef I. Mosley and James S. Harrop
24. Diskitis 225
Jacob R. Joseph, Brandon W. Smith, and Mark E. Oppenlander
25. Epidural Abscess 235
Hector G. Mejia Morales and Manish K. Singh
26. Nonsurgical Spinal Diseases 243
Lahiru Ranasinghe and Aimee M. Aysenne
Index 253
vi
Series Editor’s Preface
I am delighted to introduce this volume of Neurosurgery by Example: Key Cases and
Fundamental Principles. Neurosurgical training and practice are based on managing a
wide range of complex clinical cases with expert knowledge, sound judgment, and
skilled technical execution. Our goal in this series is to present exemplary cases in the
manner they are actually encountered in the neurosurgical clinic, hospital emergency
department, and operating room.
In this volume, Dr. Jim Harrop, Dr. Christopher Maulucci, and their contributors
share their extensive wisdom and experience with all major areas of spinal neurosur-
gery. Each chapter contains a classic presentation of an important clinical entity, guiding
readers through assessment and planning, decision-m aking, surgical procedure, after
care, and complication management. “Pivot points” illuminate the changes required to
manage patients in alternate or atypical situations.
Each chapter also presents lists of pearls for the accurate diagnosis, successful treat-
ment, and effective complication management of each clinical problem. These three
focus areas will be especially helpful to neurosurgeons preparing to sit for the American
Board of Neurological Surgery oral examination, which bases scoring on these three
topics.
Finally, each chapter contains focused reviews of medical evidence and expected
outcomes, helpful for counseling patients and setting accurate expectations. Rather than
exhaustive reference lists, the authors provide lists of high-p riority additional reading
recommended to deepen understanding.
The resulting volume should provide you with a dynamic tour through the prac-
tice of spinal neurosurgery, guided by some of the leading experts in North America.
Additional volumes cover each subspecialty area of neurosurgery using the same case-
based approach and board review features.
Nathan R. Selden, MD, PhD
Campagna Professor and Chair
Department of Neurological Surgery
Oregon Health and Science University
Portland, Oregon
vii
viii
Contributors
Bizhan Aarabi, MD, FRCSC, FACS Domagoj Coric, MD
Professor, Neurosurgery Chief, Department of Neurosurgery
Director of Neurotrauma, R. Adams Carolinas Medical Center
Cowley Shock Trauma Center Carolina Neurosurgery and Spine
Department of Neurosurgery Associates
University of Maryland School of Charlotte, North Carolina
Medicine
Baltimore, Maryland Andrew Dailey, MD
Professor
Aimee M. Aysenne, MD, MPH Department of Neurosurgery
Director of Neurocritical Care University of Utah
Department of Clinical Neurosciences Salt Lake City, Utah
Tulane University, School of Medicine
New Orleans, Louisiana Justin R. Davanzo, MD
Department of Neurological Surgery
Tej D. Azad, BA Penn State Health Milton S. Hershey
Medical Student Medical Center
Department of Neurosurgery Pennsylvania, Pennsylvania
Stanford University School of Medicine
Stanford, California Hansen Deng, BS
Medical Student
G. Damian Brusko, BS Department of Neurological Surgery
Department of Neurological Surgery University of California, San Francisco
The Miami Project to Cure Paralysis San Francisco, California
University of Miami Miller School of
Medicine Atman Desai, MD
Miami, Florida Assistant Professor
Department of Neurosurgery
Joseph Cheng, MD, MS Stanford University School of Medicine
Professor of Neurosurgery Stanford, California
Frank H. Mayfield Chair
Department of Neurological Surgery Alexander B. Dru, MD
University of Cincinnati Health University of Florida
Cincinnati, Ohio Department of Neurosurgery
Gainesville, Florida
ix
