Spine Surgery Basics

565 Pages·2013·21.16 MB·English

by  Vikas V. Patel

Vikas V. Patel
Alpesh Patel
James S. Harrop
Evalina Burger
Editors
Spine Surgery Basics
123
Spine Surgery Basics

Vikas V. Patel (cid:129) Alpesh Patel
James S. Harrop (cid:129) Evalina Burger
Editors
Spine Surgery Basics
Editors
Vikas V. Patel James S. Harrop
Department of Orthopaedics Department of Neurosurgery
University of Colorado, Denver Jefferson Medical College
Aurora, CO Philadelphia, PA
USA USA
Alpesh Patel Evalina Burger
Department of Orthopaedic Surgery Department of Orthopaedics
Northwestern University University of Colorado, Denver
Chicago, IL Aurora, CO
USA USA
ISBN 978-3-642-34125-0 ISBN 978-3-642-34126-7 (eBook)
DOI 10.1007/978-3-642-34126-7
Springer Heidelberg New York Dordrecht London
Library of Congress Control Number: 2013946428
© Springer-Verlag Berlin Heidelberg 2014
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way,
and transmission or information storage and retrieval, electronic adaptation, computer software,
or by similar or dissimilar methodology now known or hereafter developed. Exempted from this
legal reservation are brief excerpts in connection with reviews or scholarly analysis or material
supplied speci fi cally for the purpose of being entered and executed on a computer system, for
exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is
permitted only under the provisions of the Copyright Law of the Publisher’s location, in its
current version, and permission for use must always be obtained from Springer. Permissions for
use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable
to prosecution under the respective Copyright Law.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a speci fi c statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of
publication, neither the authors nor the editors nor the publisher can accept any legal responsibility
for any errors or omissions that may be made. The publisher makes no warranty, express or
implied, with respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
To our families for all the support and to Heidi Armbruster for
all the organization to make this project possible.

Preface
The stronger the foundation, the grander the possibilities!
The purpose of this textbook is to lay the foundation of spine education for
medical students, residents, fellows, and junior attendings. It provides a con-
cise and accurate methodology to understanding and diagnosing different
spine conditions followed by the basics of treatment. This textbook will, thus,
provide the link between education, optimized clinical evaluation, and evi-
dence-based decision making.
This is especially relevant today as with an enlarging and aging popula-
tion, spinal diseases will become more prevalent. Already back pain is the
second most common complaint for which patients seek care after the com-
mon cold. Concurrently, the past two decades have seen an explosion of tech-
nology utilization in patient care. This has led to students and naive practioners
diagnosing by exclusion-based testing as opposed to using sound clinical
judgement. As healthcare funding becomes limited, this current trend in uti-
lization of special high-end testing and imaging will be unsustainable. The
skills to obtain an accurate, real-time clinical diagnosis and treatment plan
will be in high demand. In the ever growing plethora of diagnoses, adhering
to basics will provide the knowledge and framework necessary to make the
correct decision for the patient.
Aurora, CO Vikas V. Patel
Chicago, IL Alpesh Patel
Philadelphia, PA James S. Harrop
Aurora, CO Evalina Burger
vii

Contents
Part I General
1 Anatomy ........................................................................................ 3
Christopher M.J. Cain
2 Physical Examination of the Cervical Spine .............................. 13
Virgilio Matheus and Edward C. Benzel
3 Examination of Back Pain ........................................................... 23
Jennifer Malone, Ravi Madineni, Niti Cooper, Angud Mehdi,
and Ashwini Sharan
4 Radiologic Imaging of the Spine ................................................. 37
Angela Valladares-Otero, Brian Christenson,
and Brian D. Petersen
5 Diagnostic Evaluations ................................................................ 75
Richard Kendall and Zach Beresford
6 General Considerations for Spine Surgery Including
Consent and Preparation. General Surgical Principles,
Guidelines for Informed Consent, Patient Positioning
for Surgery, Equipment Needed, and Postoperative
Considerations .............................................................................. 83
Evalina Burger
7 Surgical Approaches .................................................................... 91
Michael C. Gerling and Sheeraz A. Qureshi
8 Cervical and Cervicothoracic Instrumentation ........................ 99
Adam Pearson and Todd Albert
9 Lumbosacral Instrumentation .................................................... 113
Joanne Elston and Nelson Saldua
10 Bone Graft and Bone Substitute Biology ................................... 147
Harshpal Singh and Allan D. Levi
11 Neurological Monitoring in Orthopedic Spine Surgery ........... 153
Tod B. Sloan, Leslie Jameson, Daniel Janik, and Paul Mongan
ix