Künzel, Norbert Boos Core Messages.. Werner, Norbert Boos Core Messages.. 285 11 Neurological Assessment in Spinal Disorders Uta Kliesch, Armin Curt Core Messages.. 369 Peri- and Postope
Trang 1Interspinous Process Distraction Technique 83
Recapitulation 84
Key Articles 85
References 86
4 Age-Related Changes of the Spine Atul Sukthankar, Andreas G Nerlich, Günther Paesold Core Messages 91
Epidemiology 91
Case Introduction 92
General Age-Related Changes 92
Functional Spine Unit 93
The Intervertebral Disc and Cartilage Endplate 95 Intervertebral Disc 95
The Cartilage Endplate 107
The Facet Joints 109
Normal Anatomy 109
Age-Related Changes 109
Vertebral Bodies 110
Normal Anatomy and Composition 110
Age-Related Changes 110
Spinal Ligaments 111
Normal Anatomy and Composition 111
Age-Related Changes 111
Spinal Muscles 112
Normal Anatomy and Structure 112
Age-Related Changes 112
Recapitulation 114
Key Articles 115
References 116
5 Pathways of Spinal Pain Heike E Künzel, Norbert Boos Core Messages 123
Historical Background 123
Precartesian Theories 123
Cartesian Theory 124
Gate Control Theory 124
Modern Pain Theories 124
Epidemiology of Chronic Pain 125
Definition and Classification 125
Temporal Course 126
Contemporary Pain Classification 126
Pathways of Pain 128
Transduction 129
Conduction 130
Transmission and Modulation 130
Pain Projection 133
Pain Perception 134
Neuroplasticity 135
Peripheral Sensitization 135
Transcriptional DRG Changes 136
Central Sensitization 136
Disinhibition 137
Endogenous and Environmental Influences on Pain Perception 137
Clinical Assessment of Pain 138
Differentiating Inflammatory and Neuropathic Pain 138
General Concepts of Pain Treatment 141
Pharmacological Treatment 141
Non-pharmacological Treatment of Spinal Pain 143
Biopsychosocial Interventions 143
Surgical Treatment 144
Recapitulation 144
Key Articles 145
References 146
6 Epidemiology and Risk Factors of Spinal Disorders Achim Elfering, Anne F Mannion Core Messages 153
General Scope 153
Objectives in Spinal Disorders 154
Classification of Spinal Disorders 155
Etiology 155
Time Course 155
Low Back Pain 156
Neck Pain 157
Pain, Impairment and Disability 157
Burden of Spinal Disorders 159
Economic Costs 159
Risk Factors 161
Individual Risk Factors 161
Morphological Risk Factors 162
Psychosocial Factors 162
Occupational Physical Risk Factors 163
Occupational Psychological Risk Factors 163
Absence of Evidence for Certain Risk Factors 164 Geographical Variation 164
Flag System for the Risk Factors 165
Red Flags 165
Yellow Flags 166
Blue Flags 166
Black Flags 166
Direction for Future Epidemiological Research 167 Recapitulation 167
Key Articles 168
References 169
7 Predictors of Surgical Outcome Anne F Mannion, Achim Elfering Core Messages 175
Epidemiology 175
Outcome Measures 179
What Constitutes a “Successful Outcome” 180
XIV Contents
Trang 2The Outcome of Common Spine Surgical
Procedures 182
Predictors of Outcome of Spinal Surgery 183
Medical Factors 184
Biological and Demographic Variables 186
Health Behavioral and Lifestyle Factors 187
Psychological Factors 187
Sociological Factors 189
Work-Related Factors 189
Risk Factor Assessment in Clinical Practice 190
Recapitulation 192
Key Articles 193
References 194
Patient Assessment 8 History and Physical Examination Cl ´ement M.L Werner, Norbert Boos Core Messages 201
Epidemiology 201
Case Introduction 202
History 203
Pain 204
Function 210
Spinal Deformity 210
Physical Examination 211
Walking 211
Standing 211
Sitting 216
Lying Supine 220
Lying on Left/Right Side 220
Lying Prone 221
Abnormal Illness Behavior 221
Reproducibility 221
Differential Diagnosis of Spinal Pain Syndromes 222 Recapitulation 222
Key Articles 223
References 224
9 Imaging Studies Marius R Schmid, Jürg Hodler Core Messages 227
Imaging Methods 227
Standard Radiographs 227
Magnetic Resonance Imaging 229
Computed Tomography 241
Additional Imaging Methods 244
Indications for Spinal Imaging 247
Acute Low Back Pain Without Radicular Symptoms, Without Trauma 247
Acute Low Back Pain With Radicular Symptoms 248
Spinal Cord and Cauda Compression Syndromes 249
Acute Trauma 249
Chronic Low Back Pain 251
Postoperative Imaging 251
Whiplash-Associated Disorders 252
Pain Relating to the Sacroiliac Joint 253
Disease of the Spinal Cord 255
Recapitulation 255
Key Articles 256
References 257
10 Spinal Injections Massimo Leonardi, Christian W Pfirrmann Core Messages 261
Rationale for Spinal Injections 261
Lumbar and Cervical Nerve Root Blocks 262
Indications 262
Technique 263
Complications 265
Diagnostic and Therapeutic Efficacy 265
Epidural and Caudal Blocks 267
Indications 267
Technique 268
Complications 268
Therapeutic Efficacy 268
Provocative Discography 271
Indications 271
Technique 272
Complications 273
Diagnostic Efficacy 273
Facet Joint Blocks 275
Indications 275
Technique 276
Complications 277
Diagnostic and Therapeutic Efficacy 278
Sacroiliac Joint Blocks 280
Indications 280
Technique 280
Complications 280
Diagnostic Efficacy 281
Contraindications for Spinal Injections 281
Algorithm for Spinal Injections 282
Recapitulation 283
Key Articles 284
References 285
11 Neurological Assessment in Spinal Disorders Uta Kliesch, Armin Curt Core Messages 291
Epidemiology 291
Case Introduction 292
Anatomy and Somatotopic Background 294
Classification 295
Neurological Assessment 298
Pain 298
Contents XV
Trang 3Sensory Deficits 298
Motor Deficits 299
Reflex Deficits 299
Gait Disorders 301
Bowel and Bladder Dysfunction 303
Disorders of the Autonomic System 303
Spinal Cord Injury 304
Spinal Cord Syndrome 304
Differential Diagnosis 306
Differentiation of Central and Peripheral Paresis 306
Differentiation of Radicular and Peripheral Nerve Lesions 306
Differential Diagnosis of Spinal Cord Compression Syndromes 311
Miscellaneous Differential Diagnoses 311
Recapitulation 312
Key Articles 313
References 314
12 Neurophysiological Investigations Armin Curt, Uta Kliesch Core Messages 319
Historical Background 319
Neuroanatomy 320
Neurophysiological Modalities 321
Electromyography 321
Nerve Conduction Studies 322
F-Wave Recordings 324
H-Reflex 325
Somatosensory Evoked Potentials 326
Motor Evoked Potentials (Transcranial Magnetic Stimulation) 328
Intraoperative Neuromonitoring 329
Role of Neurophysiology in Specific Disorders 330
Spinal Cord Injury 330
Cervical/Lumbar Radiculopathy 330
Cervical Myelopathy 331
Lumbar Spinal Canal Stenosis 331
Neurophysiology in Differential Diagnosis 332
Peripheral Nerve Lesion Versus Radiculopathy 332 Neuropathy Versus Spinal Canal Stenosis 332
Myopathy and Myotonic Disorders 333
Hereditary and Neurodegenerative Disease 333 Recapitulation 334
Key Articles 334
References 335
13 Surgical Approaches Norbert Boos, Claudio Affolter, Martin Merkle, Frank J Ruehli Core Messages 337
Surgery and Planning 337
Anterior Medial Approach to Cervical Spine 337
Indications 338
Patient Positioning 338
Surgical Exposure 339
Pitfalls and Complications 341
Posterior Approach to the Cervical Spine 342
Indications 342
Patient Positioning 342
Surgical Exposure 343
Pitfalls and Complications 345
Right-Sided Thoracotomy 345
Indications 346
Patient Positioning 346
Surgical Exposure 346
Pitfalls and Complications 349
Left-Sided Thoraco-Phrenico-Lumbotomy 350
Indications 350
Patient Positioning 350
Surgical Exposure 350
Pitfalls and Complications 353
Anterior-Lateral Retroperitoneal Approach to L2–L5 353
Indications 353
Patient Positioning 353
Surgical Exposure 353
Pitfalls and Complications 355
Anterior Lumbar Retroperitoneal Approach 355
Indications 355
Patient Positioning 355
Surgical Exposure 356
Pitfalls and Complications 358
Posterior Approach to the Thoracolumbar Spine 358 Indications 358
Patient Positioning 358
Surgical Exposure 359
Pitfalls and Complications 361
Landmarks for Screw Insertion 361
Cervico-occipital Spine 361
Recapitulation 368
Key Articles 369
References 369
Peri- and Postoperative Management 14 Preoperative Assessment Stephan Blumenthal, Youri Reiland, Alain Borgeat Core Messages 373
Aim of Preanesthetic Evaluation 373
Information and Instructions 374
Patient Assessment 374
History 374
Physical Examination 375
Laboratory Studies 375
XVI Contents
Trang 4Organ-Specific Assessment 376
Airway Assessment 376
Respiratory System 376
Cardiovascular Assessment 378
Neurological Assessment 379
Perioperative Drug Therapy 379
What to Stop, to Continue and to Add? 379
Premedication 380
Thromboembolic Prophylaxis 380
Special Conditions Requiring Spinal Surgery 382
Spinal Deformity 382
Neuromuscular Disease 383
Cerebral Palsy 383
Malignancy 384
Spinal Cord Injury 384
Recapitulation 385
Key Articles 386
References 387
15 Intraoperative Anesthesia Management Juan Francisco Asenjo Core Messages 389
Historical Background 389
Goals of Anesthesia in Spinal Surgery 389
Preoperative Patient Assessment 390
Induction of Anesthesia 390
Airway Control and Endotracheal Intubation 391 Antibiotic Prophylaxis 393
Patient Positioning 394
Maintenance of Anesthesia 396
Intraoperative Monitoring Techniques 397
Advanced Monitoring of Vital Functions 397
Monitoring Depth of Anesthesia (Consciousness) 400
Intraoperative Blood Preserving Techniques 400
Controlled Hypotensive Anesthesia 401
Intrathecal Opiates 402
Blood Predeposit and Erythropoietin Injection 402
Cell Salvage 402
Pharmacological Measures 403
Blood Transfusion and Coagulation Factor Substitution 403
Intraoperative Spinal Cord Monitoring 405
Anesthetic Effects on SSEPs 406
Anesthetic Effects on MEPs 407
Nerve Root Monitoring 408
Wake-up Test 408
End of Anesthesia 409
Postoperative Pain Management 409
Recapitulation 411
Key Articles 411
References 412
16 Postoperative Care and Pain Management Stephan Blumenthal, Alain Borgeat Core Messages 417
Postoperative Care 417
Postoperative Ventilation or Extubation 418
Hemodynamic Assessment 419
Neurological Assessment 419
Gastrointestinal Function 420
Thromboembolic Prophylaxis 420
Postoperative Pain Management 420
Consequences of Pain 420
Non-narcotics 421
Non-steroidal Drugs 421
Opioids 421
Local Anesthetics 422
N-Methyl-D-aspartate Antagonists 422
Recapitulation 423
Key Articles 423
References 424
Degenerative Disorders 17 Degenerative Disorders of the Cervical Spine Massimo Leonardi, Norbert Boos Core Messages 429
Case Introduction 430
Epidemiology 430
Pathogenesis 432
Neck Pain 432
Cervical Disc Herniation 432
Cervical Spondylotic Radiculopathy 433
Cervical Spondylotic Myelopathy 433
Clinical Presentation 435
History 436
Physical Findings 437
Functional Assessment 439
Diagnostic Work-up 439
Imaging Studies 439
Neurophysiological Assessment 444
Differential Diagnosis 444
Non-operative Treatment 444
Natural History 445
Conservative Treatment Modalities 446
Operative Treatment 448
General Principles 448
Surgical Techniques 449
Case Study 1 451
Case Study 2 454
Case Study 3 456
Surgical Decision-Making 459
Complications 463
Recapitulation 464
Key Articles 466
References 468
Contents XVII
Trang 518 Disc Herniation and Radiculopathy
Massimo Leonardi, Norbert Boos
Core Messages 481
Epidemiology 481
Case Introduction 482
Pathogenesis 483
Risk Factors 483
Radiculopathy 484
Clinical Presentation 486
History 486
Physical Findings 487
Diagnostic Work-up 488
Imaging Studies 488
Neurophysiologic Assessment 490
Urologic Assessment 490
Differential Diagnosis 491
Classification 491
Non-operative Treatment 493
Natural History 494
Conservative Measures 494
Operative Treatment 496
General Principles 496
Case Study 1 497
Surgical Techniques 497
Case Study 2 499
Conservative Versus Operative Treatment 503
Complications 504
Recapitulation 505
Key Articles 506
References 507
19 Lumbar Spinal Stenosis Patrick O Zingg, Norbert Boos Core Messages 513
Epidemiology 513
Case Introduction 514
Pathogenesis 515
Anatomy 515
Pathogenesis 515
Spinal Claudication Syndrome 517
Classification 517
Clinical Presentation 519
History 519
Physical Findings 520
Diagnostic Work-up 520
Imaging Studies 520
Neurophysiologic Studies 523
Differential Diagnosis 524
Non-operative Treatment 524
Natural History 525
Non-operative Options 525
Operative Treatment 526
General Principles 526
Surgical Techniques 526
Case Study 1 527
Case Study 2 529
Operative Risks and Complications 530
Recapitulation 531
Key Articles 532
References 533
20 Degenerative Lumbar Spondylosis Martin Merkle, Beat Wälchli, Norbert Boos Core Messages 539
Epidemiology 539
Case Introduction 540
Pathogenesis 541
Disc Degeneration and Discogenic Back Pain 542 Facet Joint Osteoarthritis 543
Segmental Instability 544
Clinical Presentation 545
History 546
Case Study 1 547
Physical Findings 548
Diagnostic Work-up 548
Imaging Studies 549
Case Study 2 550
Injection Studies 551
Temporary Stabilization 552
Patient Selection for Treatment 552
Non-operative Treatment 553
Operative Treatment 554
General Principles 554
Biology of Spinal Fusion 555
Surgical Techniques 558
Comparison of Treatment Modalities 568
Complications 569
Recapitulation 570
Key Articles 571
References 573
21 Non-specific Low Back Pain Florian Brunner, Sherri Weiser, Annina Schmid, Margareta Nordin Core Messages 585
Epidemiology 585
Case Introduction 586
Classification of Back Pain 587
Pathogenesis of NSLBP 587
Patient Assessment and Triage for Non-operative Treatment 588
Management of NSLBP 590
Management of Acute NSLBP (< 4 weeks) 590
Management of Subacute NSLBP (4 – 12 weeks) 592 Management of Chronic Non-specific LBP (> 12 weeks) 595
Recapitulation 596
XVIII Contents
Trang 6Key Articles 596
References 598
22 Postoperative Rehabilitation Florian Brunner, Shira Schecter-Weiner, Annina Schmid, Rudolf Kissling Core Messages 603
Epidemiology 603
Conceptional Background 604
Theoretical Considerations 604
Anatomical and Surgical Considerations 605
Individual and Societal Considerations 606
Indications for Postoperative Spinal Rehabilitation 606
General Goals 607
Specific Goals 607
Principles of Postoperative Rehabilitation 607
Preoperative Assessment 607
Postoperative Rehabilitation 608
Obstacles for Rehabilitation 616
Morphological Obstacles and General Medical Obstacles 616
Psychosocial Obstacles 617
Work-Related Obstacles 617
Recapitulation 617
Key Articles 618
References 619
Spinal Deformities and Malformations 23 Idiopathic Scoliosis Mathias Haefeli, Kan Min Core Messages 623
Epidemiology 623
Case Introduction 624
Pathogenesis 625
Genetic Factors 625
Connective Tissue and Skeletal Muscle Abnormalities 625
Thrombocyte Abnormalities, Calmodulin and Melatonin 626
Classification 626
Age-Related Classification 626
Radiological Classification 627
Clinical Presentation 627
History 627
Physical Examination 629
Diagnostic Work-up 632
Imaging Studies 632
Neurophysiologic Evaluation 637
Treatment 637
General Considerations 637
Natural History 637
Non-operative Options 639
Operative Treatment 641
Indications for Surgery 641
General Principles 642
Case Study 1 646
Surgical Decision Making 647
Case Study 2 651
Complications 651
Recapitulation 652
Key Articles 653
References 654
24 Neuromuscular Scoliosis Jean A Ouellet, Vincent Arlet Core Messages 663
Epidemiology 663
Case Introduction 664
Disease Specific Spinal Deformity 666
Pathogenesis 667
Classification 667
Clinical Presentation 669
History 669
Physical Examination 670
Case Study 1 671
Diagnostic Work-up 673
Medical Assessment 673
Case Study 2 674
Imaging Studies 675
Non-operative Treatment 677
Natural History 677
Non-operative Treatment Options 678
Operative Treatment 678
Surgical Indications 678
General Principles 679
Surgical Techniques 680
Case Study 3 680
Case Study 4 686
Recapitulation 689
Key Articles 690
References 691
25 Congenital Scoliosis Francis H Shen, Vincent Arlet Core Messages 693
Epidemiology 693
Case Introduction 694
Pathogenesis 694
Classification 695
Clinical Presentation 696
History 696
Physical Findings 697
Diagnostic Work-up 698
Imaging Studies 698
Specific Investigations 700
Non-operative Treatment 700
Contents XIX
Trang 7Natural History and Progression 700
Operative Treatment 701
General Principles 701
Surgical Techniques 702
Corrective Surgery Procedures 702
Case Study 1 703
Case Study 2 704
Miscellaneous Surgical Techniques 707
Recapitulation 708
Key Articles 709
References 710
26 Degenerative Scoliosis Max Aebi Core Messages 713
Epidemiology 713
Case Introduction 714
Pathogenesis 715
Classification 716
Clinical Presentation 717
History 717
Physical Findings 719
Diagnostic Workup 720
Imaging Studies 720
Interventional Radiological Procedure 721
Additional Diagnostic Tools 722
Non-operative Treatment 722
Operative Treatment 723
Decompression Procedure 724
Correction Procedures 724
Surgical Techniques 725
Case Study 1 728
Case Study 2 729
Recapitulation 729
Key Articles 730
References 731
27 Spondylolisthesis Clayton N Kraft, Rüdiger Krauspe Core Messages 733
Epidemiology 733
Case Introduction 734
Pathogenesis 735
Classification 735
Clinical Presentation 736
History 736
Physical Findings 738
Differential Diagnosis 738
Diagnostic Work-up 739
Imaging 739
Case Study 1 742
Invasive Imaging Studies 743
Non-operative Treatment 745
Natural History 745
Conservative Treatment Options 745
Operative Treatment 747
General Principles 747
Surgical Techniques 748
Case Study 2 751
Complications 756
Recapitulation 757
Key Articles 758
References 759
28 Juvenile Kyphosis (Scheuermann’s Disease) Dietrich Schlenzka, Vincent Arlet Core Messages 765
Epidemiology 765
Case Introduction 766
Pathogenesis 767
Normal Sagittal Profile 768
Definition and Classification 771
Clinical Presentation 773
History 773
Physical Findings 774
Diagnostic Work-up 775
Imaging Studies 775
Neurophysiological Tests 777
Lung Function Test 777
Differential Diagnosis 777
Non-operative Treatment 779
Natural History 779
Bracing and Casting 780
Case Study 1 780
Operative Treatment 782
Preoperative Assessment 782
General Principles 783
Operative Technique 784
Case Study 2 786
Results of Operative Treatment 788
Complications 790
Recapitulation 791
Key Articles 792
References 793
29 Malformations of the Spinal Cord Dilek Könü-Leblebicioglu, Yasuhiro Yonekawa Core Messages 797
Epidemiology 797
Case Introduction 798
Pathogenesis 799
Embryological Aspects 799
Relevant Embryogenetic Steps 800
Risk Factors 801
Pathophysiology of Tethered Cord Syndrome 802 Terminology and Classification 802
Classification of Spinal Malformation 803
XX Contents
Trang 8Case Study 1 805
Classification of Tethered Spinal Cord 811
Clinical Presentation 812
History 812
Physical Findings 813
Diagnostic Work-up 814
Prenatal Diagnosis 814
Postnatal Diagnostic Tests 815
Treatment 815
In Utero Treatment 816
Postnatal Surgery 816
Recapitulation 818
Key Articles 819
References 819
Fractures 30 Cervical Spine Injuries Michael Heinzelmann, Karim Eid, Norbert Boos Core Messages 825
Case Introduction 826
Epidemiology 827
Pathomechanisms 828
Normal Anatomy 828
Biomechanics of Cervical Spine Trauma 830
Spinal Cord Injury 832
Pathomechanism of Whiplash-Associated Disorders 833
Clinical Presentation 834
History 834
Physical Findings 835
Classification of Whiplash-Associated Disorders 836
Diagnostic Work-up 836
Imaging Studies 836
Neurophysiology 842
Vascular Assessment 842
Synopsis of Assessment Recommendations 842
General Treatment Principles 844
Whiplash-Associated Disorders 844
Non-operative Treatment Modalities 845
Spinal Cord Injuries 848
Specific Treatment of Upper Cervical Spine Injuries 850
Fractures of the Occipital Condyle 850
Atlanto-occipital Dislocation 851
Fractures of the Atlas 852
Atlantoaxial Instabilities 853
Dens Fractures 854
Case Study 1 858
Traumatic Spondylolisthesis of the Axis 860
Case Study 2 862
Combined Atlas/Axis Fractures 863
Classification and Treatment of Subaxial Injuries 863 Classification 864
Treatment 866
Case Study 3 870
Complications 871
Recapitulation 871
Key Articles 873
References 874
31 Thoracolumbar Spinal Injuries Michael Heinzelmann, Guido A Wanner Core Messages 883
Epidemiology 883
Case Introduction 884
Pathomechanisms 885
Axial Compression 885
Flexion/Distraction 886
Hyperextension 886
Rotational Injuries 886
Shear 887
Classification 887
Denis Classification 888
AO Classification 888
Clinical Presentation 892
Spinal Injuries 892
Neurological Deficit 892
Concomitant Non-spinal Injuries 893
History 893
Physical Findings 894
Diagnostic Work-up 895
Imaging Studies 895
Non-operative Treatment 898
Steroid Treatment of Spinal Cord Injury 899
Non-operative Treatment Modalities 899
Case Study 1 900
Operative Treatment 903
General Principles 903
Surgical Techniques 905
Case Study 2 906
Case Study 3 911
Outcome of Operative Versus Non-operative Treatment 914
Recapitulation 918
Key Articles 919
References 920
32 Osteoporotic Spine Fractures Paul F Heini, Albrecht Popp Core Messages 925
Epidemiology 925
Case Introduction 926
Pathogenesis and Definition 926
Classification of Vertebral Body Compression Fractures 929
Contents XXI
Trang 9Clinical Presentation 930
History 930
Physical Findings 933
Diagnostic Work-up 933
Imaging Studies 933
Radionuclide Studies 934
Densitometry 934
Bone Biopsy 935
Laboratory Investigations 935
Non-operative Treatment 936
Conservative Fracture Management 936
Medical Treatment 936
Operative Treatment 937
General Principles 937
Surgical Principles 937
Recapitulation 942
Key Articles 943
References 944
Tumors and Inflammation 33 Primary Tumors of the Spine Bruno Fuchs, Norbert Boos Core Messages 951
Epidemiology 951
Case Introduction 952
Tumor Biology 953
Molecular Tumor Biology 953
Pathways of Metastasis 954
Histology and Biology of Spinal Tumors 956
Clinical Presentation 957
History 957
Physical Findings 957
Diagnostic Work-up 958
Imaging Studies 958
Case Study 1 960
Case Study 2 961
Biopsy 964
Laboratory Investigations 964
Tumor Staging 964
Benign Tumors 965
Malignant Tumors 966
Non-operative Treatment 967
Non-steroidal Anti-inflammatory Drugs 967
Adjuvant Therapy 967
Operative Treatment 968
General Principles 968
Surgical Techniques 969
Case Study 3 971
Recapitulation 973
Key Articles 974
References 974
34 Spinal Metastasis Dante G Marchesi Core Messages 977
Epidemiology 977
Case Introduction 978
Pathogenesis 978
Clinical Presentation 980
History 980
Physical Findings 980
Diagnostic Work-up 981
Imaging Studies 981
Biopsy 983
Laboratory Investigation 983
Classification 984
Non-operative Treatment 985
Steroids 985
Radiotherapy 985
Operative Treatment 986
General Principles 986
General Surgical Techniques 987
Specific Surgical Techniques 988
Case Study 1 989
Case Study 2 992
Case Study 3 993
Postoperative Patient Management 993
Recapitulation 994
Key Articles 995
References 995
35 Intradural Tumors Yashuhiro Yonekawa, Richard Marugg Core Messages 997
Epidemiology 997
Case Introduction 998
Etiology and Pathogenesis 998
Classification of Intradural Tumors 999
Intradural-Extramedullary Tumors 999
Differential Diagnosis 1000
Case Study 1 1001
Intradural-Intramedullary Tumors 1002
Case Study 2 1004
Clinical Presentation 1005
History 1005
Physical Findings 1006
Diagnostic Work-up 1006
Imaging Studies 1007
Lumbar Puncture 1008
Treatment 1009
Non-surgical Treatment 1009
Surgical Treatment 1009
Surgical Techniques 1010
Intrinsic Spinal Cord Tumor Resection 1012
Case Study 3 1013
Recapitulation 1016
XXII Contents
Trang 10Key Articles 1017
References 1018
36 Infections of the Spine Norbert Boos Core Messages 1021
Epidemiology 1021
Case Introduction 1022
Pathogenesis 1023
Classification 1023
Clinical Presentation 1024
History 1024
Physical Findings 1025
Diagnostic Work-up 1025
Labaratory Investigations 1025
Imaging Studies 1026
Biopsy 1028
Nonoperative Treatment 1029
Case Study 1 1030
Operative Treatment 1031
General Principles 1031
Surgical Techniques 1031
Case Study 2 1035
Recapitulation 1036
Key Articles 1037
References 1037
37 Rheumatoid Arthritis Dieter Grob Core Messages 1041
Epidemiology 1041
Pathogenesis 1041
Case Introduction 1042
Classification 1044
Clinical Presentation 1045
History 1045
Physical Findings 1045
Diagnostic Work-up 1045
Imaging Studies 1045
Case Study 1 1047
Injection Studies 1048
Neurophysiological Investigations 1048
Non-operative Treatment 1048
Operative Treatment 1048
General Principles 1048
Indications 1049
Surgical Techniques 1050
Case Study 2 1053
Recapitulation 1054
Key Articles 1054
References 1055
38 Ankylosing Spondylitis Thomas Liebscher, Kan Min, Norbert Boos Core Messages 1057
Epidemiology 1057
Case Introduction 1058
Pathogenesis 1060
Clinical Presentation 1061
History 1061
Physical Findings 1062
Diagnostic Work-up 1063
Laboratory Investigations 1063
Imaging Studies 1063
Diagnostic Criteria 1066
Non-operative Treatment 1067
Natural History 1067
Non-operative Management 1068
Physiotherapy 1069
Treatment Recommendations 1069
Operative Treatment 1070
General Principles 1070
Planning of Osteotomies 1071
Surgical Techniques 1072
Case Study 1 1076
Case Study 2 1078
Complications 1080
Recapitulation 1080
Key Articles 1081
References 1082
39 Treatment of Postoperative Complications Martin Krismer, Norbert Boos Core Messages 1087
Frequency of Complications 1087
Cervical Spine Surgery 1087
Case Introduction 1088
Anterior Spinal Surgery 1089
Disc Herniation and Spinal Stenosis 1089
Lumbar Spinal Fusion 1090
Comparison of Complications 1090
Preventive Measures 1090
Screening of Risk Factors 1091
Preoperative Planning 1093
Profound Knowledge of Anatomy 1094
Patient Positioning 1094
Neuromonitoring 1095
Approach-Related Complications 1095
Anteromedial Cervical Approach 1096
Case Study 1 1097
Anterior Approach to the Cervicothoracic Junction 1098
Thoracotomy 1098
Thoracolumbar Approach 1100
Contents XXIII