E-Book, Englisch, 994 Seiten, ePub
Fessler / Sekhar Atlas of Neurosurgical Techniques
2. Auflage 2016
ISBN: 978-1-63853-071-8
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Spine and Peripheral Nerves
E-Book, Englisch, 994 Seiten, ePub
ISBN: 978-1-63853-071-8
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Originally published in 2006, the second edition of this award-winning neurosurgical atlas is written by a notable cadre of world-renowned spine surgeons. Reflecting the enormous depth and breadth of spine surgery, this volume has been completely updated with current, state-of-the-art surgical methodologies and minimally invasive options. Pathologies include degenerative changes, congenital abnormalities, rheumatic diseases, tumors, and trauma.
The authors have divided the book into six consistent sections: occipital-cervical, midcervical spine, cervicothoracic junction, thoracic and thoracolumbar spine, lumbar and lumbosacral spine, and peripheral nerve. Within each section, the opening chapters cover comprehensive discussion of pathology, etiology, and differential diagnosis. Succeeding chapters present step-by-step surgical techniques encompassing anterior, anterolateral, posterior, and posterolateral approaches, separately and in sequence. Minimally invasive techniques and peripheral nerve procedures, including the brachial plexus, lumbosacral plexus, and individual nerves are covered independently, following the same organization.
Key Highlights:
- Clearly delineated indications, contraindications, advantages, and disadvantages provided for each surgery
- Operations with same opening and closing technique covered just once, thereby minimizing redundancy
- Beautifully illustrated with more than 1,000 images
- Video compendium created by master surgeons provides up-close guidance on a wide array of surgical procedures
- Ideal for both the busy practitioner seeking review and resident looking for robust study materials
This book is an incomparable learning tool for residents, who will likely read it several times during the course of residency. A precisely edited, didactic atlas, neurosurgeons and orthopaedic surgeons will also find it an invaluable resource.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
Section I Occipital-Cervical Junction
1 Abnormalities of the Craniovertebral Junction
2 Rheumatologic and Degenerative Disease of the Craniovertebral Junction
3 Tumors of the Occipital-Cervical Junction
4 Trauma of the Occipital-Cervical Junction
5 Transoral Approaches to the Craniovertebral Junction
6 Transoral Odontoidectomy
7 Extended Transoral Approaches
8 Transoral Closure
9 Minimally Invasive Endoscopic Approaches to the Upper Cervical Spine
10 Extended Maxillotomy Approach for High Clinical Pathology
11 Retropharyngeal Approach to the Occipital-Cervical Junction, Part 1
12 Retropharyngeal Approach to the Occipital-Cervical Junction, Part 2
13 Posterior Suboccipital and Upper Cervical Exposure of the Occipital Cervical Junction
14 Suboccipital Craniectomy and Cervical Laminectomy for Chiari Malformation
15 Occipital-Cervical Encephalocele: Surgical Treatment
16 Occipital Plating and Occipital-Cervical Fusion
17 Exposure of C1 and C2
18 Atlantoaxial Wiring and Arthrodesis
19 C1-C2 Transarticular Fixation Technique
20 C1 Lateral Mass–C2 Pars, Pedicle, and Translaminar Fixation Techniques
21 Odontoid Screw Placement
Section II Midcervical Spine
22 Congenital Osseous Anomalies of the Mid- to Lower Cervical Spine
23 Cervical Spine Degenerative Disease and Cervical Stenosis
24 Intramedullary Tumors of the Spinal Cord
25 Extramedullary Tumors of the Spinal Cord
26 Vertebral Bone Tumors
27 Trauma of the Mid- and Lower Cervical Spine
28 Cervical Spine: Anterior Approach, Diskectomy, and Corpectomy
29 Cervical Arthroplasty
30 Transcorporeal Tunnel Approach for Unilateral Cervical Radiculopathy
31 Cervical Spine: Posterior Exposure
32 Cervical Laminectomy
33 Posterior Cervical Foraminotomy and Diskectomy
34 Minimally Invasive Posterior Cervical, Diskectomy, Laminectomy, and Foraminotomy for Stenosis
35 Cervical Laminoplasty
36 Gardner-Wells Tong or Crown-Halo Reduction for Cervical Facet Dislocations
37 Posterior Approach for the Treatment of Locked Cervical Facets
38 Subaxial Cervical Lateral Mass Screw Fixation
39 Subaxial Cervical Pedicle Screw Fixation
40 C7 Pedicle Subtraction Osteotomy
41 Combined Anterior-Posterior Approach for Complete Vertebral Resection in the Midcervical Spine
Section III Cervicothoracic Junction
42 Supraclavicular Approach to the Cervicothoracic Junction
43 Transmanubrial-Transclavicular and Transsternal Approach to the Cervicothoracic Junction
44 Cervicothoracic Corpectomy
45 Anterior Reconstruction Following Cervicothoracic Corpectomy
46 Posterior Cervicothoracic Instrumentation and Fusion
Section IV Thoracic and Thoracolumbar Spine
47 Congenital Abnormalities of the Thoracic and Thoracolumbar Spine
48 Disk Disease of the Thoracic and Thoracolumbar Spine
49 Tumors of the Thoracolumbar Spine
50 Trauma of the Thoracic and Thoracolumbar Spine
51 Thoracic Epidural Abscess and Osteomyelitis
52 Vascular Malformations of the Spine
53 Open Lateral Transthoracic Approach
54 Open Lateral Transthoracic Diskectomy and Vertebrectomy
55 Endoscopic Lateral Transthoracic Approach
56 Endoscopic Thoracic Sympathectomy
57 Endoscopic Lateral Transthoracic Diskectomy and Vertebrectomy
58 Lateral Transthoracic and Retropleural MIS Approaches
59 Lateral Transthoracic MIS Diskectomy and Vertebrectomy
60 Lateral Graft and Plate Reconstruction
61 Open Thoracoabdominal Approach
62 MIS Thoracoabdominal Approach
63 Open Retroperitoneal Approach
64 Minimally Invasive Retroperitoneal Lateral Lumbar Interbody Fusion
65 Minimally Invasive Retroperitoneal Vertebrectomy
66 Thoracoabdominal/Retroperitoneal Graft and Lateral Plating
67 Open Costotransversectomy
68 MIS Costotransversectomy
69 Thoracic Laminectomy
70 Thoracic Laminoplasty
71 Transpedicular Thoracic Diskectomy
72 Intradural Extramedullary Tumor Resection
73 Intramedullary Tumor Resection
74 Open Anterolateral Cordotomy
75 Commissural Myelotomy
76 Thoracic DREZ Operation
77 Caudalis DREZ
78 Shunt Placement for Syringomyelia
79 Posterior Approach and In-Situ Fusion of the Thoracic Spine
80 Pedicle Screw Instrumentation of the Thoracic Spine
81 Open Scoliosis Correction
82 Minimally Invasive Correction of Spinal Deformity
83 Minimally Invasive Thoracic Decompression for Multilevel Thoracic Pathology
Section V Lumbar and Lumbosacral Spine
84 Spondylolysis and Spondylolisthesis in Children
85 Lumbar Degenerative Disk Disease
86 Tumors of the Lumbosacral Spine
87 Trauma of the Lumbar Spine and Sacrum
88 Anterior Approach to the Lumbosacral Junction
89 Anterolateral Retroperitoneal Approach to the Lumbosacral Spine
90 Open Posterior Lumbar Approach
91 Open Posterior Lumbar Foraminotomy
92 Open Posterior Lumbar Hemilaminectomy
93 Open Posterior Lumbar Microdiskectomy
94 Open Posterior Lumbar Laminectomy
95 MIS Posterior Lumbar Approach
96 MIS Posterior Lumbar Foraminotomy
97 MIS Posterior Lumbar Hemilaminectomy
98 MIS Posterior Lumbar Diskectomy
99 MIS Posterior Lumbar Decompression of Stenosis
100 Microdiskectomy for Foraminal or Far Lateral Disc Herniations
101 Far Lateral MIS Diskectomy
102 Transverse Process Fusion
103 Open Placement of Pedicle Screws: Lumbar, Sacral, and Iliac Screws
104 Minimally Invasive Transforaminal Lumbar Interbody Fusion
105 MIS Placement of Pedicle Screws: Lumbar, Sacral, and Iliac Wing Screws
106 Lumbar Osteotomies
107 Cortical Trajectory Screws
108 MIS Facet Screw
109 Transacral Approach
110 Repair of Cerebrospinal Fluid Leaks
111 Lumboperitoneal Shunt
112 Dorsal Rhizotomy of the Lumbosacral Nerve Roots for the Treatment of Spastic Diplegia in Cerebral Palsy Patients
113 Resection of Cauda Equina Ependymomas
114 Release of the Tethered Spinal Cord
115 MIS Release of the Tethered Spinal Cord
116 Implantation of Spinal Cord Stimulators
117 Placement of an Intrathecal Drug Delivery System
118 Vertebroplasty and Kyphoplasty
119 Resection of Lumbosacral Lipomas
120 Repair of Myelomeningoceles
121 Excision of Spinal Congenital Dermal Tract/Dermoid
122 Resection of Sacrococcygeal Teratoma
123 Surgical Management of Spinal Dysraphism
124 Repair of Diastematomyelia
125 Sacral Agenesis
126 Iliac Crest Bone Grafting
Section VI Peripheral Nerves
127 Neoplasms of Peripheral Nerves
128 Traumatic Peripheral Nerve Injuries
129 Compressive Lesions of the Peripheral Nerve
130 Supraclavicular Approach to Brachial Plexus Surgery
131 Infraclavicular Approach to Brachial Plexus Surgery
132 Surgical Approach to the Spinal Accessory Nerve
133 Surgical Approach to the Axillary Nerve
134 Surgical Treatment of the Musculocutaneous Nerve
135 Open and Endoscopic Decompression of the Median Nerve
136 Decompression of the Ulnar and Radial Nerve
137 Trauma to the Lumbosacral Plexus
138 Tumors of the Lumbosacral Plexus
139 Approach to the Nerves of the Lower Extremity
140 Exposure and Biopsy of the Sural Nerve
141 Approach to the Lumbosacral Plexus
142 The Intercostal Nerves
143 Surgical Treatment of Ilioinguinal Neuralgia
144 Surgical Treatment of Genitofemoral Neuralgia
145 Lateral Femoral Cutaneous Nerve
146 Peripheral Nerve Grafting and Harvesting Techniques
147 Superficial Peroneal Nerve Biopsy
Video Contents
Video 6.1 Transoral approach: A 5-year-old with Down syndrome with a dystopic os odontoideum and dorsal displacement of the hypoplastic dens with instability between the craniocervical region and C2. At an outside institution, she underwent two previous posterior approaches including posterior decompression with instrumentation and fusion. However, proper reduction was not achieved. She was unable to stand and walk and use her arms after her second operative procedure due to severe cervicomedullary compression. Given her pathology and occipitocervical fusion, the reduction was unable to be performed. Therefore, a ventral transoral-transpalato-pharyngeal approach and decompression with removal of the anterior arch of C1, os odontoideum, and odontoid process was performed. The patient did well postoperatively and regained significant strength.
Video 8.1 Transoral closure: A proper closure after a transoral-transpalatopharyngeal approach is essential to minimizing complications. Proper closure reestablishes a barrier between the posterior pharyngeal space created by the approach and bony resection and the oropharyngeal space, eliminating dead space, therefore preventing abscess and hematoma formation. Proper closure also enables proper swallowing and prevention of velopharyngeal incompetence.
Video 11.1 High anterior cervical retropharyngeal surgical approach.
Video 28.1 Anterior cervical approach, diskectomy, and instrumented fusion: The video demonstrates the anterior approach to the cervical spine, with diskectomy, grafting, and instrumentation at the C6-C7 level. Video authorship: Anay R. Patel.
Video 30.1 Motion-preserving transcorporeal cervical forminotomy: The video demonstrates a short version of two surgical case examples: in the first case, a right-sided C6 transcorporeal foraminotomy, and in the second, a two-level left C5 and C6. Note that in both cases the disk is spared and a complete decompression is successfully achieved.
This technique is done through a regular anterior Smith-Robinson approach. One major difference between the surgical access for an anterior cervical diskectomy and fusion (ACDF) and the tunnel technique is that in the latter, exposure of only the target disk and proximal vertebral body is required, without the exposure of the inferior vertebral body. The level is confirmed at this stage, and an operating microscope is brought into the field. Before drilling is begun, indigo-carmine dye is injected in the affected disk to facilitate the orientation of disk space while drilling. The position of the drill hole is 4 to 6 mm above the lower border of the proximal vertebra, at the level of the medial border of the longus coli muscle. Drilling is done using a 4-mm diamond bur initially and a 3-mm bur later. At approximately one-third depth of the drilling, we can see the bluish discoloration of the stained disk and we can safely continue to drill further, keeping the blue-stained material in the center of the hole so as to maintain the direction of the trajectory.
After the desired depth is achieved, a blunt probe is used to palpate the base of the tunnel so that the thin ivory-white shell of the posterior vertebral wall can be carefully lifted with a fine bone punch or curette. The posterior longitudinal ligament still acts as a protective barrier between the instruments and the neural structures. Bone wax can be used to stop the bleeding from the spongy bone, and epidural bleeds can be managed with thrombin-soaked Gelfoam or FloSeal. The use of bipolar coagulation is strongly discouraged at this step.
The adequacy of the decompression can be confirmed by observing the bulging nerve root with cerebrospinal fluid (CSF) flow and palpating the superior and inferior pedicles along the course of the nerve root using a root probe.
Wound closure is the same as ACDF with a Hemovac drain for aspiration of postoperative hematoma.
Video 34.1 Tredway cervical microendoscopic foraminotomy.
Video 35.1 Cervical laminoplasty for cervical spondylotic my-elopathy (C3–C6: left open door; C7: partial laminectomy of the cranial third): A dorsal skin incision is made from the caudal C2 to C6 spinous process. An avascular plane between the right and left paraspinal muscles is divided at the midline. While preserving the muscles attaching to C2 and C7, the spinous processes from C3 to C6 and to the inner half of where the lateral mass is exposed. Then, the spinous processes of C3 through C6 are cut at the base with a Liston bone-cutting forceps, and the C6 spinous process is set aside for later use as a bone graft. A trough is made across each lamina using a high-speed drill with a 4-mm steel bur. Continuous irrigation is maintained to prevent thermal damage to the surrounding tissue and aid visualization of the bottom of the trough. The drilling continues until the epidural venous plexus at the cranial half of the lamina and yellow ligament at the caudal half of the lamina can be visualized through the thinned inner cortex. A 10-mm raspatory is inserted into the trough and twisted (the lamina makes a snapping sound and moves). The trough for the hinge side is subsequently made in the same manner. When drilling down to the surface of the inner cortex of the lamina at the hinge side, the springiness of the laminae should be checked frequently to prevent laminar fracture of the hinge side. The laminae are elevated starting from C6 (with the cranial third of C7) to C3. Hemostasis from the epidural venous plexus is achieved by bipolar cauterization. The autologous spinous processes from C6 is reshaped and implanted as a supporting strut with a nonabsorbable 2-0 suture. A hydroxyapatite spacer specially made for open-door laminoplasty is used at C4 with the same nonabsorbable 2-0 suture. After sufficient irrigation of the wound with saline, retractors are removed, hemostasis is achieved, and a drainage tube is placed at the hinge side. The fascia is closed with 2-0 Vicryl suture.
Video 55.1 Endoscopic lateral transthoracic approach: This approach is a powerful surgical tool that provides access to the anterior thoracic spine for treatment of a wide range of spinal pathologies. The video demonstrates the key steps involved in safely and effectively utilizing this approach. (Courtesy of Barrow Neurological Institute, Phoenix, Arizona.)
Video 56.1 Endoscopic technique for thoracic sympathectomy: This is an effective surgical strategy for treating hyperhidrosis syndromes. The video outlines the surgical steps involved in treating palmar and plantar hyperhidrosis syndromes via the endoscopic thoracic sympathectomy technique. (Courtesy of Barrow Neurological Institute, Phoenix, Arizona.)
Video 64.1 Minimally invasive retroperitoneal lateral lumbar interbody fusion: The video demonstrates the steps necessary to perform this fusion utilizing the “shallow docking” technique.
Video 72.1 Removal of an intradural schwannoma: This video illustrates the techniques of removal of an intradural schwannoma arising from the proximal caudal equina.
Video 78.1 Syrinx to subarachnoid space shunt placement.
Video 81.1 Open posterior pedicle screw construct correction of an idiopathic scoliosis deformity.
Video 95.1 Right L4-L5 microdiskectomy performed through a tubular retractor.
Video 107.1 Cortical bone screw fixation technique: The video demonstrates the use of this technique with a bilateral posterior lumbar interbody fusion (PLIF) in the treatment of degenerative spondylolisthesis at L3-L4. The video also demonstrates the hybrid mini-open techniques using the Minimal Access Spinal Technologies (MAST) retractor and illumination system (Medtronic, Memphis, TN).
Video 111.1 Lumboperitoneal shunt placement.
Video 112.1 Dorsal rhizotomies for cerebral palsy: This is an efficient and safe technique because of the accuracy of its radicular identification and root sectioning quantification. To optimize accuracy and selectivity while minimizing invasiveness, we developed a tailored interlaminar procedure targeting directly and individually the radicular levels involved in the harmful components of spasticity. In each patient, two to three interlaminar spaces, preselected based on preoperative planning, were enlarged in a “keyhole” fashion, respecting the spinous processes and interspinous ligaments.
The procedure is based on neurophysiological recordings. Ventral root stimulation identifies the radicular level (anatomic mapping). Dorsal root stimulation evaluates its implication in the hyperactive segmental circuits (physiological testing), helping quantify the percentage of rootlets to be cut.
Keyhole interlaminar dorsal rhizotomy (KIDr) offers direct intradural access to each of the ventral/dorsal roots, thus maximizing the reliability of anatomic mapping and enabling individual physiological testing of all targeted roots. The interlaminar (enlarged) approach minimizes invasiveness by respecting the posterior...
