Neurosurgery clinics of North America
-
Iatrogenic cervical deformity can develop after anterior or posterior procedures. Careful attention to detail can minimize the likelihood of creating a sagittal or coronal plane deformity. Strategies for the prevention and correction of postoperative cervical deformity are presented.
-
Neurosurg. Clin. N. Am. · Jul 2006
ReviewComplication avoidance: thoracolumbar and lumbar burst fractures.
Most thoracolumbar and lumbar burst fractures can be treated conservatively. Unstable fractures or fractures resulting in neurologic deficits usually require surgical treatment. Choosing an appropriate surgical approach requires a thorough understanding of the various techniques for decompression, fusion, and stabilization. ⋯ Each surgical option has unique advantages and disadvantages. Generally, the anterior approaches are best used at the thoracolumbar junction, posterior approaches are ideal for low lumbar injuries and lumbar injuries that result in complete spinal cord injuries,and anteroposterior surgeries typically are reserved for highly unstable fracture subluxations. Case illustrations show the various treatment options.
-
Neurosurg. Clin. N. Am. · Jul 2006
Review Case ReportsIntraoperative electrophysiologic monitoring: considerations for complex spinal surgery.
Intraoperative neurophysiologic monitoring techniques have evolved as the complexity of spinal surgery has increased and the limitations of individual modalities have become apparent. Current monitoring strategies include a combination of techniques directed toward detecting changes in sensory, motor, and nerve root function. Close coordination and communication between the monitoring personnel, surgeon, and anesthesiologist is essential to effective intraoperative monitoring.
-
Sagittal imbalance may be either segmental (type 1) or global (type 2). Careful preoperative evaluation is essential to determine the presence and extent of any inherent flexibility in the deformity. ⋯ More rigid or fixed sagittal plane deformities may be corrected with one or more osteotomies. Thorough planning and meticulous execution of osteotomies are essential to obtaining optimal surgical results.
-
Idiopathic scoliosis in adolescents and adults presents many challenges to the spinal surgeon. Preoperative planning, intraoperative technique, and postoperative management all contribute to the ultimate outcome. Avoiding complications in the treatment of idiopathic scoliosis depends on a thorough knowledge of the fundamental principles of spinal deformity evaluation and treatment.