Patient Selection for Spine Surgery
Summary of Key Points • Unlike other musculoskeletal disorders, the etiology of back pain is often difficult to determine and lacks clear indications and criteria for surgical or nonsurgical intervention….
NEUROSURGERY
Anatomy of Nerve Root Compression, Nerve Root Tethering, and Spinal Instability
Summary of Key Points • A dynamic lumbar function that includes a tethered nerve root can create significant stretch or compression. Nerve roots have a limited ability for excursion secondary…
Pathophysiology of Cervical Myelopathy: Biomechanics and Deformative Stress
Summary of Key Points • Clinical and neurobiologic studies support mechanical deformity of the spinal cord as an important cause of myelopathy. • Static and dynamic elongation and displacement of…
Biology of Spine Fusion
Summary of Key Points • The ideal graft to promote successful arthrodesis has strong osteogenic, osteoinductive, and osteoconductive properties. • Autograft, allograft, demineralized bone matrix, xenograft, ceramics, or any of…
Preoperative and Surgical Planning for Avoiding Complications
Summary of Key Points • To avoid neurologic complications in high-risk patients, steroids may be used before incision and continued for 24 hours after surgery. • In patients with severe…
Applied Anatomy of the Thoracic and Lumbar Spine
Summary of Key Points • Transverse pedicle width is the limiting variable in pedicle screw diameter. Width is usually smallest around T4-6, but it does not increase much until lower…
Applied Anatomy of the Cervical Spine
Summary of Key Points • The spinal column consists of the occipitocervical junction and subaxial spine. • Complex ligamentous structures constrain excessive translation and rotation in the occipitocervical junction and,…
Fundamentals of Spine Surgery
Summary of Key Points • Key goals in spine surgery include neural decompression, spinal stabilization, and the restoration of alignment. • The overarching goal of surgery is to restore the…
Pathophysiology of Thoracic Myelopathy: Biomechanics and Deformative Stress
Summary of Key Points • The thoracic spine has unique biomechanical and physiologic features. • The thoracic spine is a relatively rigid transition zone between the more mobile cervical and…
Neural Injury at the Molecular Level
Summary of Key Points • The molecular mechanisms of neural damage due to spinal cord injury and chronic spinal cord compression. • Apoptosis is the primary force driving cellular loss…
