(1) St. Anthony’s Neurosurgery Specialists, Saint Louis, MO, USA   Posterior and posterolateral approaches for thoracic disc herniations include (a) laminotomy-facetotomy, (b) transpedicular; and (c) limited costotransversotomy (Fig. 45.1) [1…

(1) Marina Spine Center, Marina del Rey, CA, USA   1. Bleeding from lumbar spinal surgery is best minimized by proper positioning of the patient to prevent abdominal pressure that…

Fig. 50.1 AP c-arm image. Note operative L4–L5 operative disc endplates are not parallel to X-ray beam   4. Trendelenburg bed so that operative disc is perpendicular to floor. L5–S1…

Fig. 34.1 Appropriate positioning for the patient Fig. 34.2 The AP view should have parallel endplates and the spinous process should be centered between the pedicles. In the lateral view,…

Myelopathy Pain Miscellaneous Sensory disturbances Band-like chest pain Multiple sclerosis symptoms ↑ or ↓ skin sensitivity Axial thoracic back pain Spinal neoplasm/tumor symptoms Hypoesthesia Axial lumbar pain Psychiatric disorder symptoms…

(1) Marina Spine Center, Marina del Rey, CA, USA   Microscopic lumbar discectomy is an ideal way to remove a disc fragment. Indications include the following: 1. Morbidity of sufficient…

, Hiroyuki Tsuchiya1, Norio Kawahara1, Masahiko Hata1 and Hideki Murakami1 (1) Kanazawa University, Kanazawa, Japan   Sacral tumors may present a difficult problem to the surgeon who desires to obtain a clear margin of…

Fig. 35.1 This image illustrates skin marking that needs to be performed prior to incision to ensure adequate exposure to the L5–S1 disc space See Fig. 35.1—This image illustrates skin…

(1) Mayo Clinic, Rochester, MN, USA   Several terms that reappear throughout this chapter are first defined: neural foramen, nerve root, and foraminotomy. When two contiguous vertebrae are apposed, a…

(1) Marina Spine Center, Marina del Rey, CA, USA   Use the standard thoracotomy approach for safe exposure of vertebral levels T2–L2. Proper rib selection depends on the pathology for…