Spine Fusion: Anatomy and Biomechanics of Bone-Bone Interface
Summary of Key Points • Mechanical performance of a bone graft is a function of the intrinsic property of the graft and the properties of the graft-host interface. • Bone…
Intervertebral Disc Process of Degeneration: Physiology and Pathophysiology
Summary of Key Points • Intervertebral disc degeneration is very common and is associated with significant costs to the American health care system. • Normal aging and degeneration of the…
Bone Modeling and Remodeling
Summary of Key Points • In general, modeling alludes to bone turnover that alters the shape of the bone, whereas remodeling is the turnover that recycles bone without changing its…
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….
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,…
