Perhaps no subspecialty field within orthopaedic or neurosurgery has realized advancements in treatments as those that have occurred in spine surgery. Rapid developments of technology that have been intended to improve patient care and clinical outcomes have transpired including production of novel fixation devices, identification and purification of osteobiologics substances, and enhancement of minimally invasive techniques. The process of incorporating new technology into a spine surgeon's practice requires familiarity with application of these devices, and a learning curve not only may occur but also is expected. Adverse events or complications may transpire despite reasonable patient selection, surgical technique, and postoperative care and should not be thought as a lack of understanding or experience on the part of the surgeon.
The purpose of Complications of Spine Surgery: Treatment and Prevention is not to accumulate a series of chapters simply describing the types of complications that may occur with the use of a given technology or procedure, but rather to present a source to refer to for learning how to prevent and how to recognize and manage such problems. We have enlisted experts in the field of spine surgery to assist us with this endeavor and believe we have accomplished our goals of providing a state-of-the-art, updated review of techniques and “nuggets” in the prevention and management of complications and morbidity in patients undergoing spinal surgery.
The text is divided into sections for cervical and thoracolumbar surgeries and various morbidities affecting all spine patients. Where appropriate, the chapters include descriptions of complications and incidence, discussion of pertinent anatomical considerations related to the complication, and insight from the experts that may be applied to clinical practice.
The anterior or posterior approach to the cervical spine is one of the most commonly performed procedures for experienced spine surgeons. Several key points from patient positioning to anatomic dissection are discussed in Dr. Grauer's chapter. The surgeon performing cervical decompression and fusion techniques needs to be aware of potential injuries to surrounding structures, and the next four chapters relate to recognition and prevention of morbidity associated with these techniques. Drs. Kwon and Jenis cover vascular morbidity with emphasis on an understanding of anatomy and etiology of iatrogenic injury, while Drs. Anderson, Apfelbaum, and Biyani detail excellent chapters on management of esophageal, vocal cord, and neurologic injuries, respectively.
The next series of chapters on cervical spine topics covers issues relating to prevention and management of postoperative complications. Dr. Albert provides a thorough review of post laminectomy cervical kyphosis and provides valued information regarding identifying high-risk patients and techniques for prevention of this deformity. A common problem following anterior cervical bone grafting is pseudarthrosis, although the diagnosis and management of persistent neck pain related to nonunion remains a clinical challenge. Dr. Delamarter covers this subject with emphasis on discussion of treatment options. Finally, Dr. An offers an extensive chapter on the role of instrumentation in the cervical spine and provides several tips on indications and techniques for the placement of these devices.
The next section covers the thoracolumbar spine and associated morbidities. Similar to the cervical section, the initial chapter serves as a review of basics and covers approach-related issues. Dr. Rao presents this topic thoroughly, which flows into the next several chapters on management of specific problems. Prevention of morbidity related to thoracolumbar instrumentation is covered in the following chapters, with Dr. Lenke reporting on anterior instrumentation while Drs. Jenis and Tromanhauser describe the role of posterior instrumentation. Each chapter is focused on not only proper technical application of instrumentation but also how to recognize and manage inaccurate placement. The problem of neurologic injury associated with lumbar decompression or insertion of implant is an important topic to consider. While present in relatively low-frequency neurologic morbidity, sequelae may have a devastating effect, and Dr. Wang presents this information in a concise, informative chapter.
The difficulty in achieving successful arthrodesis is evident in the literature and, similar to the cervical spine, identification and management of a painful pseudarthrosis is difficult at best. The following two chapters address this specific problem, with Dr. Yoon presenting a chapter on lumbar pseudarthrosis and Dr. Banco et al. focusing on the challenging problem of achieving arthrodesis at the lumbosacral junction. Dr. Kim presents an overview of the morbidity of autogenous bone graft harvest and associated patient morbidity and techniques to limit collateral injury to tissues.
The final section of this text covers the topics of complications related to other categories of spinal surgery. A common technique that has been advanced over the last several
P.viiiyears is the percutaneous management of vertebral fractures. Dr. Phillips describes these techniques and details the potential morbidities associated with this approach to patient care. Posttraumatic spinal deformity is a challenging problem, and Dr. Vaccaro presents a thorough descriptive chapter on the importance of identification of risk factors and management of this deformity.
Dr. Boachie-Adjei contributes a chapter on a very common and often underappreciated problem of nutritional deficiencies surrounding patients undergoing spinal surgery.
We would like to thank each author and their associates for providing their excellent work for this publication and the timeliness of submission of each chapter, as well as their devotion to teaching us who have established a career as spine surgeons in this challenging field.
Foreword
A busy surgeon will have complications throughout his or her career, no matter now meticulously and carefully he or she performs surgery. A surgeon who has no complications is a surgeon who either does not operate or is not truthful. How a surgeon deals with complications that arise intraoperatively or postoperatively is one of the key components that separates a great surgeon from one who is average. The ability to prevent, recognize, and treat complications is critical to the well-being of our patients, our own psyche, and reputation, along with our department and institution's standing.
The topics are organized not only to review complications related to a specific operation or anatomic region, but also to focus on the anatomy related to that complication along with management and prevention. This provides for a much clearer understanding of how complications can occur. The chapters are written in a clear, concise manner. The authors have extensive backgrounds in spinal surgery; much of the information is related to first-hand experience rather than literature review.
The textbook is divided by region, with Section I devoted to the cervical spine and Section II to the thoracic and lumbosacral spine. Section III covers issues relevant to more than one anatomic region.
Complications of Spine Surgery is a must-read for spinal surgeons. It is an excellent reference for residents and fellows as they prepare for their own careers.
CERVICAL SPINE
THORACOLUMBAR/LUMBOSACRAL SPINE
MISCELLANEOUS
Product Details
The purpose of Complications of Spine Surgery: Treatment and Prevention is not to accumulate a series of chapters simply describing the types of complications that may occur with the use of a given technology or procedure, but rather to present a source to refer to for learning how to prevent and how to recognize and manage such problems. We have enlisted experts in the field of spine surgery to assist us with this endeavor and believe we have accomplished our goals of providing a state-of-the-art, updated review of techniques and “nuggets” in the prevention and management of complications and morbidity in patients undergoing spinal surgery.
The anterior or posterior approach to the cervical spine is one of the most commonly performed procedures for experienced spine surgeons. Several key points from patient positioning to anatomic dissection are discussed in Dr. Grauer's chapter. The surgeon performing cervical decompression and fusion techniques needs to be aware of potential injuries to surrounding structures, and the next four chapters relate to recognition and prevention of morbidity associated with these techniques. Drs. Kwon and Jenis cover vascular morbidity with emphasis on an understanding of anatomy and etiology of iatrogenic injury, while Drs. Anderson, Apfelbaum, and Biyani detail excellent chapters on management of esophageal, vocal cord, and neurologic injuries, respectively.
The next series of chapters on cervical spine topics covers issues relating to prevention and management of postoperative complications. Dr. Albert provides a thorough review of post laminectomy cervical kyphosis and provides valued information regarding identifying high-risk patients and techniques for prevention of this deformity. A common problem following anterior cervical bone grafting is pseudarthrosis, although the diagnosis and management of persistent neck pain related to nonunion remains a clinical challenge. Dr. Delamarter covers this subject with emphasis on discussion of treatment options. Finally, Dr. An offers an extensive chapter on the role of instrumentation in the cervical spine and provides several tips on indications and techniques for the placement of these devices.
The next section covers the thoracolumbar spine and associated morbidities. Similar to the cervical section, the initial chapter serves as a review of basics and covers approach-related issues. Dr. Rao presents this topic thoroughly, which flows into the next several chapters on management of specific problems. Prevention of morbidity related to thoracolumbar instrumentation is covered in the following chapters, with Dr. Lenke reporting on anterior instrumentation while Drs. Jenis and Tromanhauser describe the role of posterior instrumentation. Each chapter is focused on not only proper technical application of instrumentation but also how to recognize and manage inaccurate placement. The problem of neurologic injury associated with lumbar decompression or insertion of implant is an important topic to consider. While present in relatively low-frequency neurologic morbidity, sequelae may have a devastating effect, and Dr. Wang presents this information in a concise, informative chapter.
The difficulty in achieving successful arthrodesis is evident in the literature and, similar to the cervical spine, identification and management of a painful pseudarthrosis is difficult at best. The following two chapters address this specific problem, with Dr. Yoon presenting a chapter on lumbar pseudarthrosis and Dr. Banco et al. focusing on the challenging problem of achieving arthrodesis at the lumbosacral junction. Dr. Kim presents an overview of the morbidity of autogenous bone graft harvest and associated patient morbidity and techniques to limit collateral injury to tissues.
The final section of this text covers the topics of complications related to other categories of spinal surgery. A common technique that has been advanced over the last several
P.viiiyears is the percutaneous management of vertebral fractures. Dr. Phillips describes these techniques and details the potential morbidities associated with this approach to patient care. Posttraumatic spinal deformity is a challenging problem, and Dr. Vaccaro presents a thorough descriptive chapter on the importance of identification of risk factors and management of this deformity.
Dr. Boachie-Adjei contributes a chapter on a very common and often underappreciated problem of nutritional deficiencies surrounding patients undergoing spinal surgery.
We would like to thank each author and their associates for providing their excellent work for this publication and the timeliness of submission of each chapter, as well as their devotion to teaching us who have established a career as spine surgeons in this challenging field.
Louis G. Jenis MD and Howard S. An MD
Foreword
A busy surgeon will have complications throughout his or her career, no matter now meticulously and carefully he or she performs surgery. A surgeon who has no complications is a surgeon who either does not operate or is not truthful. How a surgeon deals with complications that arise intraoperatively or postoperatively is one of the key components that separates a great surgeon from one who is average. The ability to prevent, recognize, and treat complications is critical to the well-being of our patients, our own psyche, and reputation, along with our department and institution's standing.
The topics are organized not only to review complications related to a specific operation or anatomic region, but also to focus on the anatomy related to that complication along with management and prevention. This provides for a much clearer understanding of how complications can occur. The chapters are written in a clear, concise manner. The authors have extensive backgrounds in spinal surgery; much of the information is related to first-hand experience rather than literature review.
The textbook is divided by region, with Section I devoted to the cervical spine and Section II to the thoracic and lumbosacral spine. Section III covers issues relevant to more than one anatomic region.
Complications of Spine Surgery is a must-read for spinal surgeons. It is an excellent reference for residents and fellows as they prepare for their own careers.
Harry N. Herkowitz MD
Contents CERVICAL SPINE
- Anterior/Posterior Cervical Approaches
- Vascular Complications in Cervical Spine Surgery
- Dysphagia/Esophageal Injuries
- Vocal Cord Paralysis After Anterior Cervical Spine Surgery
- Complications of Cervical Spine Surgery
- Postlaminectomy Kyphosis
- Cervical Pseudarthrosis
- Anterior/Posterior Cervical Instrumentation
THORACOLUMBAR/LUMBOSACRAL SPINE
- Complications of Anterior and Posterior Open Approaches to the Lumbar Spine
- Complications of Open Anterior Instrumentation in Adolescent Idiopathic Scoliosis
- Posterior Instrumentation
- Complications Related to Lumbar Pedicle Screw Instrumentation
- Neurological Injury in the Lumbar Spine
- Lumbar Pseudarthrosis
- Complications of Lumbosacral and Spinopelvic Fusion
- Complications of Iliac Crest: Bone Graft Harvesting
MISCELLANEOUS
- Percutaneous Vertebral Augmentation
- The Management of Complications Associated with Treatment of Post-Traumatic Deformity of the Thoracolumbar Spine
- Perioperative Morbidity
Product Details
- Hardcover: 235 pages
- Publisher: Lippincott Williams & Wilkins; 1 edition (October 19, 2005)
- Language: English
- ISBN-10: 0781757916
- ISBN-13: 978-0781757911
- Product Dimensions: 11.1 x 8.4 x 0.6 inches