Summary of Key Points Preoperative evaluation of the patient scheduled for spine surgery most commonly focuses on functional capacity, neurological assessment, and upper airway examination. In patients with significant spinal cord compression or an unstable cervical spine undergoing cervical spine…
Summary of Key Points Intraoperative imaging is an essential component of effective and safe spinal surgery. Common indications for intraoperative imaging include anatomic localization, placement and evaluation of spinal instrumentation, tumor resection, and assessment of decompression. Plain film radiography and…
Summary of Key Points Surgical positions, incisions, and retractors are reviewed for cervical, thoracic, lumbar, and sacral operations. Technical details of various surgical approaches are outlined. The anatomy of ventral, dorsal, and combined approaches and how to avoid complications are…
Summary of Key Points With an ageing and more infirm population, coupled with health economic pressures and an evolving opioid crisis, never has there been a greater need for more effective perioperative management strategies to mitigate the physiological and psychosocial…
Summary of Key Points The overarching objective of spine surgery is to restore patients’ functional capacity and independence. Key goals in spine surgery include neural decompression, spinal stabilization, arthrodesis, and restoration of alignment. Treatment decision-making should be centered on each…
Summary of Key Points Many medication options exist for the management of chronic spinal and back pain disorders, including nonsteroidal antiinflammatories, acetaminophen, oral steroids, antidepressants, anticonvulsants, opioids, cannabinoids, and topical ointments. Muscle relaxants, oral steroids, opioids, and nonsteroidal antiinflammatories can…
Summary of Key Points Spinal cord stimulation (SCS) has traditionally been clinically used to treat chronic pain; however, the indications for spinal neuromodulation are growing. It recently has been used to treat paralysis after spinal cord injury, spinal instability, and…
Summary of Key Points Cell-based therapy for intervertebral disc degeneration has the potential to restore the physiological function of the spine and improve back pain and disability. Cell sources explored to date include mesenchymal stem cells, notochordal cells, induced pluripotent…
Summary of Key Points Pain is a multifaceted and complex experience, with both sensory and emotional components. When pain persists beyond the expected time of healing, chronification of pain occurs and is best treated within a biopsychosocial framework. National physician…
Summary of Key Points There are numerous types of spine injections used to diagnose and treat pathophysiology of the spine. To accurately diagnose and treat the underlying pathophysiology with an injection, correct diagnosis based on history, physical exam, and imaging…