Summary of Key Points Decision-making in complex spinal problems can be made easier by a systematic approach to the problems. “Problem, Goals, Tools, Plan” is one way to approach the problems. The primary driver of a good clinical outcome in…
Summary of Key Points Spinal deformity has many different causes and affects patients of all ages. Depending on the patient’s symptomatology and magnitude of deformity, surgical intervention may be necessary. Iatrogenic spinal deformities, such as lumbar flatback syndrome and proximal…
Summary of Key Points The sacroiliac (SI) joint is responsible for symptoms in up to 30% of patients presenting with lower back pain. SI joint pain symptoms include low back, buttock, and radiating lower extremity pain and can be easily…
Summary of Key Points Randomized controlled trial evidence supports the use of surgical treatment of degenerative lumbar spondylolisthesis. There are a variety of surgical approaches for treating these patients. Lumbar fusion is associated with more complications and greater cost when…
Summary of Key Points Symptomatic thoracic disc herniation is rare and may have a wide variety of symptoms, which delays diagnosis. The relative surgical inexperience of surgeons and the complex unique anatomy of the thoracic spine has hampered the development…
Summary of Key Points Lumbar disc herniation is a common cause of back pain with sciatica. Although most cases improve with conservative management, many other cases require surgical decompression, specifically microdiscectomy. Recurrent lumbar disc herniations following microdiscectomy are not uncommon,…
Summary of Key Points Cervical disc herniation is a common cause of neck pain, radiculopathy, and cervical myelopathy. Risk factors include male gender, increasing age, white race, cigarette smoking, heavy lifting, and occupation. Disc herniations results from traumatic, overuse, or…
Summary of Key Points Axial low back pain is a common clinical problem with a significant healthcare impact. The pathophysiology and underlying etiology of axial low back pain remain poorly defined. The diagnosis of axial low back pain is largely…
Summary of Key Points The percutaneous vertebral augmentation procedures vertebroplasty and kyphoplasty are indicated for painful vertebral compression fractures refractory to conservative medical management. Vertebroplasty involves injection of the bone cement, polymethylmethacrylate (PMMA), into a fractured vertebral body, typically using…
Summary of Key Points Diseases of the sacrum and lumbosacral junction lead to clinically complex problems for surgical treatment and biomechanical stabilization. The lumbosacral pivot point, the axis of rotation at the lumbosacral junction, is marked by the intersection of…