Core Techniques in Operative Neurosurgery

Minimally Invasive C1-2 Fusion

Indications Approximately 50% of the normal rotation of the cervical spine occurs at the atlantoaxial motion segment. Factors that lead to instability at the atlantoaxial junction include traumatic injury to the axis or atlas and traumatic ligamentous injury. Other pathologic…

Partial Sacrectomy

Indications Primary sacral tumors, many of which benefit from en bloc removal. Locally advanced rectal cancer with sacral involvement, for which pelvic exenteration is indicated. Nonunion of symptomatic sacral fracture. You’re Reading a Preview Become a Clinical Tree membership for…

Pelvic Fixation

Procedure notes Fusion to the pelvis in spine surgery can be difficult because of the complex anatomy of the lumbosacral region, the decreased bone density of the sacrum, and the large biomechanical stress placed on fixation at this transitional zone…

Lumbar Disk Arthroplasty

Indications Lumbar disk arthroplasty (LDA) is indicated as a treatment of chronic, incapacitating low back pain that is diskogenic in origin at the L4-5 or L5-S1 level and not accompanied by neural element compression resulting in claudication or radiculopathy. Diagnosis…

Pedicle Subtraction Osteotomy

Indications Fixed sagittal deformity (e.g., demonstrate poor correction on bending radiographs) secondary to previous surgery with an anterior fusion mass, traumatic deformity, neoplastic disease, or congenital anomalies. The need to introduce up to 35 degrees of lumbar lordosis, the need…

Anterior Lumbar Corpectomy

Indications Tumor, fracture, tuberculosis, or other pathology of the vertebral body requiring direct decompression of the spinal canal with resection of anterior pathology. Instability of anterior spinal elements requiring restoration of height and stability to prevent progressive deformity and kyphosis.…

Transforaminal Lumbar Interbody Fusion

Indications Segmental instability requiring fusion for stabilization. Recurrent disk herniation and broad-based herniation. Symptomatic spinal stenosis with a significant back pain component that would benefit from fusion. Degenerative disk disease with a significant back pain component. Spondylolisthesis that is progressive,…

Posterior Lumbar Interbody Fusion

Indications Spondylolisthesis that is symptomatic, progressive, or requiring decompression that necessitates stabilization. Degenerative disk disease with low back pain that can benefit from fusion at the symptomatic level or levels. Pseudarthrosis of a previous intertransverse fusion that requires a fusion…

Anterior Lumbar Interbody Fusion

Indications Anterior lumbar interbody fusion (ALIF) is indicated as a treatment of chronic, incapacitating low back pain secondary to degenerative disk disease, such as collapsed disk and Modic changes, or degenerative spondylolisthesis in the absence of severe neural element compression.…

Lumbar Microdiskectomy

Indications Patients with back pain, sciatic pain, Lasègue sign (pain with straight leg raise), or sensory deficit that fails to improve with conservative measures. Referable foraminal stenosis from posterolateral disk herniation. New or progressive motor deficits require more urgent surgical…