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Advances in Spinal Cord Stimulation
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Iatrogenic Spinal Instability: Causes, Evaluation, Treatment, and Prevention
Introduction Instability in the lumbar spine is a well-recognized entity for both degenerative and traumatic processes. Less well defined is instability following an index decompressive or fusion procedure. This complex issue can exist as iatrogenic destabilization at either the same…
Pseudarthrosis/Nonunion
Introduction Degenerative disease of the lumbar spine is a common cause of disability and pain, with lumbar spondylolisthesis affecting 11.5% of the US population and lumbar stenosis affecting more than 200,000 adults in the United States. Spinal fusion surgery is…
Adjacent Segment Disease After Fusion
Definitions Adjacent segment disease (ASD) has been broadly and inconsistently defined in the literature. Other terms that have been used to describe ASD include junctional disease, junctional stenosis, or a transitional lesion. ASD has been applied to a plethora of…
Postoperative Considerations
Introduction Revision lumbar spine surgery comes with unique challenges and special considerations in the postoperative setting. In this chapter, we will cover some topics pertinent to postoperative care. Specifically, we will cover drains, antibiotic prophylaxis, venous thromboembolic prophylaxis, bracing, and…
Revision Lumbar Deformity Surgery
Introduction The term “adult spinal deformity” generally refers to any major coronal, sagittal, or biplane malalignment of the spine in a patient over the age of 18. The revision rate for primary adult deformity surgery patients is approximately 9% to…
Vertebral Column Resection
Introduction Vertebral column resection (VCR) is a challenging and lengthy procedure that is generally used as a last resort for the correction of severe rigid spinal deformities. Given VCR’s unique ability to translate the spinal column and provide truncal balance,…
Pedicle Subtraction Osteotomy
Introduction Lumbar pedicle subtraction osteotomy (PSO) was first described by Thomasen in 1985 for the surgical treatment of 11 patients with severe disabling kyphosis secondary to ankylosing spondylitis. In this series, Thomasen performed posterior bony wedge resection (i.e., removal of…
Robotics for Revision Spine Surgery
Introduction Despite advances in our understanding of spinal pathologies, diagnostics, implant designs, and biological adjuncts, there is a significantly sized cohort of patients who fail to achieve resolution of pain following surgery or have recurrent symptoms after surgery. Revision spine…