The Edwin Smith Papyrus (17th century bce ) described 48 cases of fractures, tumors, injuries, and wounds that occurred during the time period in which it was written. The document also laid out a fairly complex method of examining and…
Adjacent-segment pathology (ASP) is a common complication of spinal surgery. This chapter focuses on the causes, common clinical scenarios, and treatment options to avoid or treat ASP. Surgery changes the anatomy, physiology, kinematics, and biomechanics of the operated and contiguous…
Introduction Spinal fusions are one of the most common spine surgeries performed today. The number of spinal fusion surgeries performed has significantly increased over the past 2 decades. From 1998 to 2008, the rates of spinal fusion surgery have increased…
Introduction Postoperative spinal wound infections are relatively frequent problems that treating spine surgeons must know how to diagnose and address. Although strategies to reduce the occurrence of infection after spine surgery have seen some success, infection rates of up to…
Introduction The evolution of spinal instrumentation from simple wiring, to segmental, rigid fixation, to motion-preservation and dynamic implants has been powered by an improved understanding of spinal disease and its impact on the biomechanics of the spine. Coincident with that…
Introduction A vascular complication may be defined as an injury to a blood vessel and the sequelae of that injury, which may be the direct or indirect result of the procedure, surgical approach, or operative technique. For the purposes of…
Anatomy and Pathophysiology The meninges cover the brain and spinal cord. They consist of dura mater, arachnoid, and pia mater. The dura has three distinct layers: a fibroelastic outer layer, a fibrous middle layer, and a cellular inner layer. Although…
Introduction Neurologic injury is one of the most dreaded complications associated with spine surgery. Depending on the location, injury can be relatively minor (nerve root) to completely debilitating (spinal cord injury). Luckily, the frequency of devastating neurologic complication is rare.…
Syringomyelia, or cavitation within the substance of the spinal cord without an ependymal lining, has been recognized for more than 300 years as a pathologic entity. Etienne is credited for the first pathologic description in 1564 in La Dissection du…
Normal Vascular Anatomy of the Spine An accurate and thorough understanding of the normal vascular anatomy of the spine and spinal cord is vital for the safe and appropriate performance of spinal angiography and endovascular intervention. Learning these skills is…