Chapter Preview Chapter Synopsis Image-guided spinal navigation is a computer-based surgical technology designed to improve intraoperative orientation to the nonvisualized anatomy during both conventional and minimally invasive spinal procedures. This chapter covers the principles of image-guided spinal navigation, current types…
Chapter Preview Chapter Synopsis The goals of individual minimally invasive surgery (MIS) approaches in the cervical spine are to minimize disruption of the normal anatomic structures, to diminish soft tissue disruption, and to prevent both short-term and long-term morbidity while…
Chapter Preview Chapter Synopsis Interspinous wiring techniques were developed as a means of stabilizing traumatic cervical injuries. Although increasingly replaced by newer technologies, such as lateral mass screws and pedicle screws, interspinous wiring remains a useful supplemental or alternative means…
Chapter Preview Chapter Synopsis Lateral mass screw–based instrumentation is a well-established technique for cervical spine fusion. Screw placement is constrained by the course of the vertebral artery, the nerve roots, and the anatomy of the facet joints. Many screw trajectories…
Chapter Preview Chapter Synopsis Cervical pedicle screws offer a biomechanical advantage over other types of posterior cervical instrumentation, but at the expense of increased risk of iatrogenic neurovascular injury. Careful preoperative planning with evaluation of three-dimensional imaging and meticulous surgical…
Chapter Preview Chapter Synopsis C2 translaminar screws are an effective method for fixation of the C2 vertebra. Compared with other techniques, this procedure is technically less demanding and has potentially fewer risks. A thorough history and examination, as well as…
Chapter Preview Chapter Synopsis Placement of the C1-C2 transarticular screw (Magerl technique) remains a viable alternative for the surgical management of a variety of atlantoaxial disorders. Although the operation is technically demanding, a careful understanding of the procedure and its…
Chapter Preview Chapter Synopsis Although many different fixation techniques have been developed to manage atlantoaxial instability, C1 lateral mass–C2 pedicle screw fixation has emerged as a preferred treatment, based on its comparative biomechanical strength and modest risk of neurologic or…
Chapter Preview Chapter Synopsis Occipitocervical fixation techniques have evolved significantly from early occipitocervical wiring techniques to the current rod-screw-occipital plate constructs. Indications for occipitocervical fixation include traumatic injuries, congenital malformations, rheumatoid arthritis, and oncologic processes involving the craniovertebral junction. Judicious…
Chapter Preview Chapter Synopsis Cervical deformity correction commonly includes kyphosis correction, regional sagittal balance restoration, and correction of the chin-brow vertical angle to restore horizontal gaze, decrease cantilever forces at the cervical thoracic junction, and decrease spinal cord tension-induced myelopathy.…