The upper limb functions as a series of articulated segments, which act in a coordinated manner to allow the hand to manipulate and sense its surrounding environment. The degree of coordination of these movements is such that the hand can…
Core Procedures Epidural injections: commonplace in obstetrical anaesthesia, as well as in the treatment of radiculitis throughout the spine Epidural catheterization: permits continuous administration of an anaesthetic agent Lumbar puncture: single injection of local anaesthetic into the subarachnoid space via…
Core Procedures Posterior Approach Microdiscectomy Foraminotomy Laminectomy Posterolateral fusion (PLF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF) Vertebroplasty, kyphoplasty Lumbar osteotomies Lateral Approach Lateral lumbar interbody fusion (LLIF) Oblique lumbar interbody fusion (OLIF) Anterior Approach Anterior lumbar…
Core Procedures Direct posterior exposure Costotransversectomy Transpedicular approach to the thoracic disc space Anterior open transthoracic exposure Endoscopic approach to the thoracic spine Lateral extracavitary approach Trans-sternal approach to the cervicothoracic junction Surgical surface anatomy There are limited reliable surface…
Core Procedures Anterior and posterior approaches to the occipitocervical region Anterior and posterior approaches to the subaxial cervical spine Main indications for cervical spine surgery include excision of herniated discs with either a subsequent fusion or disc replacement, excision of…
Core Procedures Anterior and posterior cervical foraminotomy Lumbar microdiscectomy Lumbar laminotomy and foraminotomy Endoscopic foraminotomy and discectomy Transforaminal lumbar interbody fusion (TLIF) A number of surgical procedures are performed in and around the foramina of the spine, commonly in the…
The patterned anatomy of the spine is not without its drawbacks. While the study of any individual level can enlighten the surgeon about several adjacent, or even all, levels, a blind reliance on repetition and consistency can be disorienting, leading…
Core Procedures Myelotomy for intramedullary tumour Dorsal root entry zone lesioning for pain Selective dorsal rhizotomy for spasticity Cordotomy for pain Syringoperitoneal/syringopleural shunting The spinal cord lies within the upper two-thirds of the vertebral canal (spinal canal), which is formed…
Core Procedures Brainstem Midline suboccipital craniotomy to the cerebellum and fourth ventricle Retrosigmoid craniotomy to the lateral cerebellum and cerebellopontine angle Far lateral approach to the ventral brainstem Cranio-orbitozygomatic approach to the upper brainstem Pineal Gland Supracerebellar infratentorial approach Occipital…
Core Procedures Stereotactic deep-brain stimulation electrode implantation (subthalamic nucleus, globus pallidus pars interna, Vim), radiofrequency lesioning (e.g. pallidotomy), biopsy or radiosurgery Management of any lesion (e.g. tumour, arteriovenous malformation, haematoma) partly or wholly involving the basal ganglia or thalamus Surface…