Summary of Key Points Randomized controlled trial evidence supports the use of surgical treatment of degenerative lumbar spondylolisthesis. There are a variety of surgical approaches for treating these patients. Lumbar fusion is associated with more complications and greater cost when…
Summary of Key Points Symptomatic thoracic disc herniation is rare and may have a wide variety of symptoms, which delays diagnosis. The relative surgical inexperience of surgeons and the complex unique anatomy of the thoracic spine has hampered the development…
Summary of Key Points Lumbar disc herniation is a common cause of back pain with sciatica. Although most cases improve with conservative management, many other cases require surgical decompression, specifically microdiscectomy. Recurrent lumbar disc herniations following microdiscectomy are not uncommon,…
Summary of Key Points Cervical disc herniation is a common cause of neck pain, radiculopathy, and cervical myelopathy. Risk factors include male gender, increasing age, white race, cigarette smoking, heavy lifting, and occupation. Disc herniations results from traumatic, overuse, or…
Summary of Key Points Axial low back pain is a common clinical problem with a significant healthcare impact. The pathophysiology and underlying etiology of axial low back pain remain poorly defined. The diagnosis of axial low back pain is largely…
Summary of Key Points The percutaneous vertebral augmentation procedures vertebroplasty and kyphoplasty are indicated for painful vertebral compression fractures refractory to conservative medical management. Vertebroplasty involves injection of the bone cement, polymethylmethacrylate (PMMA), into a fractured vertebral body, typically using…
Summary of Key Points Diseases of the sacrum and lumbosacral junction lead to clinically complex problems for surgical treatment and biomechanical stabilization. The lumbosacral pivot point, the axis of rotation at the lumbosacral junction, is marked by the intersection of…
Summary of Key Points Patient positioning is paramount for a successful procedure. Triggered directional electromyography findings should guide retractor placement anterior to the femoral nerve for the transpsoas approach. Open (expanded) retractor time should be minimized as much as possible…
Summary of Key Points Anterior lumbar interbody fusion (ALIF) provides a biomechanically sound structural intervertebral arthrodesis with a large fusion surface area. ALIF may indirectly decompress the exiting nerve roots by increasing the neural foraminal height. ALIF allows for improved…
Summary of Key Points Minimally invasive fusion options have been shown to have similar complication rates compared with their open counterparts while providing similar or improved clinical outcomes, such as decreased postoperative pain, operative times, length of hospitalization, and blood…