Summary of Key Points The intervertebral disc (IVD) is composed of the inner gelatinous nucleus pulposus (NP) and the outer annulus fibrosus (AF) and flanked by the cartilaginous end plates. The NP is composed primarily of various types of proteoglycans…
Chapter Preview Chapter Synopsis The current gold standard for treatment of disk degeneration is spinal fusion. Although effective in controlling pain, spinal fusion leads to restricted spinal motion and potentially to adjacent level degeneration. The goal of management should be…
Chapter Preview Chapter Synopsis Many techniques have been developed for the surgical management of compressive cervical myelopathy. Laminoplasty is a posterior canal expanding procedure that in selected patients allows for spinal cord decompression, avoids the loss of cervical range of…
Chapter Preview Chapter Synopsis Anterior cervical diskectomy and fusion (ACDF) comprises a common procedure used to treat cervical radiculopathy and cervical myelopathy. Excellent results can be achieved through careful patient selection and operative technique, which allows for reliable decompressiosn of…
Chapter Preview Chapter Synopsis Ankylosing spondylitis (AS) is a disease of unknown origin that is characterized by inflammation of the axial skeleton. It affects the cervical spine in many patients in the late stages of the disease. Cervical spine involvement…
Chapter Preview Chapter Synopsis Cervical disk degeneration becomes more prevalent with increasing age and can affect both male and female patients equally. Genes associated with disk degeneration include those coding for collagen I and IX, vitamin D receptor, and matrix…
Key points Lumbar spinal stenosis is a complex disease with a plethora of clinical and imaging phenotypes. Developmental lumbar spinal stenosis is caused by mal-development of pedicles and posterior elements leading to narrowed bony spinal canals, and these patients are…
Key points Modic changes are subchondral and vertebral bone marrow changes in conjunction with intervertebral disc degeneration, and they are classified into three categories (types 1, 2, and 3) based on magnetic resonance imaging appearance. Modic changes, especially Modic type…
Key points The vertebral endplate is the key regulator of disc nutrient and oxygen transport. The endplate is composed of an inner bony and an outer cartilaginous layer in relation to the vertebra. Vertebral endplates are innervated so represent an…
Key points High-intensity zones (HIZs) represent a hyperintense signal on T2-weighted MRI in the region of the annulus fibrosus and can be used to represent annular tears. HIZs have variable biomechanics, epidemiology, and risk factors and are associated with or…