Introduction Cervical spondylotic myelopathy (CSM) is caused by a reduction of the sagittal diameter of the cervical spinal canal as a result of congenital and/or degenerative changes in the cervical spine. It is the most common type of spinal cord…
Background Revision lumbar spine surgery is predominantly associated with several distinct pathological processes resulting from an initial index surgery. For example, in the treatment of disc herniations, residual stenosis and recurrent disc herniations are well described in the literature. There…
Clinical Pearls A detailed history and neurologic exam can be used to isolate the level at which the underlying pathology originated. Understanding the presenting symptoms can help one to appreciate the significance of the extent of degeneration present and therefore…
Clinical Pearls Degeneration in the spine is a naturally occurring process that can be understood through the “three-joint complex,” which is composed of the intervertebral disk and the two dorsal articulating joints. Degeneration of any one joint leads to degeneration…
Summary of Key Points All patients with injuries to the spinal column will require appropriate nonoperative management during their care. The majority of spine fractures can be managed nonoperatively with excellent long-term results. Those that require surgical treatment must be…
Summary of Key Points Minimally invasive spine surgery has gained popularity. It may be used for decompression and stabilization of all segments of the spine and spinal cord. The evolution of minimally invasive spine techniques includes more historical surgical approaches,…
Summary of Key Points Syringomyelia is the formation of a fluid cavity within the spinal cord thought to result from a pathophysiological disruption of cerebrospinal fluid flow. Arachnoiditis is the scaring of the arachnoid and pia resulting from multiple etiologies,…
Summary of Key Points Although most surgeons understand the importance of sterile technique in preventing surgical site infections, other steps can be taken before, during, and after the procedure to reduce the risk. Thorough preoperative evaluation, including nasal Staphylococcus aureus…
Summary of Key Points Surgical positions, incisions, and retractors are reviewed for cervical, thoracic, lumbar, and sacral operations. Technical details of various surgical approaches are outlined. The anatomy of ventral, dorsal, and combined approaches and how to avoid complications are…
Summary of Key Points Motion-preserving surgery has been developed in an attempt to reduce the likelihood of intervertebral disc degeneration at segments adjacent to a fusion. The functional spinal unit (FSU) is defined as the smallest motion segment of the…