Indications “Failed back syndrome”, i.e., pain despite maximal medical and surgical therapies. Radiculopathy in the absence of compressive pathology. Neuropathic pain due to nerve root avulsion, postherpetic neuralgia, iatrogenic nerve injury, or complex regional pain syndrome. Phantom limb and stump…
Indications Some experts advocate surgical resection for intramedullary spinal cord cavernous malformation only after progressive neurologic deterioration or for pain, which is often the presentation seen in adults. Others recommend surgical treatment after hemorrhage within the spinal cord, which is…
Indications Symptomatic spinal dural arteriovenous fistula (SDAVF) should be treated. Symptoms often develop insidiously and progress over time and include weakness, sensory loss, and bowel/bladder dysfunction. High cervical fistulas can even present with basilar insufficiency–like symptoms. Dermatomal and myotomal symptoms…
Indications Spinal cord arteriovenous malformations (AVMs) causing: Positive neurologic symptoms—pain, neurogenic claudication, myelopathy, radiculopathy, and progressive motor and sensory dysfunction. Positive radiologic signs for imminent damage to the spinal cord—venous hypertension, subarachnoid or intramedullary hemorrhage, edema, and significant mass effect.…
Indications Any situation or condition requiring interbody fusion at the level of L1-L2 through L4-L5 including adult spinal deformity, degenerative disk disease, adjacent segment disease, low-grade spondylolisthesis, and even foraminal stenosis where direct neural decompression is not required. The direct…
Indications Lumbar fusion for symptomatic isthmic, degenerative, or traumatic spondylolisthesis; intractable discogenic back pain; or correction of symptomatic degenerative scoliosis. As an adjunct to direct lateral, transforaminal, posterior, or anterior interbody fusion. To supplement a posterolateral arthrodesis. As a posterior…
Indications Thoracoscopic diskectomy is employed for treatment of herniated disks in the thoracic spine anterior to the spinal cord using a minimally invasive anterior approach. Patients typically present with spinal myelopathy and cord compression. This approach can be used to…
Indications Conditions requiring ventral decompression of the spinal cord with removal of one to two vertebral bodies at any level of the thoracic spine. Extradural tumors. Infection (e.g., diskitis, osteomyelitis). Fractures or trauma. Degenerative disease or focal deformity. Patients for…
Indications Appropriate patient selection is an essential element when planning spine surgery to optimize patient outcome. The decision to pursue surgery is based on the history, physical examination, and radiographic findings. Radiographic evidence of a disk herniation in the absence…
Indications Approximately 50% of the normal rotation of the cervical spine occurs at the atlantoaxial motion segment. Factors that lead to instability at the atlantoaxial junction include traumatic injury to the axis or atlas and traumatic ligamentous injury. Other pathologic…