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Lumbar Interbody Fusions E-Book

Lumbar Interbody Fusions E-Book
A Book

by Sunil V Manjila,Thomas Mroz,Michael P Steinmetz

  • Publisher : Elsevier Health Sciences
  • Release : 2018-09-11
  • Pages : 288
  • ISBN : 0323497411
  • Language : En, Es, Fr & De
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Authored by experienced surgeons and key innovators in the fast-moving field of LIF surgery, Lumbar Interbody Fusions provides an in-depth, focused approach to recent advances in surgical techniques and technology. Covering both minimally invasive and open procedures, this comprehensive reference provides step-by-step details for proven techniques, including extreme lateral, oblique lateral, and direct lateral approaches; intertransverse approaches; axial approaches; and endoscopic approaches. Focuses on the technical nuances, pearls and pitfalls of each procedure, as well as complication avoidance and management. Features high-quality radiographs and intraoperative images for superb visual guidance throughout. Covers topics that have as-yet unsettled surgical management, such as thoracolumbar and lumbosacral overlap diseases. Includes a concise review of evidence-based spine literature at the end of each procedural chapter. Features chapters on adjunct instrumentation such as pedicle screw and facet fixation, as well as graft selection and revision surgeries.

Lumbar Interbody Fusions E-Book

Lumbar Interbody Fusions E-Book
A Book

by Sunil V Manjila,Thomas Mroz,Michael P Steinmetz

  • Publisher : Elsevier Health Sciences
  • Release : 2018-09-11
  • Pages : 288
  • ISBN : 0323497411
  • Language : En, Es, Fr & De
GET BOOK

Authored by experienced surgeons and key innovators in the fast-moving field of LIF surgery, Lumbar Interbody Fusions provides an in-depth, focused approach to recent advances in surgical techniques and technology. Covering both minimally invasive and open procedures, this comprehensive reference provides step-by-step details for proven techniques, including extreme lateral, oblique lateral, and direct lateral approaches; intertransverse approaches; axial approaches; and endoscopic approaches. Focuses on the technical nuances, pearls and pitfalls of each procedure, as well as complication avoidance and management. Features high-quality radiographs and intraoperative images for superb visual guidance throughout. Covers topics that have as-yet unsettled surgical management, such as thoracolumbar and lumbosacral overlap diseases. Includes a concise review of evidence-based spine literature at the end of each procedural chapter. Features chapters on adjunct instrumentation such as pedicle screw and facet fixation, as well as graft selection and revision surgeries.

Comparison of Posterior Lumbar Interbody Fusion Versus Posterolateral Fusion for the Treatment of Isthmic Spondylolisthesis

Comparison of Posterior Lumbar Interbody Fusion Versus Posterolateral Fusion for the Treatment of Isthmic Spondylolisthesis
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 2017
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Abstract : Study Design: Systematic review and meta-analysis. Background: Posterolateral fusion (PLF) and posterior lumbar interbody fusion (PLIF) were widely used in the treatment of lumbar isthmic spondylolisthesis (IS). There was a great controversy over the preferred fusion method. Objective: The purpose of this study is to evaluate the clinical outcomes between PLF and PLIF for the treatment of IS. Materials and Methods: Related studies that compared the clinical effectiveness of PLIF and PLF for the treatment of IS were acquired by a comprehensive search in 4 electronic databases (PubMed, EMBASE, Cochrane Controlled Trial Register, and MEDLINE) from January 1950 through December 2014. Included studies were performed according to eligibility criteria. The main endpoints included: improvement of clinical satisfaction, complication rate, reoperation rate, fusion rate, and reoperation rate. Results: A total of 9 studies were included in the meta-analysis; 6 were low-quality evidence and 2 were high-quality evidence as indicated by the Jadad scale. Compared with PLIF, PLF patients showed lower fusion rates [ P =0.005, odds ratio (OR)=0.29 (0.14, 0.58)] and shorter operation times [ P

Lateral Lumbar Interbody Fusion

Lateral Lumbar Interbody Fusion
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 2016
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Anterior Lumbar Interbody Fusion for Degenerative Discogenic Low Back Pain

Anterior Lumbar Interbody Fusion for Degenerative Discogenic Low Back Pain
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 2015
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Abstract : Abstract: The treatment of degenerative discogenic pain is controversial, and anterior lumbar fusion for the treatment of degenerative discogenic low back pain has also been a controversial topic for over a generation. The aim of this systematic review was to evaluate the outcome of different anterior lumbar fusion levels for degenerative discogenic low back pain. In this study, we performed a clinical outcome subgroup analysis. The outcomes of 84 consecutive patients who underwent anterior lumbar interbody fusion from 2004 to 2009 were reviewed. The operative time, intraoperative blood loss, hospital stay, Oswestry Disability Index (ODI), visual analog scale (VAS) results, and complication rate were recorded separately. Medical indications were degenerative disc disease (73.8%), postdiscectomy disc disease (16.1%), and disc herniation (9.5%). Patients with severe spondylolysis or disc degeneration, with more than 3 or multilevel lesions, were excluded. The mean operative time was 124.5 ± 10.9 min (range 51–248 min), the mean intraoperative blood loss was 242.1 ± 27.7 mL (range 50–2700 mL), the mean hospital stay was 3.9 ± 1.1 days (range 3–6 days), the mean preoperative VAS score was 7.5 ± 1.4, and the mean preoperative ODI score was 60.0 ± 5.7. At the 1-year follow-up, the mean postoperative VAS score was 3.3 ± 1.3 and the mean postoperative ODI score was 13.6 ± 3.4 ( P

Techniques in Spinal Fusion and Stabilization

Techniques in Spinal Fusion and Stabilization
A Book

by Patrick W. Hitchon,Setti S. Rengachary,Vincent Charles Traynelis

  • Publisher : Thieme
  • Release : 1995
  • Pages : 352
  • ISBN : 9780865775237
  • Language : En, Es, Fr & De
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This popular book provides clear, expert descriptions of the instrumentation currently in use for spine stabilization and fusion. Experienced surgeons discuss indications, guidelines for patient selection, operating room techniques, anticipated outcomes, potential complications, and documented results. Your understanding will be deepened by nearly 600 high-quality surgical photographs and illustrations. Excellent...covers the majority of spinal stabilization procedures...the authors are very knowledgeable... recommended for those new to spinal stabilization and [for] experienced spinal surgeons. - Journal of Orthopedic Trauma

Spinal Instrumentation

Spinal Instrumentation
Surgical Techniques

by Richard G. Fessler

  • Publisher : Thieme
  • Release : 2005
  • Pages : 1330
  • ISBN : 9783131413314
  • Language : En, Es, Fr & De
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Better understanding of biomechanics, improvements in technology, and new knowledge of the disease process in the spine have led to rapid advances in spinal instrumentation.

Extreme Lateral Interbody Fusion (XLIF)

Extreme Lateral Interbody Fusion (XLIF)
A Book

by J. Allan Goodrich,Ildemaro J. Volcan

  • Publisher : Quality Medical Publishing
  • Release : 2013
  • Pages : 329
  • ISBN : 9781576263631
  • Language : En, Es, Fr & De
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Modern Thoraco-Lumbar Implants for Spinal Fusion

Modern Thoraco-Lumbar Implants for Spinal Fusion
A Book

by Roberto Delfini,Alessandro Landi,Cristina Mancarella,Fabrizio Gregori

  • Publisher : Springer
  • Release : 2017-08-07
  • Pages : 190
  • ISBN : 3319601431
  • Language : En, Es, Fr & De
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This book presents an updated perspective on spinal implants currently used in thoraco-lumbar spine surgery, leading to a rigid or dynamic spine fusion. The development of new surgical devices and techniques is mostly focused on a spinal fusion for lumbar instability due to trauma, tumours or degenerative or infectious diseases. Pedicle-screw fixation and fusion are currently considered to be the gold standard for most of the above-mentioned pathologies, and modern implants are designed to improve the accuracy of pedicle-screw placement and to allow the use of new surgical techniques and minimally invasive approaches. The content is relevant for surgeons, orthopaedic specialists, neurosurgeons, physiotherapists and osteopaths.

Unilateral Minimally Invasive Posterior Lumbar Interbody Fusion (Unilateral Micro-PLIF) for Degenerative Spondylolisthesis: Surgical Technique

Unilateral Minimally Invasive Posterior Lumbar Interbody Fusion (Unilateral Micro-PLIF) for Degenerative Spondylolisthesis: Surgical Technique
A Book

by Shigeru Kobayashi

  • Publisher : Unknown Publisher
  • Release : 2012
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Unilateral Minimally Invasive Posterior Lumbar Interbody Fusion (Unilateral Micro-PLIF) for Degenerative Spondylolisthesis: Surgical Technique.

Standard Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Randomized Study

Standard Versus Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Prospective Randomized Study
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 2017
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Abstract : Introduction: Symptomatic spondylolisthesis patients may benefit from surgical decompression and stabilization. The standard (S) technique is a transforaminal lumbar interbody fusion (TLIF). Newer, minimally invasive (MI) techniques seem to provide similar results with less morbidity. However, prospective studies comparing S versus MI TLIF are rare. Case description: Patients with at least 6 months of symptoms and image-confirmed low-grade spondylolisthesis (grade 1 or 2) were enrolled, at a single academic institution, between 2011 and 2015. The patients were randomized to either S or MI TLIF. Iliac crest graft, polyether ether ketone (PEEK) interbody cages, and pedicle screw-rod constructs were used in both groups. The primary outcome measure was the Oswestry Disability Index (ODI) improvement at 1 year. Secondary outcome measures included length of operation, estimated blood loss, length of hospitalization, and fusion rates at 1 year. Complications were also recorded. Results and Conclusions: Forty patients were enrolled in each group. There was no crossover between groups. The age was 50.12+/-11.09 years in the S TLIF group and 51.3+/-9.36 years in the MI TLIF group. There were 23 and 24 females in the S and MI TLIF group, respectively. The mean operative time and estimated blood loss in the S versus MI TLIF group were 297+/-101 versus 323 +/-85 minutes and 417+/-211 versus 351+/-198 ml, respectively. There were 4 transfusions in the S TLIF and 3 transfusions in the MI TLIF group. The patients were discharged after surgery at 4.12+/-0.88 days for the S TLIF group and 1.92+/-0.52 days for the MI TLIF group. The ODI improved from 37+/-6 to 11+/-6 in the S TLIF group (ODI difference: 26+/-7) and from 38+/-7 to 11+/-6 in the MI TLIF group (ODI difference: 26+/-8). The fusion was considered solid (Grade I) in 36 (90%) and partial (Grade II) in 4 (10%) patients at 1 year. There were no reoperations for pseudarthrosis or any other postoperative complication. There were 2 superficial wound infections in the standard TLIF group, which resolved with oral antibiotic treatment alone. Take home message: In this prospective randomized study, the standard and minimally invasive TLIF in patients with symptomatic spondylolisthesis provided similar clinical and radiological outcomes at 1 year. The patients undergoing MI TLIF had a shorter hospital stay. Both surgical techniques yielded good results at 1 year.

Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Banana-Shaped and Straight Cages

Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Banana-Shaped and Straight Cages
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 2018
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Stability Imparted by a Posterior Lumbar Interbody Fusion Cage Following Surgery

Stability Imparted by a Posterior Lumbar Interbody Fusion Cage Following Surgery
A Biomechanical Evaluation

by Vadapalli Sasidhar

  • Publisher : Unknown Publisher
  • Release : 2004
  • Pages : 264
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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In order to promote solid fusion across a decompressed spinal segment, inter-body spacers/cages are used with and without posterior instrumentation to provide an initial "rigid" fixation of the segment. Inter-body spacers (cages) of various shapes (e.g., rectangular, cylindrical) and materials are currently available on the market. Important factors affecting the biomechanics of the fused segment are (i) cage shape and placement, (ii) cage material property (iii) surgical approach used-posterior vs. antero lateral (iv) cage with additional instrumentation. The objective of this study is to address change in the stability and stress patterns associated with the various factors described above. A cadaveric study using established protocols and a finite element (FE) study were conducted. For the cadaveric study, nine fresh ligamentous lumbar spine specimens (L1-S2) were radiographed out of which six specimens were prepared for testing by fixing a base to the sacrum and a loading frame to the top-most vertebra. Each specimen was subjected to pure moment (6 Nm in steps of 1.5 Nm) in six loading modes: flexion, extension, right and left lateral bending, and right and left axial rotation. The load-displacement data was collected in a sequential manner for the following cases: 1) intact spine, 2) insertion of rectangular cages (Vertebral spacer PR, Synthes, Inc.), 3) fixation with posterior instrumentation, 4) fatiguing the instrumented spine. The relative motion of L4 with respect to L5 was calculated for all these cases. A validated three-dimensional, nonlinear FE model of lumbar spine from L3-L5 was used. The model was modified to simulate the bilateral placement of cages alone. Contact surfaces were defined between the cages and the endplates to simulate the bone-implant interface. The cages were placed using posterior approach and left antero lateral approach to see the effect of the surgical approach on the stability of the segment. In the FE model with cage placed using posterior approach, posterior instrumentation was added. For this model the material property of the cage was changed form PEEK to titanium to study the change in load sharing and stresses on the endplates. For all the models a 6Nm moment was applied and all the six loading cases were simulated. The relative motion of L4 with respect to L5 was calculated, stresses in the implants and endplates were studied. Results from the in vitro study indicate that the stability of the spine decreased after the stand alone placement of bilateral cage when compared to the intact for all the loading cases except in flexion. However, no statistically significant difference was seen in the stability between intact and stand alone cage placement. After stabilization with posterior fixation using the pedicle screw rod system, the stability increased in all loading cases. There was no significant change in stability after fatiguing. The FE model predictions for the bilateral cage alone and with additional instrumentation placed at L4-L5 disc space were within 1 SD of the cadaveric data in all loading modes. There was no change in stability offered by stand alone cage placement using antero lateral approach and posterior approach. For the cage made of titanium peak Von mises stress in the endplates were twice of that for cage made of PEEK. Cages placed laterally from the mid-sagittal plane provide better stability in bending when compared to medially placed cages.

Comparing Minimally Invasive Transforaminal Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion for Spondylolisthesis

Comparing Minimally Invasive Transforaminal Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion for Spondylolisthesis
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 2017
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Abstract : Abstract: Although spondylolisthesis was traditionally treated with posterior lumbar interbody fusion (PLIF), minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) was recently proposed as an alternative treatment for spondylolisthesis. However, no studies have focused on the comparison of these 2 techniques' outcome on spondylolisthesis. The operative reports and perioperative data of patients who underwent single-level primary open PLIF (n = 29) and MIS-TLIF (n = 26) for I/II spondylolisthesis were retrospectively evaluated. Patients' demographics, operative blood loss, hospital length of stay, creatine kinase (CK) level, radiographic fusion, complications, and patient-reported outcomes were evaluated. Radiographic fusion was assessed using the Bridwell grading criteria. Preoperative and postoperative patient-reported outcomes included the visual analog scale (VAS) and Oswestry Disability Index (ODI). Average follow-up was 28 ± 3.6 months (range 24–32 months). Bed rest time, hospital stay, estimated blood loss, and operative time in the MIS-TLIF group were significantly lower than those in the PLIF group ( P .05). The 3-month postoperative ODI and VAS in the MIS-TLIF group were significantly better than the PLIF group ( P

Biomechanical Comparison of Anterior Lumbar Interbody Fusion Devices

Biomechanical Comparison of Anterior Lumbar Interbody Fusion Devices
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 1997
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Minimally Invasive Spine Surgery Techniques

Minimally Invasive Spine Surgery Techniques
A Book

by Gabriel Tender

  • Publisher : Springer
  • Release : 2018-03-07
  • Pages : 235
  • ISBN : 3319719432
  • Language : En, Es, Fr & De
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This book includes operative videos and teaches the reader how to perform all currently available minimally invasive spine surgery (MISS) techniques. Each chapter covers a MISS procedure and includes an introduction, indications and contraindications, surgical technique, pitfalls and pearls, discussion, conclusion, references, videos and figures. Minimally Invasive Spine Surgery Techniques is aimed at spine surgeons who are interested in learning or improving their MISS skills.

Benzel's Spine Surgery E-Book

Benzel's Spine Surgery E-Book
Techniques, Complication Avoidance, and Management

by Michael P Steinmetz,Edward C. Benzel

  • Publisher : Elsevier Health Sciences
  • Release : 2016-06-29
  • Pages : 2240
  • ISBN : 0323415210
  • Language : En, Es, Fr & De
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In the latest edition of Benzel’s Spine Surgery, renowned neurosurgery authority Dr. Edward C. Benzel, along with new editor Dr. Michael P. Steinmetz, deliver the most up-to-date information available on every aspect of spine surgery. Improved visuals and over 100 brand-new illustrations enhance your understanding of the text, while 26 new chapters cover today's hot topics in the field. A must-have resource for every neurosurgeon and orthopedic spine surgeon, Benzel's Spine Surgery provides the expert, step-by-step guidance required for successful surgical outcomes. Glean essential, up-to-date information in one comprehensive reference that explores the full spectrum of techniques used in spine surgery. Covers today's hot topics in spine surgery, such as pelvic parameters in planning for lumbar fusion; minimally invasive strategies for the treatment of tumors and trauma of the spine; and biologics and stem cells. A total of 18 intraoperative videos allow you to hone your skills and techniques. New editor Michael P. Steinmetz brings fresh insights and improvements to the text. Features the addition of 26 chapters, including: -Biologics in Spine Fusion Surgery -Endoscopic and Transnasal Approaches to the Craniocervical Junction -Cellular Injection Techniques for Discogenic Pain -Minimally Invasive Techniques for Thoracolumbar Deformity -Spinal Cord Herniation and Spontaneous Cerebrospinal Fluid Leak -MIS Versus Open Spine Surgery Extensive revisions to many of the existing chapters present all of the most up-to-date information available on every aspect of spine surgery. Improved visuals and over 100 brand-new illustrations enhance learning and retention.

Biomechanical Evaluation of Lumbar Interbody Fusion Surgeries with Varying Interbody Device Shapes, Material Properties, and Supplemental Fixation

Biomechanical Evaluation of Lumbar Interbody Fusion Surgeries with Varying Interbody Device Shapes, Material Properties, and Supplemental Fixation
A Book

by Sushil P. Sudershan

  • Publisher : Unknown Publisher
  • Release : 2017
  • Pages : 130
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Low back pain (LBP) is one of the most commonly reported problems in the United States. The most common causes of LBP are injury or overuse, pressure on neural tissue from different pathologies (disc herniation, stenosis, degenerative disc disease, etc.). Interbody fusion is a well-established treatment option for patients with LBP. For each patient, the pathology and the surgeon's preference determine the surgical approach. The implants are usually manufactured from either PEEK or Titanium in a variety of shapes and sizes. Usually, the spacers are supplemented with supplemental fixation for motion restriction. However, the initial surgery studies showed success for standalone scenarios without any major complications. Ideally, a standalone surgery that provided stability while fusion occurred, could help decrease operation time and cost. To this date, a large scale study that compared various surgical approaches, implant footprints and materials, and addition of supplemental fixation has not been conducted. To conduct this parametric study, the experiment was separated into an in-vitro and in-silico study. The in-vitro study will allow us to record ROM data that can be used in conjunction with the in-silico model to determine parameters such as stress, strain, and load on the endplate. The in-vitro study showed that a standalone PLIF surgical approach may be a viable option but the TLIF standalone case does not successfully restrict the motion to less than intact or stabilize the motion segment with peek cages. However, for both surgical approaches the pedicle screw fixation successfully restricted motion or stabilized the motion segment. The in-silico study showed that the ALIF and LLIF surgical approaches may be viable options for standalone scenarios but require further investigation. Similar, to the in-vitro study, pedicle screw greatly restricted the motion segment for all surgical approaches regardless of implant size or material property. The study showed that an increase in implant footprint resulted in higher overall motion restriction for all surgical approaches. The various simulated supplemental fixation stabilized the motion for all loading conditions. For the anterior and lateral approaches, lumbar plates provide an additional means of stabilization instead of pedicle screw fixation. The study also observed that a larger implant footprint also shifted the endplate stresses to the periphery, which is composed of stronger bone. Overall, PEEK cages produced lower endplate stresses than titanium cages which may help reduce subsidence incidence. Supplemental fixation always reduced the endplate stresses compared to standalone scenarios except for some cases in the TLIF surgery. The TLIF surgery also showed higher endplate shear load when compared with other surgeries.

Contralateral Radiculopathy After Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Degenerative Diseases

Contralateral Radiculopathy After Transforaminal Lumbar Interbody Fusion in the Treatment of Lumbar Degenerative Diseases
A Book

by Anonim

  • Publisher : Unknown Publisher
  • Release : 2018
  • Pages : 329
  • ISBN : 9876543210XXX
  • Language : En, Es, Fr & De
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Abstract: Rationale: Transforaminal lumbar interbody fusion (TLIF) is an effective treatment for patients with degenerative lumbar disc disorder. Contralateral radiculopathy, as a complication of TLIF, has been recognized in this institution, but is rarely reported in the literature. Patient concerns: In this article, we report 2 cases of contralateral radiculopathy after TLIF in our institution and its associated complications. Diagnoses: In the 2 cases, the postoperative computed tomography (CT) and magnetic resonance image (MRI) showed obvious upward movement of the superior articular process, leading to contralateral foraminal stenosis. Interventions: Revision surgery was done at once to partially resect the opposite superior facet and to relieve nerve root compression. Outcomes: After revision surgery, the contralateral radiculopathy disappeared. Lessons: Contralateral radiculopathy is an avoidable potential complication. It is very important to create careful preoperative plans and to conscientiously plan the use of intraoperative techniques. In case of postoperative contralateral leg pain, the patients should be examined by CT and MRI. If CT and MRI show that the superior articular process significantly migrated upwards, which leads to contralateral foraminal stenosis, revision surgery should be done at once to partially resect the contralateral superior facet so as to relieve nerve root compression and avoid possible long-term impairment.

Lateral Access Minimally Invasive Spine Surgery

Lateral Access Minimally Invasive Spine Surgery
A Book

by Michael Y. Wang,Andrew A. Sama,Juan S. Uribe

  • Publisher : Springer
  • Release : 2016-11-26
  • Pages : 362
  • ISBN : 3319283200
  • Language : En, Es, Fr & De
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This well-illustrated textbook is the first comprehensive and authoritative source of information on minimally invasive lateral access spine surgery. It covers all aspects of the subject, including patient selection, approach and monitoring techniques, soft tissue management, application in a variety of pathologies, technical nuances, and the prevention and management of complications. In addition, current controversies in the field are discussed and the biomechanics of lateral spinal reconstruction, the physiologic benefits, and cost implications are explained. As use of the lateral approach in spinal surgery has become more popular, so its diversity and complexity have increased. Nevertheless, publications devoted entirely to the technique are lacking, and Lateral Access Minimally Invasive Spine Surgery is designed to fill this vacuum. Written by the world’s experts on the topic, it will be an excellent resource for both beginning and experienced surgeons.