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SpinescopeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Lumbar spinal stenosis is quite common among the elderly population. There are insufficient data concerning the effectiveness of nonoperative treatments. Koc and coworkers performed a randomized single-blinded controlled trial to compare the effects of epidural steroid injections and physical therapy on pain and function in patients with lumbar spinal stenosis. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Authors: Scott D. Boden Source Type: journals

Complications of Cervical Disc ArthroplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Anterior cervical discectomy and fusion (ACDF) has long been the gold standard for the treatment of cervical pathology. ACDF, when performed successfully, has shown good disease-free survival of up to 89% at 5 years for patients. However, the potential for complications has prompted clinicians to search for alternatives to cervical discectomy and fusion. Recent efforts have focused on total disc arthroplasty and interest in its application to the cervical spine. If performed successfully, total disc arthroplasty would preclude the need for graft harvest for fusion, attempt to maintain more physiological kinematics of the c...
Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Authors: Leonard K. Kibuule, Jeffrey S. Fischgrund Source Type: journals

Long-Term Outcomes and Complications Following Anterior and Posterior Cervical Spine SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The past several decades have seen tremendous progress in the technology and techniques used in cervical spine surgery. Regardless of the technique, anatomical approach, or implants used, the long-term goals of spine surgery, including neurologic decompression and vertebral column stability, remain unchanged. Furthermore, achievement of these outcomes with minimal complications is of utmost importance. By critically evaluating the various techniques available and their respective long-term outcomes and complications, surgeons can provide their patients with more optimized surgical solutions. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Authors: Nitin N. Bhatia Source Type: journals

Complications of Occipitocervical FixationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Occipitocervical fixation (OCF) is indicated for OC instability, or atlantoaxial instability where the patient is not a candidate for atlantoaxial arthrodesis or has failed prior C1-C2 fusion. Most commonly, OC instability is caused by trauma, rheumatoid arthritis (RA), and tumors/tumor excision, and can be associated with significant vertical migration of the odontoid and cranial settling (eg, RA). In this review, we discuss complications that can occur during stabilization of the craniovertebral junction (CVJ), providing the reader some pearls on how to avoid them and how to manage them should they occur. Complications d...
Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Authors: R. Todd Allen, Robert Decker, Jae Taek Hong, Rick Sasso Source Type: journals

Cerebrospinal Fluid Leaks in Anterior and Posterior Cervical Spine SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Cerebrospinal fluid leaks are among the most commonly reported complications in spinal surgery. The prevalence of cervical dural tears is 0.5%-3%. Although the gold standard for management of cervical dural leaks is direct suture repair, most cervical dural tears can be managed by observation alone. Large dural defects or tenuous repairs may warrant the placement of a lumbar cerebrospinal fluid shunt. The diagnosis of an occult or a chronic dural leak can be made from clinical information with patients classically complaining of a spinal headache. Properly managed cervical dural tears heal without adverse effects and witho...
Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Authors: Morgan N. Chen, James D. Kang Source Type: journals

Intraoperative Complications During Surgery on the Posterior Cervical SpineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Intraoperative complications during posterior spinal surgery are best avoided by awareness of which complications are possible during each portion of the surgery. Neurologic injury, vascular injury, and mechanical instability are the major complications that occur during the posterior cervical surgery. The relevance of positioning, tissue resection, instrumentation, and wound closure to each complication is considered. Preoperative planning, understanding each patient's anatomy, optimization in surgical positioning, and use of appropriate surgical tools form the basis for avoiding these complications. Early recognition int...
Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Authors: John R. Ehteshami, Howard S. An Source Type: journals

Table of ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Source Type: journals

Forthcoming/Previous IssuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Source Type: journals

ContributorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Source Type: journals

EditorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - August 31, 2009 Category: Orthopaedics Source Type: journals

Perioperative and Approach-Related Complications Associated with Anterior Cervical SurgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article reviews the published data on complications of the anterior approach to the cervical spine, focusing on etiology, diagnosis, and management of these complications. Raising the surgeons' awareness on complications that are possible during the procedure is essential in minimizing the incidence of adverse events, and allows for early detection and appropriate management of complications when they do occur. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - July 20, 2009 Category: Orthopaedics Authors: Shu-jie Tang, Raj D. Rao Source Type: journals

IntroductionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The surgeon's desire to improve patient function is always tempered by a risk of potential adverse effects from the surgical endeavor itself. Possibly, more than any other surgical discipline, complications after cervical spine surgery can have a profound effect on patient function and outcomes. Our efforts toward preventing these complications need to be aggressive and proactive. This issue of Seminars in Spine Surgery is part of that effort. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - July 9, 2009 Category: Orthopaedics Authors: Raj D. Rao Source Type: journals

SpinescopeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Osteogenic protein 1 (OP-1) Putty is a commercially available recombinant BMP preparation that is already approved for limited use in humans. Previous clinical studies involving patients with degenerative spondylolisthesis have reported the efficacy and safety of OP-1 Putty was comparable to that of autogenous bone graft at 2-year follow-up. Vaccaro and coworkers performed a review to evaluate the intermediate term efficacy and safety of OP-1 Putty as an alternative to autogenous bone. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Scott D. Boden Source Type: journals

Stereotactic Radiosurgery for the Treatment of Tumors of the SpineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Hypofractionated stereotactic radiosurgery allows the treatment of metastatic and primary spinal tumors with highly conformal dosing while sparing the adjacent neural structures. This enables the physician to treat tumors which are recurrent after standard external beam radiation, are radioresistant in doses normally tolerated by the spinal cord or are in patients with primary tumors who are not candidates for surgical resection. Initial results have shown satisfactory achievement of treatment goals with minimal occurrence of complications. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Alan M. Levine Source Type: journals

Radiotherapy for Primary and Metastatic Spinal TumorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Primary and metastatic spinal tumors as a group represent a heterogeneous mixture of benign and malignant processes. In general, primary tumors of the spine remain relatively uncommon, and the majority of spinal tumors that are treated annually represent systemic spread of extraosseous primary malignancy. The management of spinal tumors requires meticulous yet expedient attention as the consequences of failed or inappropriate treatment can be devastating. Radiotherapy has proven beneficial in many tumors of the spine, particularly metastatic lesions, Ewing's sarcoma, and myeloid malignancies. A review of the use of radioth...
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: O. Kenneth Macdonald, Christopher M. Lee Source Type: journals

Minimally Invasive Treatment of Spinal TumorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In an effort to reduce the burden of harm that our treatments cause to our patients, there has been a trend toward the minimalization of spine surgery. We review the minimally invasive procedures used in the treatment of spinal tumors, including minimally invasive diagnostic techniques, vertebral augmentation, radiofrequency ablation, endoscopic/thoracoscopic spine surgery, and minimal access open spine surgery. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Evan Frangou, Daryl R. Fourney Source Type: journals

Aneurysmal Bone Cysts and Giant Cell Tumors of the SpineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Tumors affecting the spinal column include primary and metastatic tumors. Primary tumors of the spine comprise less than 11% of all primary musculoskeletal tumors, and only 4.2% of all spine tumors and include aneurysmal bone cysts (ABCs) and giant cell tumors (GCTs). The radiographic and histologic features of these tumors may appear similar, as both create osteolysis and cystic patterns in the vertebra, and both may contain giant cells and hemosiderin on histology. However, the biological behavior and clinical course of these tumors differ significantly and an effective approach to treatment is distinct in these conditio...
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Sigurd Berven, Shane Burch Source Type: journals

Sacrectomy and Spinopelvic ReconstructionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article presents techniques for sacral resection and subsequent spinopelvic reconstruction. Biomechanical studies are summarized on construct stability, and recommendations are made as to when reconstruction is required. The expected bowel and bladder functional outcomes are summarized, based on the level of sacral resection. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Jason C. Eck, Michael J. Yaszemski, Franklin H. Sim Source Type: journals

En Bloc Resection of Primary Spinal TumorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This report details this technique along with a discussion of the reconstruction and associated potential complications. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Jason C. Eck, Mark B. Dekutoski Source Type: journals

The Role of “Tumor-Free Margins” in the Resection of Spinal Tumors: Who Should Be Treating Spine Tumors?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
En bloc resection is a surgical procedure attempting to remove the whole tumor in a single piece, intact, encased by a continuous cuff of healthy (tumor-free) tissue. This cuff is called the “margin”: its quality and thickness defines the oncologic feature of the procedure. When en bloc resection is planned in the treatment of bone tumors of the spine, obtaining a tumor-free margin can be extremely difficult and is a much more frequent problem in the axial spine than in limb tumors. Structures, such as the spinal cord and the vital vascular anatomy in and around the spine, present challenges that make achieving tumor-f...
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Stefano Boriani, James N. Weinstein Source Type: journals

Biopsy Principles and Techniques for Spinal TumorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A major advance has been made in the diagnosis, classification and treatment of neoplasms of the spine. The biopsy represents a final step in the diagnosis of such lesions. Although technically it may be a minor procedure, it is well established that poorly conceived or executed biopsy may result in adverse outcome. In this article, we discuss issues related to preoperative work-up, optimal planning, and executing of the vertebral and paraspinous biopsy. (Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Authors: Robert Talac, Robert F. McLain Source Type: journals

Table of ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Seminars in Spine Surgery)
Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Source Type: journals

Forthcoming/Previous IssuesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Source Type: journals

ContributorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Source Type: journals

EditorsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
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Source: Seminars in Spine Surgery - June 1, 2009 Category: Orthopaedics Source Type: journals

Surgical Management of Metastatic Spine DiseaseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Metastatic disease of the spine is a common and troublesome complication in many cancer patients. Metastases may cause debilitating pain and neurologic dysfunction, significantly limiting functional ability and quality of life. With advances in chemotherapy, radiation therapy, and surgical techniques, the treatment of metastatic spine disease has facilitated improved quality of life for many patients. Surgical advances have allowed more aggressive surgical decompression, debulking, and stabilization for vertebral metastases. With an aging population and as more patients survive longer with their burden of disease, surgical...
Source: Seminars in Spine Surgery - April 27, 2009 Category: Orthopaedics Authors: Rory J. Petteys, Daniel M. Sciubba, Ziya L. Gokaslan Source Type: journals

IntroductionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Spinal tumors include a wide range of entities, all of which can have a major impact on the quality, if not the length, of an individual's life. Cancer is the second leading cause of death in the United States, and between 30% and 70% of patients who die of cancer have spinal metastases at autopsy. Up to 14% have clinically symptomatic disease, and with an aging population and improved survival, more patients will likely require treatment for spinal metastases in the future. Advances in surgical and radiotherapy techniques over the past several decades have caused a pendulum swing in the management strategy preferred at th...
Source: Seminars in Spine Surgery - April 27, 2009 Category: Orthopaedics Authors: Bradford L. Currier Source Type: journals