By Rahul Jandial MD PhD, Steven R. Garfin MD
Best proof for backbone surgical procedure presents consultant circumstances that assist you be certain the optimum surgical interventions in your sufferers. Drs. Rahul Jandial and Steven R. Garfin, and a balanced staff of preeminent neurosurgeons and orthopaedists, handle the rage towards a extra collaborative strategy among backbone and orthopaedic surgical procedure. This easy-to-read, evidence-based source additionally positive factors "Tips from the masters" for a fast overview of vital components of analysis and remedy and on-line entry at www.expertconsult.com with totally searchable textual content and downloadable images.
- Choose the easiest thoughts to your sufferers utilizing proof that helps the optimum surgical intervention for every case.
- Access the totally searchable textual content on-line at www.expertconsult.com, in addition to a downloadable photograph gallery and a video library demonstrating nuances of key techniques.
- Apply a multi-disciplinary technique via assurance that displays the altering nature of the strong point with chapters written via neurosurgeons and orthopaedists.
- Quickly evaluate crucial parts of analysis via "Tips from the masters."
- Easily locate the data you wish with a constant, case-based structure that basically provides proof and techniques.
Best proof for backbone surgical procedure is the suitable source for any health professional attracted to studying concerning the top facts on situations for which there's debate concerning the surgical administration. details offered features a thorough overview of literature, approach, and instances as provided by means of preeminent backbone surgeons. info is gifted from a balanced panel of orthopaedic and neurological surgeons, to articulate a collaborative technique that has been the common evolution within the educational surroundings. This name provides a consultant case and the proof for the optimum surgical intervention for that case, inside a layout that makes an important parts obtainable and appealing.
Read or Download Best Evidence for Spine Surgery: 20 Cardinal Cases PDF
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Additional info for Best Evidence for Spine Surgery: 20 Cardinal Cases
9-11 Some patients will continue to have severe or intolerable, progressive symptoms (pain, weakness, or numbness) after several weeks or months. Once a course of conservative care has failed, surgery becomes a good option to adequately address the abnormality and improve both pain and/or neurologic symptoms in most patients requiring surgery. 12-15 FIGURE 5-1 Mechanism of radiculopathy secondary to disk herniation. The herniated disk is compressing the exiting nerve root. Annulus Nucleus Herniation Nerve root 48 • • • BEST EVIDENCE FOR SPINE SURGERY FIGURE 5-2 T2-weighted sagittal MRI scan showing L4-5 herniated disk.
Those patients who had an available cord space of between 6 mm and 14 mm and had an increased C2-C7 range of motion were also more likely to develop myelopathy. 16 Chapter 3 — OSSIFICATION OF THE POSTERIOR LONGITUDINAL LIGAMENT • • • 35 TABLE 3-1 Nurick Grade 0 1 2 3 4 5 Grade for Cervical Myelopathy Description Signs or symptoms of root involvement but without evidence of spinal cord disease Signs of spinal cord disease, but no difficulty in walking Slight difficulty in walking that does not prevent full-time employment Difficulty in walking that prevents full-time employment or the ability to do all housework, but that is not so severe as to require someone else’s help to walk Able to walk only with someone else’s help or with the aid of a walking frame Chair bound or bedridden Adapted from Nurick S: The pathogenesis of the spinal cord disorder associated with cervical spondylosis, Brain 95(1):87–100, 1972.
Her symptoms progressed over several months despite physical therapy. • PMH: Unremarkable • PSH: Unremarkable • Exam: Neurologic examination revealed mild bilateral leg weakness to confrontation, disproportionately increased reflexes in the legs, and a mildly spastic gait. On her initial office visit/neurologic examination, the patient had noticeable progression of leg extensor weakness, had a progressive foot drop, and had developed a sensory deficit at the midthoracic level. • Imaging: magnetic resonance imaging (MRI) and computed tomography (CT) imaging showed a ventral T7-8 thoracic disk herniation with partial calcification and cord compression (Figure 4-1, A and B).