Spine Surgery Basics
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Spine surgery has increasingly become a surgical field of its own, with a distinct body of knowledge. This easy-to-use book, written by acknowledged experts, is designed to meet the practical needs of the novice and the busy resident by providing essential information on spine pathology, diagnostic evaluation, surgical procedures, and other treatments. After an opening general section, degenerative spinal disease, pediatric spine conditions, spine trauma, spine tumors, infections, inflammatory disorders, and metabolic conditions are all discussed in more depth. Alongside description and evaluation of surgical options, important background information is included on pathology, presentation, diagnosis, and nonsurgical treatments. Potential complications of surgery are also carefully considered. Spine Surgery Basics will be an invaluable aid for all who are embarking on a career in spinal surgery or require a ready reference that can be consulted during everyday practice.
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completes their preparation of the patient, possibly including arterial line placement. The surgical team determines the necessity of catheterization of the bladder and neurologic monitoring as indicated depending on magnitude of case. Cord level cases typically require spinal cord monitoring. After intubation, the patient is rolled into the prone position on the operative table. The arms are typically placed overhead and abducted 90° at the shoulder and 95 elbow. Bony prominences are padded,
and utilized for grafting purposes. In order to be classified as a ceramic bone graft material, the material must meet the following qualities: tissue and mechanical compatibility, stability in body fluids, ability to withstand sterilization, and capability to be molded into functional shapes. On a molecular level, they can be composed of hydroxyapatite, tricalcium phosphate, bovine collagen, natural coral, calcium carbonate, or a combination of these . Compared to allograft, ceramics do not
stimulation can activate the motor pathway at the anterior horn cell through reflex pathways. Despite the uncertainty of the exact tract monitored, NMEP responses appeared useful for monitoring, and it has been advocated as a safe and effective method to perform monitoring in children and young adults with idiopathic or neuromuscular scoliosis [2, 101, 115]. However, studies indicate it is not a specific monitor of the motor tract and it has been replaced by the transcranial stimulation technique
decrease the quality of the motor response and the ability to monitor. Adults often have preexisting conditions such as diabetes, spinal cord or nerve root injury, chronic hypoperfusion, and axonal conduction changes that reduce response amplitude. Very young children, particularly those under 6 years, have an immature central nervous system, which makes obtaining a motor response challenging [73, 111]. When scoliosis procedures are performed on children and young adults with substantial