Atlas of Spine Trauma: Adult and Pediatric

Description

Master the latest techniques in spine trauma surgery and achieve optimal outcomes! Over 600 outstanding step-by-step photographs and drawings, show you exactly how to perform today's most effective procedures for both adult and pediatric spine trauma patients. And, advanced insights from renowned neurologists and orthopaedists provide the expert know-how you need to avoid complications and overcome difficult clinical obstacles.Over 650 step-by-step, full-color surgical photos and line drawings demonstrate precisely how to proceed.A consistent, logical presentation allows for fast and easy reference - ideal both when initially learning procedures, and for a quick brush-up before heading into the OR.Detailed coverage of spine trauma Cover Frontmatter Copyright Dedication Acknowledgments Preface Contributors Epidemiology of Spinal Cord Injury INTRODUCTION PREVALENCE INCIDENCE AGE AT INJURY ETIOLOGY GENDER ETHNICITY ASSOCIATED INJURIES NEUROLOGIC LEVEL AND EXTENT OF INJURY TIME OF INJURY DISCHARGE PLACEMENT MARITAL STATUS LEVEL OF EDUCATION LIFE EXPECTANCY OCCUPATIONAL STATUS COMPLICATIONS OPERATIVE PROCEDURES COST OF SCI CAUSE OF DEATH CONCLUSION Anatomy and Pathophysiology of Spinal Cord Injury INTRODUCTION ANATOMY PATHOPHYSIOLOGY OF SPINAL CORD INJURY CONCLUSION Evaluation and Early Management of Spinal Injury in a Polytrauma Patient CLINICAL MANAGEMENT INTRODUCTION PRIMARY SURVEY SECONDARY SURVEY RADIOLOGIC ASSESSMENT MANAGEMENT OF THE POLYTRAUMA PATIENT CONCLUSION Physical Examination in Spinal Trauma: American Spinal Injury Association Examination and Spinal Cord Injury Syndromes INTRODUCTION ASSIGNING AN ASIA LEVEL EXAMINATIONS LEVELS OF INJURY COMPLETE VERSUS INCOMPLETE INJURY ZONES OF PARTIAL PRESERVATION ASIA IMPAIRMENT SCALE SPINAL CORD INJURY SYNDROMES TETRAPLEGIA AND PARAPLEGIA SPINAL CORD INJURY IN CHILDREN CONSISTENCY OF EXAMINATION AND CLASSIFICATION Radiographic Imaging of the Traumatically Injured Spine: Plain Radiographs, Computed Tomography, Magnetic Resonance Imaging, Ang INTRODUCTION PLAIN RADIOGRAPHS CT SCANNING MAGNETIC RESONANCE IMAGING ANGIOGRAPHY CLEARING THE SPINE Timing of Surgery After Spinal Cord Injury INTRODUCTION CASE STUDY EXPERIMENTAL STUDIES OF EARLY DECOMPRESSION ROLE OF NONSURGICAL MANAGEMENT ALONE IN SPINAL CORD INJURY CLINICAL STUDIES OF EARLY DECOMPRESSION FOR SPINAL CORD INJURY CONCLUSION The Role of Pharmacologic Treatment of Patients with Acute Spinal Cord Injuries INTRODUCTION RESUSCITATION THROMBOEMBOLISM SECONDARY INJURY CONCLUSION Intraoperative Neurophysiologic Monitoring of the Patient with Trauma INTRODUCTION TYPES OF MONITORING PRACTICAL APPLICATION CONCLUSION ACKNOWLEDGMENT Mechanisms of Injury in the Cervical Spine: Concepts, Pathomechanics, Classifi cations, Instability, and Clinical Applications INTRODUCTION CONCEPTS PATHOMECHANICS CLASSIFICATIONS OF INJURIES INSTABILITY CLINICAL APPLICATIONS Nonoperative Treatment of Cervical Fractures: Cervical Orthoses and Cranioskeletal Traction in Patients with Cervical Spine Frac IN-THE-FIELD IMMOBILIZATION INTRODUCTION CERVICAL BIOMECHANICS CHOOSING AN ORTHOTIC DEVICE CERVICAL ORTHOSES CERVICOTHORACIC ORTHOSES EFFECTIVE USE OF ORTHOSES DISCONTINUING ORTHOSES THE HALO CRANIOSKELETAL TRACTION ACKNOWLEDGMENTS PEDIATRIC CERVICAL SPINE CONCLUSION Cervical Whiplash Injuries INTRODUCTION BIOMECHANICS MUSCLE STRAIN FACET INJURY CERVICAL DISK WHIPLASH IN CHILDREN TREATMENT SUMMARY Cervical Spine Injuries in Athletes CLASSIFICATION OF INJURY TYPES EPIDEMIOLOGY RETURN-TO-PLAY CRITERIA Surgical Approaches for the Operative Management of Cervical Spine Fractures INTRODUCTION AND BACKGROUND ANTERIOR SURGICAL APPROACH TO THE CERVICAL SPINE C3 TO C7 POSTERIOR SURGICAL APPROACH TO THE CERVICAL SPINE C3 TO C7 C7 TO T1 Operative Techniques: Anterior Cervical Decompression, Fusion, and Instrumentation INTRODUCTION INDICATIONS OF ANTERIOR CERVICAL APPROACH EVALUATION OF THE PATIENT SURGICAL ANATOMY OPERATIVE TECHNIQUES REDUCTION OF SUBLUXATION THROUGH AN ANTERIOR APPROACH GRAFTING AND INSTRUMENTATION AFTER DISKECTOMY CERVICAL CORPECTOMY CERVICAL INSTRUMENTATION COMPLICATIONS RESULTS CONCLUSION Operative Techniques: Posterior Cervical Decompression, Fusion, and Instrumentation INTRODUCTION OPERATIVE CONSIDERATIONS PREOPERATIVE ASSESSMENT POSTERIOR DECOMPRESSION POSTERIOR INSTRUMENTATION CONCLUSION Pediatric Craniocervical Trauma INTRODUCTION DEVELOPMENTAL ANATOMY AND BIOMECHANICS IMAGING TECHNIQUES CAUSES OF CRANIOVERTEBRAL INJURY CLINICAL PRESENTATION OF NEUROLOGIC DEFICITS SPECIFIC INJURIES OF THE CRANIOVERTEBRAL JUNCTION: CLINICAL PRESENTATION AND MANAGEMENT OPERATIVE AND NONOPERATIVE MANAGEMENT OF TRAUMA COMPLICATIONS AND AVOIDANCE CONCLUSION PROGNOSIS Atlas Fractures INTRODUCTION ANATOMY MECHANISM OF INJURY CLASSIFICATION CLINICAL PRESENTATION DIAGNOSTIC STUDIES TREATMENT CONCLUSION Transverse Atlantal Ligament Injuries PRESENTATION AND CLINICAL FEATURES INTRODUCTION DIAGNOSTIC WORKUP SURGICAL ANATOMY OF THE LIGAMENTOUS COMPLEX BIOMECHANICS OF TAL INJURY INJURY CLASSIFICATION AND TREATMENT OPTIONS CONCLUSION Atlantoaxial Rotatory Deformities INTRODUCTION ANATOMY PATHOGENESIS DIFFERENTIAL DIAGNOSIS DIAGNOSIS TREATMENT Odontoid Fractures in Pediatric and Adult Patients ODONTOID INJURIES IN CHILDREN ADULT ODONTOID INJURIES CONCLUSION ACKNOWLEDGMENTS Traumatic Spondylolisthesis of the Axis/Axis Fractures HANGMAN’S FRACTURE: HISTORICAL BACKGROUND ANATOMY EPIDEMIOLOGY AND CLINICAL PRESENTATION MECHANISM OF INJURY CLASSIFICATION CLINICAL MANAGEMENT NONODONTOID, NONHANGMAN’S FRACTURES CONCLUSION PEDIATRIC HANGMAN’S FRACTURES Distractive Flexion Cervical Spine Injuries: Unilateral/ Bilateral Facet Dislocation INTRODUCTION ANATOMICAL CONSIDERATIONS OF PEDIATRIC VERSUS ADULT CERVICAL SPINE INJURY MECHANISMS OF CERVICAL FACET DISLOCATIONS TYPES OF FLEXION-DISTRACTION INJURIES DIAGNOSTIC IMAGING CLINICAL PRESENTATION CLINICAL MANAGEMENT CONCLUSION SURGICAL OUTCOME STUDIES Cervical Burst Fractures: Compression Flexion/ Compression Extension Injuries INTRODUCTION CLINICAL MANAGEMENT OPERATIVE PROCEDURE AND TECHNIQUE CONCLUSION Distraction-Extension Injuries of the Cervical Spine INTRODUCTION POSTERIOR LAMINAR FRACTURES VERTEBRAL BODY FRACTURES AND ANTERIOR LONGITUDINAL LIGAMENT DISRUPTION TRAUMATIC SPONDYLOLISTHESIS C2 (HANGMAN’S FRACTURE) CONCLUSION Lateral Mass Fractures of the Cervical Spine: Diagnosis and Surgical Management INTRODUCTION EPIDEMIOLOGY CLASSIFICATION OF LATERAL MASS FRACTURES NEUROLOGIC INVOLVEMENT CLINICAL PRESENTATION MECHANISM OF INJURY DIAGNOSTIC WORKUP CLINICAL MANAGEMENT OPERATIVE PROCEDURE AND TECHNIQUE SURGICAL OUTCOMES CONCLUSION Surgical Complications Related to the Management of Traumatic Spinal Injuries of the Cervical Spine GENERAL COMPLICATIONS INTRODUCTION SURGERY-SPECIFIC COMPLICATIONS CONCLUSION Mechanisms of Injury in the Thoracic/ Lumbar Spine: Concepts, Pathomechanics, Classifi cation, Instability, and Clinical Applica INTRODUCTION CLASSIFICATIONS OF SPINAL FRACTURES TRANSLATIONAL DISPLACEMENT CLINICAL ASSESSMENT OF TRAUMA PATIENTS CLINICAL ASSESSMENT OF THE SPINE IN A PATIENT WITH A SPINAL FRACTURE ROLE OF SURGERY AND SPINAL STABILIZATION IN IMPROVING SPINAL COLUMN FUNCTION—AVOIDING “POST-TRAUMATIC KYPHOSIS” AND DELAYED SPIN TREATMENT SELECTION FOR SPINAL INJURIES ROLE OF SURGERY IN IMPROVING SPINAL CORD FUNCTION FOLLOWING A SPINAL CORD INJURY OPTIMAL CURRENT MANAGEMENT OF SPINAL FRACTURES AND FRACTURE DISLOCATIONS, WITH OR WITHOUT SPINAL CORD INJURY APPROACH FOR OPEN REDUCTION, SPINAL INSTRUMENTATION AND FUSION Bracing for Thoracolumbar Trauma INTRODUCTION BIOMECHANICS OF SPINAL TRAUMA AND NATURAL HISTORY OF HEALING SURVEY OF BRACES CLINICAL EVALUATION ALGORITHMS AND DECISION MAKING RADIOGRAPHIC EVALUATION TECHNICAL ASPECTS OF BRACE MANAGEMENT OF SPINAL TRAUMA OUTCOMES DRAWBACKS AND COMPLICATIONS OF BRACING CONCLUSION AND FUTURE DIRECTIONS Surgical Approaches for the Operative Management of Thoracolumbar Spine Fractures SURGICAL APPROACHES RADIOLOGIC IMAGING POSTERIOR APPROACHES POSTEROLATERAL APPROACHES ANTERIOR APPROACHES ANTEROLATERAL APPROACHES TO THE THORACOLUMBAR SPINE SIMULTANEOUS ANTERIORPOSTERIOR APPROACH Operative Techniques: Anterior Thoracolumbar Decompression, Fusion, and Instrumentation RATIONALE FOR ANTERIOR SURGICAL INTERVENTION INTRODUCTION TIMING OF DECOMPRESSION AND STABILIZATION CONTRAINDICATIONS FOR ANTERIOR TREATMENT PREOPERATIVE PLANNING OPEN ANTERIOR THORACOLUMBAR DECOMPRESSION ENDOSCOPIC ANTERIOR THORACOLUMBAR DECOMPRESSION ANTERIOR THORACOLUMBAR RECONSTRUCTION ANTERIOR THORACOLUMBAR INSTRUMENTATION POSTOPERATIVE CARE PITFALLS AND SALVAGE OPTIONS CONCLUSION RESULTS OF ANTERIOR TECHNIQUES Operative Techniques: Posterior Thoracolumbar Decompression, Fusion, and Instrumentation INTRODUCTION INJURY TYPES EPIDEMIOLOGY CLINICAL PRESENTATION CLINICAL MANAGEMENT DIAGNOSTIC METHODS OPERATIVE PROCEDURE AND TECHNIQUE OPERATIVE TECHNIQUE: POSTERIOR STABILIZATION AND FUSION OPERATIVE TECHNIQUE: LAMINECTOMY AND REPAIR OF TRAUMATIC DURAL TEARS OPERATIVE TECHNIQUE: POSTEROLATERAL (TRANSPEDICULAR) DECOMPRESSION COMPLICATION AVOIDANCE SURGICAL OUTCOMES CONCLUSION Management of Traumatic Thoracic Compression and Burst Fractures INTRODUCTION CLASSIFICATION AND SURGICAL INDICATIONS EPIDEMIOLOGY NONOPERATIVE TREATMENT TIMING OF SURGERY SURGICAL OPTIONS ANTERIOR-ONLY INSTRUMENTATION POSTERIOR-ONLY INSTRUMENTATION COMBINED ANTERIOR AND POSTERIOR SURGERY KYPHOPLASTY FOR TRAUMATIC FRACTURES Fracture Dislocations of the Thoracic Spine INTRODUCTION CLASSIFICATION DIAGNOSTIC TESTS AND RADIOGRAPHS CLINICAL MANAGEMENT CONCLUSION Thoracolumbar Compression and Burst Fractures INTRODUCTION MECHANISM OF INJURY CLASSIFICATION NEUROLOGIC INJURY INITIAL MANAGEMENT TREATMENT CONSIDERATIONS NONOPERATIVE TREATMENT OPERATIVE TREATMENT REHABILITATION CONCLUSION COMPLICATIONS Flexion-Distraction Injuries of the Thoracolumbar Spine CLASSIFICATION INTRODUCTION EPIDEMIOLOGY CLINICAL PRESENTATION CLINICAL MANAGEMENT CONCLUSION Fracture-Dislocations of the Thoracolumbar Spine INTRODUCTION CLASSIFICATION SYSTEMS TREATMENT OPTIONS FRACTURE-DISLOCATION INJURIES IN CHILDREN CONCLUSION Low Lumbar Burst Fractures INTRODUCTION CLINICAL MANAGEMENT OPERATIVE PROCEDURES AND TECHNIQUES SUMMARY Sacral Fractures INTRODUCTION ANATOMY CLASSIFICATION INJURY PATTERNS EVALUATION TREATMENT PRINCIPLES OPERATIVE TREATMENT STABILIZATION TECHNIQUES NONOPERATIVE TREATMENT NEUROLOGIC DECOMPRESSION CONCLUSION Complications Related to the Surgical Management of Thoracolumbar Injuries INTRODUCTION SURGICAL COMPLICATIONS OF THE ANTERIOR APPROACH TO THORACOLUMBAR FRACTURES GENERAL COMPLICATIONS OF SURGICAL CARE OF THORACOLUMBAR FRACTURES SURGICAL COMPLICATIONS OF THE POSTERIOR APPROACH TO THORACOLUMBAR FRACTURES Mechanisms of Injury in the Sacral Spine: Concepts, Pathomechanics, Classifi cations, Instability, and Clinical Applications GENERAL CONCEPTS PATHOMECHANICS CLASSIFICATION INSTABILITY AND CLINICAL APPLICATIONS SUMMARY Operative Techniques for Sacral Injuries: Surgical Approaches, Techniques for Decompression, and Instrumentation INTRODUCTION CLASSIFICATION OF SACRAL FRACTURES MANAGEMENT OF LOWER LUMBAR AND SACRAL INJURIES APPROACHES TO LUMBOSACRAL JUNCTION AND SACRUM OPERATIVE TECHNIQUES FOR SACRAL FRACTURES COMPLICATIONS ASSOCIATED WITH OPERATIVE TREATMENT FOR SACRAL FRACTURES Fractures of the Sacrum and Coccyx INTRODUCTION EPIDEMIOLOGY AND PRESENTATION OF SACRAL FRACTURES INITIAL EVALUATION OF SACRAL FRACTURES FRACTURES OF THE COCCYX CLINICAL MANAGEMENT OPERATIVE PROCEDURES AND TECHNIQUE SUMMARY OUTCOMES Spinopelvic Fixation Techniques RELEVANT ANATOMY FOR LUMBOSACRAL INTERNAL FIXATION INTRODUCTION LOW LUMBAR BURST FRACTURES STRUCTURES AT RISK IN SPONDYLOPELVIC FIXATION TRAUMATIC SPONDYLOLISTHESIS TRAUMATIC SPONDYLOPELVIC DISSOCIATION PEDIATRIC LUMBOSACRAL INJURIES CONCLUSION Development and Maturation of the Axial Skeleton: Developmental Abnormalities of the Cervical Spine INTRODUCTION GENETICS AND EMBRYOGENESIS EPIDEMIOLOGY OF CONGENITAL DISORDERS DIAGNOSTIC EVALUATION UPPER CERVICAL SPINE ABNORMALITIES CONCLUSION Spinal Biomechanics of the Pediatric Spine: Clinical Applications ANATOMIC DIFFERENCES CHARACTERISTICS OF THE PEDIATRIC SPINE GROWTH AND GROWTH PLATES ADAPTABILITY, MALLEABILITY, AND MOBILITY SCOLIOSIS KYPHOSIS SPONDYLOLYSIS AND SPONDYLOLISTHESIS PROGRESSION OF SPONDYLOLISTHESIS CONCLUSION Imaging Modalities of the Traumatically Injured Pediatric Spine RADIOGRAPHY COMPUTED TOMOGRAPHY MAGNETIC RESONANCE IMAGING ULTRASOUND MYELOGRAPHY RADIONUCLIDE SCAN Pediatric Spinal Cord Injury and Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) EPIDEMIOLOGY INTRODUCTION BIOMECHANICS AND PATHOPHYSIOLOGY CLINICAL PRESENTATION RADIOGRAPHIC FINDINGS PROGNOSIS TREATMENT CONCLUSION The Use of Cervical/ Thoracolumbar Orthoses, Halo Devices, and Traction in Children INTRODUCTION CERVICAL ORTHOSES THORACOLUMBAR ORTHOSES HALO DEVICES PIN INSERTION TECHNIQUES APPLICATION TECHNIQUE COMPLICATIONS CERVICAL SPINE TRAUMA TRACTION COMPLICATIONS CONCLUSION The Use of Spinal Instrumentation in the Traumatically Injured Pediatric Spine INTRODUCTION EPIDEMIOLOGY INITIAL MANAGMENT CERVICAL SPINE INJURIES THORACOLUMBAR FRACTURES Evaluation and Surgical Management of Cervical Spine Injuries in Children INTRODUCTION ANATOMIC FEATURES INITIAL EVALUATION AND MANAGEMENT OCCIPITOATLANTAL DISLOCATION ATLANTOAXIAL ROTATORY FIXATION ATLAS FRACTURES DENS FRACTURE HANGMAN’S FRACTURE TRAUMATIC ATLANTOAXIAL SUBLUXATION SUBAXIAL SPINE INJURIES SPINAL CORD INJURY WITHOUT RADIOGRAPHIC ABNORMALITY Evaluation and Surgical Management of Thoracic/ Thoracolumbar Junction Injuries in Children INTRODUCTION MECHANISMS OF INJURY/ PATTERNS OF INJURY EPIDEMIOLOGY CLINICAL EVALUATION CLINICAL MANAGEMENT NONOPERATIVE APPROACHES OPERATIVE PROCEDURE AND TECHNIQUE INDICATIONS AND CONTRAINDICATIONS FOR SURGERY CONCLUSION Evaluation and Surgical Management of Lumbar Injuries in Children INTRODUCTION ANATOMY AND IMAGING OF THE PEDIATRIC LUMBAR SPINE MECHANISM OF INJURY TYPES OF INJURIES CONCLUSIONS Sacral Fractures in Skeletally Immature Patients DEVELOPMENT INTRODUCTION EVALUATION INCIDENCE IMAGING OTHER DIAGNOSTIC MODALITIES EMERGENT TREATMENT OF SACRAL FRACTURES SURGICAL TREATMENT TREATMENT OF PEDIATRIC SACRAL FRACTURES TREATMENT RESULTS IN LITERATURE CONCLUSION Complications Associated with Surgical Management of Pediatric Spine Trauma COMPLICATIONS RELATED TO PATIENT POSITIONING INTRODUCTION COMPLICATIONS RELATED TO HALO SKELETAL IMMOBILIZATION BONE GRAFT HARVEST SITE COMPLICATIONS BLEEDING COMPLICATIONS ASSOCIATED WITH SPINE SURGERY INFECTION COMPLICATIONS RELATED TO HARDWARE AND INSTRUMENTATION ACKNOWLEDGMENT CONCLUSION Pediatric Spinal Column and Spinal Cord Injury and the Use of Luque Segmental Instrumentation in the Injured Pediatric Spine INTRODUCTION CLINICAL MANAGEMENT OPERATIVE PROCEDURE AND TECHNIQUE CONCLUSION Pedicle Screw Fixation in the Pediatric Spine: Anatomic Considerations and Techniques for Placement of Screws in the Thoracic, L ANATOMY INTRODUCTION BIOMECHANICS VERIFICATION OF SCREW PLACEMENT LUMBAR SCREW PLACEMENT SCREW PLACEMENT EXPOSURE SACRAL SCREWS THORACIC PEDICLE SCREWS CONCLUSION Anterior Instrumentation Techniques for the Pediatric Spine INTRODUCTION INDICATIONS FOR ANTERIOR SPINAL FUSION IN PEDIATRIC SPINE TRAUMA SURGICAL TECHNIQUE TECHNIQUE ACKNOWLEDGMENT CONCLUSION Gunshot Wounds to the Spine INTRODUCTION BALLISTICS AND BULLET DESIGN EPIDEMIOLOGY CLINICAL MANAGEMENT RADIOGRAPHIC IMAGING AND DIAGNOSTIC TESTS SPECIFIC EVALUATION OF SPINAL INJURY TREATMENT PROPHYLAXIS AND ANTIBIOSIS ASSOCIATED INJURIES PATIENTS WITH NO NEUROLOGIC DEFICIT PATIENTS WITH NEUROLOGIC DEFICIT COMPLICATIONS REHABILITATION CONCLUSION Management of Spine Fractures in Patients with Diffuse Idiopathic Skeletal Hyperostosis and Ankylosing Spondylitis INTRODUCTION ANKYLOSING SPONDYLITIS DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS SPINAL TRAUMA DIAGNOSIS AND EVALUATION OF SPINAL FRACTURE SURGICAL MANAGMENT PATIENT MANAGEMENT THORACIC SPINE STABILIZATION CERVICAL SPINE STABILIZATION CONCLUSION Surgical Treatment of Patients with Osteoporotic Fractures of the Spine IMPLANT CONSIDERATIONS INTRODUCTION BONE GRAFTING AND FUSION CONSTRUCT PLANNING CONCLUSION Surgical Management of Post-Traumatic Spinal Deformity INTRODUCTION PATIENT PRESENTATION EPIDEMIOLOGY SURGICAL CONSIDERATIONS OUTCOME CONCLUSION Management of Post-Traumatic Syringomyelia EPIDEMIOLOGY INTRODUCTION PATHOLOGIC FINDINGS PATHOPHYSIOLOGY TREATMENT CLINICAL PRESENTATION DIAGNOSIS CONCLUSION OUTCOMES Rehabilitation and Recovery after Spinal Cord Injury INTRODUCTION PROGNOSIS LEVEL OF INJURY REHABILITATION MEDICAL COMPLICATIONS ACKNOWLEDGMENT