Produkt

KlappentextDon't miss it! The second, completely revised and expanded edition of the successful surgical manual on minimally invasive spine surgery includes 51 chapters (including more than 20 new chapters) covering all current minimally invasive techniques in spine surgery. A complete survey of all microsurgical and endoscopic techniques with a special focus on semi-invasive injection techniques for diagnostic and therapeutic purposes in low back pain is given. The clear chapter structure with terminology, history, surgical principles, advantages/disadvantages, indications, access principles, complications, and results facilitates navigation through the manual. Topics include the principles of microsurgical and endoscopic treatment, spinal navigation and computer-assisted surgery, minimally invasive reconstruction, fusion, dynamic stabilization in fractures, degenerative disc disease, spinal stenosis, low back pain and deformities. The didactic presentation of surgical steps makes the reader familiar with all types of new minimally invasive techniques in clinical use or still in ongoing clinical trials such as minimally invasive spine arthroplasty.

Details

Weitere ISBN/GTIN9783540294900

ProduktartE-Book

EinbandartE-Book

FormatPDF

Format Hinweis1 - PDF Watermark

FormatE107

Verlag

Springer Berlin Heidelberg

Erscheinungsjahr2006

Erscheinungsdatum26.01.2006

Auflage2nd ed. 2006

Seiten492 Seiten

SpracheEnglisch

IllustrationenXX, 492 p.

Artikel-Nr.1428236

Rubriken

Genre9200

Inhalt/Kritik

Inhaltsverzeichnis

1;Preface to the Second Edition;6
2;Foreword to the First Edition;7
3;Preface to the First Edition;9
4;Contents;11
5;List of Contributors;15
6;General;22
6.1;1 Minimally Invasive Spine Surgery;23
6.1.1;1.1 Goals of Minimally Invasive Spine Surgery ( MISS);23
6.1.2;1.2 Access Principles;23
6.1.3;1.3 Preoperative Planning;25
6.1.4;1.4 Positioning of the Patient;26
6.1.5;1.5 Localization of Skin Incision;26
6.1.6;1.6 Surgical Dissection Techniques;26
6.1.7;1.7 Instruments and Implants;26
6.1.8;1.8 Summary;27
6.2;2 Technological Advances of Surgical Microscopes for Spine Surgery;28
6.2.1;2.1 History of the Surgical Microscope;28
6.2.2;2.2 The Surgical Microscope;28
6.2.3;2.3 Advantages;30
6.2.4;2.4 Disadvantages;31
6.2.5;References;31
6.3;3 Spinal Microsurgery;32
6.3.1;3.1 Terminology;32
6.3.2;3.2 Surgical Principle;32
6.3.3;3.3 History;32
6.3.4;3.4 The Surgical Microscope;32
6.3.5;3.5 Advantages;34
6.3.6;3.6 Disadvantages;34
6.3.7;References;35
6.4;4 Microsurgical Instruments;36
6.4.1;4.1 Classification of Instruments;36
6.4.2;4.2 Summary;42
6.4.3;4.3 Comment;42
6.4.4;References;42
6.5;5 Operating Room Setup and Handling of Surgical Microscopes;43
6.5.1;5.1 Introduction;43
6.5.2;5.2 Room and Microscope Setup;43
6.5.3;5.3 Microscope Handling;44
6.5.4;5.4 Transporting the Microscope;45
6.5.5;References;45
6.6;6 Computer-assisted Minimally Invasive Spine Surgery;46
6.6.1;6.1 Introduction;46
6.6.2;6.2 Computer-assisted Orthopaedic Surgery;46
6.6.3;6.3 Minimizing Invasiveness;47
6.6.4;6.4 Further Clinical Applications;50
6.6.5;6.5 Discussion and Conclusion;51
6.6.6;References;51
7;Cervical Spine;54
7.1;7 Technique of Transoral Odontoidectomy;55
7.1.1;7.1 Terminology;55
7.1.2;7.2 Surgical Principle;55
7.1.3;7.3 History;56
7.1.4;7.4 Advantages;56
7.1.5;7.5 Disadvantages;56
7.1.6;7.6 Indications and Contraindications;56
7.1.7;7.7 Patient s Informed Consent;56
7.1.8;7.8 Surgical Technique;56
7.1.9;7.9 Postoperative Care;60
7.1.10;7.10 Hazards and Complications;60
7.1.11;7.11 Conclusions;60
7.1.12;References;60
7.2;8 Microsurgical Treatment of Odontoid Fractures;62
7.2.1;8.1 Terminology ;62
7.2.2;8.2 Surgical Principle;62
7.2.3;8.3 History;63
7.2.4;8.4 Advantages;63
7.2.5;8.5 Disadvantages;64
7.2.6;8.6 Indications;64
7.2.7;8.7 Contraindications;64
7.2.8;8.8 Patient s Informed Consent;65
7.2.9;8.9 Surgical Technique;65
7.2.10;8.10 Postoperative Care and Complications;69
7.2.11;8.11 Results;70
7.2.12;8.12 Critical Evaluations;71
7.2.13;References;71
7.3;9 Microsurgery of the Cervical Spine: The Anterior Approach;74
7.3.1;9.1 Terminology;74
7.3.2;9.2 Surgical Principle;74
7.3.3;9.3 History;75
7.3.4;9.4 Advantages;75
7.3.5;9.5 Disadvantages;75
7.3.6;9.6 Indications;76
7.3.7;9.7 Contraindications;80
7.3.8;9.8 Patient s Informed Consent;80
7.3.9;9.9 Surgical Technique;81
7.3.10;9.10 Postoperative Care;96
7.3.11;9.11 Results;98
7.3.12;9.12 Critical Evaluation;99
7.3.13;References;99
7.4;10 Anterior Cervical Foraminotomy (Microsurgical and Endoscopic);102
7.4.1;10.1 Terminology;102
7.4.2;10.2 Surgical Principle;102
7.4.3;10.3 History;102
7.4.4;10.4 Advantages;103
7.4.5;10.5 Disadvantages;103
7.4.6;10.6 Indications;103
7.4.7;10.7 Contraindications;103
7.4.8;10.8 Patient s Informed Consent;103
7.4.9;10.9 Surgical Technique;103
7.4.10;10.10 Postoperative Care and Complications;109
7.4.11;10.11 Results;109
7.4.12;10.12 Critical Evaluation;109
7.4.13;References;111
7.5;11 Functional Segmental Reconstruction with the Bryan Cervical Disc Prosthesis;112
7.5.1;11.1 Introduction ;112
7.5.2;11.2 Theoretical considerations;112
7.5.3;11.3 History;112
7.5.4;11.4 Structural and Functional Objectives of the Bryan Cervical Disc Prosthesis;114
7.5.5;11.5 Description of the Bryan Cervical Disc Prosthesis;114
7.5.6;11.6 Biocompatibility of the Bryan Cervical Disc Prosthesis;115
7.5.7;11.7 Mechanical Testing of the Bryan Cervical Disc Prosthesis;115
7.5.8;11.8 Animal Testing of the Bryan Cervical Disc Prosthesis;115
7.5.9;11.9 Surgical Technique;115
7.5.10;11.10 Preliminary Clinical Experience with the Bryan Cervical Disc Prosthesis;117
7.5.11;11.11 Conclusions;119
7.5.12;References;119
7.6;12 Microsurgical Total Cervical Disc Replacement;120
7.6.1;12.1 Terminology;120
7.6.2;12.2 Surgical Principle;120
7.6.3;12.3 History;120
7.6.4;12.4 Advantages;120
7.6.5;12.5 Disadvantages;120
7.6.6;12.6 Indications;121
7.6.7;12.7 Contraindications;121
7.6.8;12.8 Patient s Informed Consent (see also Chapter 9);121
7.6.9;12.9 Surgical Technique;121
7.6.10;12.10 Postoperative Care;125
7.6.11;12.11 Hazards and Complications;125
7.6.12;12.12 Conclusions;125
7.6.13;References;126
7.7;13 Microsurgical Posterior Approaches to the Cervical Spine;127
7.7.1;13.1 Terminology;127
7.7.2;13.2 Surgical Principle;127
7.7.3;13.3 History;127
7.7.4;13.4 Advantages;128
7.7.5;13.5 Disadvantages;128
7.7.6;13.6 Indications;128
7.7.7;13.7 Patient s Informed Consent;128
7.7.8;13.8 Surgical Technique;128
7.7.9;13.9 Postoperative Care;135
7.7.10;13.10 Hazards and Complications;136
7.7.11;13.11 Results;136
7.7.12;13.12 Critical Evaluation;136
7.7.13;References;137
7.8;14 Microsurgical C1-2 Stabilization;138
7.8.1;14.1 Terminology;138
7.8.2;14.2 Surgical Principle;138
7.8.3;14.3 History;138
7.8.4;14.4 Advantages;139
7.8.5;14.5 Disadvantages;139
7.8.6;14.6 Indications;139
7.8.7;14.7 Contraindications;140
7.8.8;14.8 Patient s Informed Consent;140
7.8.9;14.9 Surgical Technique;140
7.8.10;14.10 Postoperative Care;144
7.8.11;14.11 Hazards and Complications ;145
7.8.12;14.12 Conclusions;145
7.8.13;References;145
8;Thoracic/ Thoracolumbar Spine;148
8.1;15 Microsurgical Anterior Approach to T5-10 (Mini-TTA);149
8.1.1;15.1 Terminology;149
8.1.2;15.2 Surgical Principle;149
8.1.3;15.3 History;149
8.1.4;15.4 Advantages;149
8.1.5;15.5 Disadvantages;149
8.1.6;15.6 Indications;149
8.1.7;15.7 Contraindications;150
8.1.8;15.8 Patient s Informed Consent;150
8.1.9;15.9 Surgical Technique;150
8.1.10;15.10 Surgical Strategies;154
8.1.11;15.11 Postoperative Care;156
8.1.12;15.12 Complications and Hazards;156
8.1.13;15.13 Critical Evaluation;156
8.1.14;Suggested Reading;157
8.2;16 Microsurgical Anterior Approach to the Thoracolumbar Junction;158
8.2.1;16.1 Terminology;158
8.2.2;16.2 Surgical Principle;158
8.2.3;16.3 History;158
8.2.4;16.4 Advantages;158
8.2.5;16.5 Disadvantages;158
8.2.6;16.6 Indications;158
8.2.7;16.7 Contraindications;159
8.2.8;16.8 Surgical Technique;159
8.2.9;16.9 Surgical Strategies;161
8.2.10;16.10 Postoperative Care;163
8.2.11;16.11 Complications and Hazards;163
8.2.12;16.12 Critical Evaluation;163
8.2.13;Suggested Reading;163
8.3;17 Anatomic Principles of Thoracoscopic Spine Surgery;164
8.3.1;17.1. Anatomy of the Thoracic Wall with Respect to Endoscopic Approaches;164
8.3.2;17.2. Thoracoscopic Anatomy;166
8.4;18 Principles of Endoscopic Techniques to the Thoracic and Lumbar Spine;169
8.4.1;18.1 Terminology;169
8.4.2;18.2 Surgical Principle;169
8.4.3;18.3 History;169
8.4.4;18.4 Technical Equipment;170
8.4.5;18.5 Advantages;171
8.4.6;18.6 Disadvantages;171
8.4.7;18.7 Indications;171
8.4.8;18.8 Contraindications;172
8.4.9;18.9 Complications;172
8.4.10;18.10 Conclusions and Critical Evaluation;172
8.4.11;References;173
8.5;19 Biomechanical Requirements in Minimally Invasive Spinal Fracture Treatment;176
8.5.1;19.1 Anterior Spinal Stabilization;176
8.5.2;19.2 Minimally Invasive Anterior Techniques;176
8.5.3;19.3 Biomechanical Aspects;177
8.5.4;19.4 Biomechanical Testing: Overview;177
8.5.5;References;182
8.6;20 Thoracoscopic Approaches in Spinal Deformities and Trauma;184
8.6.1;20.1 Terminology;184
8.6.2;20.2 Surgical Principle;184
8.6.3;20.3 History;185
8.6.4;20.4 Advantages;185
8.6.5;20.5 Disadvantages;185
8.6.6;20.6 Indications;186
8.6.7;20.7 Contraindications;186
8.6.8;20.8 Patient s Informed Consent;186
8.6.9;20.9 Surgical Technique;186
8.6.10;20.10 Postoperative Care;193
8.6.11;20.11 Hazards and Complications;193
8.6.12;20.12 Conclusion and Critical Evaluation;193
8.6.13;References;194
8.7;21 Thoracoscopic Techniques in Spinal Deformity;196
8.7.1;21.1 Terminology;196
8.7.2;21.2 Surgical Principle;196
8.7.3;21.3 History;196
8.7.4;21.4 Advantages;196
8.7.5;21.5 Disadvantages;198
8.7.6;21.6 Indications;198
8.7.7;21.7 Contraindications 21.8 Patient s Informed Consent;203
8.7.8;21.9 Surgical Technique;203
8.7.9;21.10 Postoperative Care;211
8.7.10;21.11 Complications;212
8.7.11;21.12 Results;214
8.7.12;References;214
8.8;22 Mini-open Endoscopic Excision of Hemivertebrae;217
8.8.1;22.1 Endoscopic Excision of Hemivertebra;217
8.8.2;22.2 Terminology;217
8.8.3;22.3 Surgical Principle;217
8.8.4;22.4 History;217
8.8.5;22.5 Advantages;217
8.8.6;22.6 Disadvantages;218
8.8.7;22.7 Indications and Contraindications;218
8.8.8;22.8 Patient s Informed Consent;218
8.8.9;22.9 Surgical Technique;218
8.8.10;22.10 Postoperative Care and Complications;220
8.8.11;22.11 Patients;220
8.8.12;22.12 Results;220
8.8.13;22.13 Critical Evaluation;220
8.8.14;22.14 Conclusions;221
8.8.15;References;221
8.9;23 Thoracoscopically Assisted Anterior Approach to Thoracolumbar Fractures;223
8.9.1;23.1 Terminology;223
8.9.2;23.2 Surgical Principle;223
8.9.3;23.3 History;223
8.9.4;23.4 Advantages;223
8.9.5;23.5 Disadvantages;224
8.9.6;23.6 Indications;224
8.9.7;23.7 Contraindications;224
8.9.8;23.8 Patient s Informed Consent;224
8.9.9;23.9 Surgical Technique;224
8.9.10;23.10 Postoperative Care;230
8.9.11;23.11 Complications, Hazards, and Pitfalls;231
8.9.12;23.12 Conclusion and Critical Evaluations;232
8.9.13;References;233
8.10;24 A Minimally Invasive Open Approach for Reconstruction of the Anterior Column of the Thoracic and Lumbar Spine;235
8.10.1;24.1 Terminology;235
8.10.2;24.2 Surgical Principle;235
8.10.3;24.3 History;235
8.10.4;24.4 Advantages;236
8.10.5;24.5 Disadvantages;236
8.10.6;24.6 Indications;236
8.10.7;24.7 Contraindications;237
8.10.8;24.8 Patient s Informed Consent;237
8.10.9;24.9 Surgical Technique;237
8.10.10;24.10 Postoperative Care and Complications;239
8.10.11;24.11 Results;240
8.10.12;24.12 Critical Evaluations;240
8.10.13;References;241
8.11;25 Percutaneous Vertebroplasty in Osteoporotic Vertebral Fractures;242
8.11.1;25.1 Terminology;242
8.11.2;25.2 Surgical Principle;242
8.11.3;25.3 History;242
8.11.4;25.4 Advantages;242
8.11.5;25.5 Disadvantages;242
8.11.6;25.6 Indications;242
8.11.7;25.7 Contraindications;243
8.11.8;25.8 Patient s Informed Consent;244
8.11.9;25.9 Surgical Technique;244
8.11.10;25.10 Postoperative Care and Complications;246
8.11.11;25.11 Results;247
8.11.12;25.12 Critical Evaluations;248
8.11.13;References;248
8.12;26 Microsurgical Open Vertebroplasty and Kyphoplasty;250
8.12.1;26.1 Terminology;250
8.12.2;26.2 Surgical Principle;250
8.12.3;26.3 History;250
8.12.4;26.4 Advantages;250
8.12.5;26.5 Disadvantages;251
8.12.6;26.6 Indications;251
8.12.7;26.7 Contraindications;251
8.12.8;26.8 Patient s Informed Consent;251
8.12.9;26.9 Surgical Technique;252
8.12.10;26.10 Postoperative Care;255
8.12.11;26.11 Hazards, Pitfalls and Complications;255
8.12.12;26.12 Results and Conclusion;255
8.12.13;References;258
8.13;27 Percutaneous Kyphoplasty in Traumatic Fractures;259
8.13.1;27.1 Terminology;259
8.13.2;27.2 Surgical Principle;259
8.13.3;27.3 History;260
8.13.4;27.4 Advantages;260
8.13.5;27.5 Disadvantages;260
8.13.6;27.6 Indications;260
8.13.7;27.7 Contraindications;260
8.13.8;27.8 Surgical Technique;260
8.13.9;27.9 Postoperative Care;262
8.13.10;27.10 Results;262
8.13.11;27.11 Critical Evaluation;266
8.13.12;References;266
9;Lumbar Spine;268
9.1;28 Interventional and Semi-invasive Procedures for Low Back Pain and Disc Herniation;269
9.1.1;28.1 Terminology;269
9.1.2;28.2 Surgical Principle;269
9.1.3;28.3 History;270
9.1.4;28.4 Advantages;270
9.1.5;28.5 Disadvantages;270
9.1.6;28.6 Indications;270
9.1.7;28.7 Contraindications;270
9.1.8;28.8 Patient s Informed Consent;271
9.1.9;28.9 Surgical Technique;271
9.1.10;28.10 Postoperative Care and Complications;276
9.1.11;28.11 Results;276
9.1.12;28.12 Critical Evaluation;278
9.1.13;References;278
9.2;29 Intradiscal Electrothermal Therapy;280
9.2.1;29.1 Terminology;280
9.2.2;29.2 Surgical Principle;280
9.2.3;29.3 History;280
9.2.4;29.4 Pathophysiology of Internal Disc Derangement;280
9.2.5;29.5 Thermal Impact Upon Tissue;280
9.2.6;29.6 Patient Selection for IDET;281
9.2.7;29.7 Surgical Technique;283
9.2.8;29.8 Postoperative Care;283
9.2.9;29.9 Postoperative Exercises;283
9.2.10;29.10 Results;284
9.2.11;29.11 Complications;284
9.2.12;29.12 Conclusion;285
9.2.13;References;285
9.3;30 Microtherapy in Low Back Pain;287
9.3.1;30.1 Terminology;287
9.3.2;30.2 Surgical Principle;288
9.3.3;30.3 History;289
9.3.4;30.4 Advantages;290
9.3.5;30.5 Disadvantages;291
9.3.6;30.6 Indications;291
9.3.7;30.7 Contraindications;291
9.3.8;30.8 Patient s Informed Consent;292
9.3.9;30.9 Surgical Technique;292
9.3.10;30.10 Postoperative Care and Complications;293
9.3.11;30.11 Results 30.12 Critical Evaluations;295
9.3.12;30.13 Conclusions;296
9.3.13;References;296
9.4;31 Principles of Microsurgical Discectomy in Lumbar Disc Herniations;298
9.4.1;31.1 Terminology;298
9.4.2;31.2 Surgical Principle;298
9.4.3;31.3 History;298
9.4.4;31.4 Advantages;299
9.4.5;31.5 Disadvantages;299
9.4.6;31.6 Indications;299
9.4.7;31.7 Contraindications;299
9.4.8;31.8 Surgical Technique, Postoperative Care, and Complications;299
9.4.9;31.9 Results;299
9.4.10;31.10 Critical Evaluation;300
9.4.11;Bibliography;301
9.5;32 The Microsurgical Interlaminar, Paramedian Approach;303
9.5.1;32.1 Terminology;303
9.5.2;32.2 Surgical Principle;303
9.5.3;32.3 History;303
9.5.4;32.4 Advantages;303
9.5.5;32.5 Disadvantages ;304
9.5.6;32.6 Indications (see also Chapter 31);304
9.5.7;32.7 Contraindications;305
9.5.8;32.8 Patient s Informed Consent;305
9.5.9;32.9 Surgical Technique;306
9.5.10;32.10 Postoperative Care;315
9.5.11;32.11 Complications;315
9.5.12;32.12 Critical Evaluation;315
9.5.13;References;315
9.6;33 The Translaminar Approach;317
9.6.1;33.1 Terminology;317
9.6.2;33.2 Surgical Principle ;317
9.6.3;33.3 History;317
9.6.4;33.4 Advantages;317
9.6.5;33.5 Disadvantages;318
9.6.6;33.6 Indications;318
9.6.7;33.7 Contraindications;318
9.6.8;33.8 Patient s Informed Consent;319
9.6.9;33.9 Surgical Technique;319
9.6.10;33.10 Postoperative Care and Complications 33.11 Results;321
9.6.11;33.12 Critical Evaluations;322
9.6.12;References;323
9.7;34 The Lateral, Extraforaminal Approach;324
9.7.1;34.1 Terminology;324
9.7.2;34.2 Surgical Principle;325
9.7.3;34.3 History;326
9.7.4;34.4 Advantages;327
9.7.5;34.5 Disadvantages;327
9.7.6;34.6 Indications;327
9.7.7;34.7 Contraindications;327
9.7.8;34.8 Patient s Informed Consent;327
9.7.9;34.9 Surgical Technique;327
9.7.10;34.10 Postoperative Care;331
9.7.11;34.11 Complications;331
9.7.12;34.12 Results;332
9.7.13;34.13 Critical Evaluation;333
9.7.14;References;333
9.8;35 Transforaminal Endoscopic Discectomy;335
9.8.1;35.1 Terminology;335
9.8.2;35.2 Surgical Principle;335
9.8.3;35.3 History;336
9.8.4;35.4 Advantages;337
9.8.5;35.5 Disadvantages;337
9.8.6;35.6 Indications;338
9.8.7;35.7 Contraindications;338
9.8.8;35.8 Surgical Technique;338
9.8.9;35.9 Postoperative Treatment;340
9.8.10;35.10 Complications;340
9.8.11;35.11 Critical Evaluation;340
9.8.12;References;341
9.9;36 Microscopically Assisted Percutaneous Technique as a Minimally Invasive Approach to the Posterior Spine;342
9.9.1;36.1 Terminology;342
9.9.2;36.2 Surgical Principle;342
9.9.3;36.3 History;342
9.9.4;36.4 Advantages;342
9.9.5;36.5 Disadvantages;343
9.9.6;36.6 Indications;343
9.9.7;36.7 Contraindications;343
9.9.8;36.8 Patient s Informed Consent;343
9.9.9;36.9 Surgical Technique;343
9.9.10;36.10 Postoperative Care and Complications 36.11 Results;346
9.9.11;36.12 Critical Evaluations;349
9.9.12;References;350
9.10;37 Arthroscopic and Endoscopic Spine Surgery via a Posterolateral Approach;351
9.10.1;37.1 Terminology;351
9.10.2;37.2 Surgical Principle;351
9.10.3;37.3 History;351
9.10.4;37.4 Advantages;352
9.10.5;37.5 Disadvantages;352
9.10.6;37.6 Indications and Contraindications;352
9.10.7;37.7 Patient Education and Preoperative Consent;353
9.10.8;37.8 Anatomical Consideration;353
9.10.9;37.10 Postoperative Care;361
9.10.10;37.11 Results;362
9.10.11;37.12 Critical Evaluation and Discussion References;363
9.11;38 The Full-endoscopic Interlaminar Approach for Lumbar Disc Herniations;366
9.11.1;38.1 Terminology;366
9.11.2;38.2 Surgical Principle;366
9.11.3;38.3 History;366
9.11.4;38.4 Advantages;366
9.11.5;38.5 Disadvantages;367
9.11.6;38.6 Indications;367
9.11.7;38.7 Contraindications;367
9.11.8;38.8 Patient s Informed Consent;368
9.11.9;38.9 Surgical Technique;368
9.11.10;38.10 Postoperative Care and Complications;370
9.11.11;38.11 Results;371
9.11.12;38.12 Critical Evaluations;372
9.11.13;References;373
9.12;39 Outpatient Microsurgical Lumbar Discectomy and Microdecompression Laminoplasty;376
9.12.1;39.1 Terminology;376
9.12.2;39.2 History;376
9.12.3;39.3 Surgical Principle;376
9.12.4;39.4 Advantages 39.5 Disadvantages (see also Chapters 31 and 32);377
9.12.5;39.6 Indications;377
9.12.6;39.7 Contraindications;378
9.12.7;39.8 Patient s Informed Consent;378
9.12.8;39.9 Microsurgical Technique;379
9.12.9;39.10 Postoperative Care;382
9.12.10;39.11 Complications (see Chapters 32 and 44) 39.12 Conclusion;382
9.12.11;References;382
9.13;40 Nucleus Reconstruction by Autologous Chondrocyte Transplantation;384
9.13.1;40.1 Terminology;384
9.13.2;40.2 Surgical Principle;384
9.13.3;40.3 Cell-culturing Technique;385
9.13.4;40.4 Canine Preclinical Study;385
9.13.5;40.5 Clinical Studies;388
9.13.6;40.6 Critical Evaluation;390
9.13.7;References;392
9.14;41 Autologous Disc Chondrocyte Transplantation;394
9.14.1;41.1 Terminology;394
9.14.2;41.2 Principle;394
9.14.3;41.3 History;395
9.14.4;41.4 Advantages;395
9.14.5;41.5 Disadvantages;395
9.14.6;41.6 Inclusion criteria;395
9.14.7;41.7 Exclusion criteria;395
9.14.8;41.8 Patient s Informed Consent;396
9.14.9;41.9 Surgical Technique;396
9.14.10;41.10 Postoperative Care;397
9.14.11;41.11 Results;397
9.14.12;41.12 Critical Evaluation;397
9.14.13;References;398
9.15;42 The ALPA Approach for Minimally Invasive Nucleus Pulposus Replacement;399
9.15.1;42.1 Terminology;399
9.15.2;42.2 Surgical Principle;399
9.15.3;42.3 History;399
9.15.4;42.4 Advantages;400
9.15.5;42.5 Disadvantages;400
9.15.6;42.6 Indications;400
9.15.7;42.7 Contraindications;400
9.15.8;42.8 Patient s Informed Consent;400
9.15.9;42.9 Surgical Technique;400
9.15.10;42.10 Postoperative Care;403
9.15.11;42.11 Hazards and Complications ( see also Chapters 44 - 48);403
9.15.12;42.12 Conclusion;403
9.15.13;References;403
9.16;43 Mini-open Midline Accesses for Lumbar Total Disc Replacement;405
9.16.1;43.1 Terminology;405
9.16.2;43.2 Surgical Principle;405
9.16.3;43.3 History;405
9.16.4;43.4 Advantages;405
9.16.5;43.5 Disadvantages;405
9.16.6;43.6 Indications;405
9.16.7;43.7 Contraindications;406
9.16.8;43.8 Patient s Informed Consent;406
9.16.9;43.9 Surgical Techniques;406
9.16.10;43.10 Postoperative Care;415
9.16.11;43.11 Hazards and Complications 43.12 Conclusions;416
9.16.12;References;416
9.17;44 Microsurgical Decompression of Acquired (Degenerative) Central and Lateral Spinal Canal Stenosis;417
9.17.1;44.1 Terminology;417
9.17.2;44.2 Surgical Principle;417
9.17.3;44.3 History;417
9.17.4;44.4 Advantages;417
9.17.5;44.5 Disadvantages;418
9.17.6;44.6 Indications;418
9.17.7;44.7 Contraindications;419
9.17.8;44.8 Patient s Informed Consent;419
9.17.9;44.9 Surgical Technique;419
9.17.10;44.10 Postoperative Care;426
9.17.11;44.11 Complications;426
9.17.12;44.12 Results;426
9.17.13;44.13 Critical Evaluation;427
9.17.14;References;428
9.18;45 Microsurgical Anterior Lumbar Interbody Fusion (Mini-ALIF): The Lateral Retroperitoneal Approach to L2/3, L3/4, and L4/5;429
9.18.1;45.1 Terminology;429
9.18.2;45.2 Surgical Principle;429
9.18.3;45.3 History;429
9.18.4;45.4 Advantages;429
9.18.5;45.5 Disadvantages;430
9.18.6;45.6 Indications;430
9.18.7;45.7 Contraindications;430
9.18.8;45.8 Patient s Informed Consent;430
9.18.9;45.9 Surgical Technique;430
9.18.10;45.10 Postoperative Care;439
9.18.11;45.11 Complications, Pitfalls, and Hazards;440
9.18.12;45.12 Results;440
9.18.13;45.13 Critical Evaluation;441
9.18.14;References;442
9.19;46 Microsurgical Anterior Lumbar Interbody Fusion (Mini-ALIF): The Transperitoneal Approach to L5/S1;443
9.19.1;46.1 Terminology;443
9.19.2;46.2 Surgical Principle;443
9.19.3;46.3 History;443
9.19.4;46.4 Advantages;443
9.19.5;46.5 Disadvantages;443
9.19.6;46.6 Indications;444
9.19.7;46.7 Contraindications;444
9.19.8;46.8 Patient s Informed Consent;444
9.19.9;46.9 Surgical Technique;444
9.19.10;46.10 Postoperative Care;450
9.19.11;46.11 Complications, Pitfalls, and Hazards;450
9.19.12;46.12 Results;452
9.19.13;46.13 Critical Evaluation;452
9.19.14;Bibliography;453
9.20;47 Minimally Invasive 360° Lumbar Fusion;455
9.20.1;47.1 Terminology;455
9.20.2;47.2 Surgical Principle;455
9.20.3;47.3 History;455
9.20.4;47.4 Advantages;456
9.20.5;47.5 Disadvantages;456
9.20.6;47.6 Indications;456
9.20.7;47.7 Contraindications;457
9.20.8;47.8 Patient s Informed Consent;457
9.20.9;47.9 Surgical Technique;457
9.20.10;47.10 Closure of the Operating Field and Postoperative Care;467
9.20.11;47.11 Complications, Pitfalls, and Hazards;467
9.20.12;47.12 Results;468
9.20.13;47.13 Critical Evaluation;469
9.20.14;References;469
9.21;48 The Anterior Extraperitoneal Video-assisted Approach to the Lumbar Spine;470
9.21.1;48.1 Terminology;470
9.21.2;48.2 Surgical Principle;470
9.21.3;48.3 History;470
9.21.4;48.4 Advantages;470
9.21.5;48.5 Disadvantages;471
9.21.6;48.6 Indications and Contraindications;471
9.21.7;48.7 Patient s Informed Consent;472
9.21.8;48.8 Surgical Technique;472
9.21.9;48.9 Postoperative Care;476
9.21.10;48.10 Hazards and Complications;476
9.21.11;48.11 Critical Evaluation;476
9.21.12;References;478
9.22;49 Minimally Invasive Dynamic Stabilization of the Lumbar Motion Segment with an Interspinous Implant;479
9.22.1;49.1 Terminology;479
9.22.2;49.2 Surgical Principle;479
9.22.3;49.3 History;479
9.22.4;49.4 Advantages;481
9.22.5;49.5 Disadvantages;481
9.22.6;49.6 Indications;482
9.22.7;49.7 Contraindications;482
9.22.8;49.8 Patient s Informed Consent;482
9.22.9;49.9 Surgical Technique;482
9.22.10;49.10 Postoperative Care;483
9.22.11;49.11 Results;483
9.22.12;49.12 Critical Evaluations;484
9.22.13;References;485
9.23;50 Technical and Anatomical Considerations for the Placement of a Posterior Interspinous Stabilizer;486
9.23.1;50.1 Terminology;486
9.23.2;50.2 Surgical Principles;486
9.23.3;50.3 History, Advantages, and Disadvantages ( see also Chapter 45);486
9.23.4;50.4 Indications;486
9.23.5;50.5 Contraindications;488
9.23.6;50.6 Patient s Informed Consent;488
9.23.7;50.7 Surgical Technique;488
9.23.8;50.8 Postoperative Care;493
9.23.9;50.9 Hazards and Complications;493
9.23.10;50.10 Conclusion;493
9.23.11;Suggested Reading;494
9.24;51 Elastic Microsurgical Stabilization with a Posterior Shock Absorber;496
9.24.1;51.1 Terminology and Surgical Principle;496
9.24.2;51.2 History;496
9.24.3;51.3 Indications;499
9.24.4;51.4 Contraindications;499
9.24.5;51.5 Surgical Technique;499
9.24.6;51.6 Results;500
9.24.7;51.7 Hazards and Complications;501
9.24.8;51.8 Conclusions;501
9.25;References;503
10;Subject Index;505mehr

Leseprobe

4 Microsurgical Instruments ( p. 16)

A. Korge
As in all surgical fields, an enormous tendency has occurred recently toward minimizing both surgical procedures as well as surgical approaches. The reasons for miniaturized approaches include a reduced infection rate due to shortened skin incisions, less cosmetic alterations, as well as the fact that in the majority of cases, small and localized pathologies only need small and limited approaches.

In addition, small incisions need less time for wound closure, thus reducing the overall time of surgery [4]. This tendency is also found in spine surgery with an increasing shift frommacrosurgery tomicrosurgery [1, 2, 3, 5]. Microsurgery has become quite popular, especially in surgical procedures within the spinal canal [3], and has been established within recent decades basically due to the development of efficient optical aids such as powerful and effective surgical microscopes which are being continuously improved.

However, the use of microscopes in spine surgery delivered a new intermedium between the surgeon's eye and the operating field, thus influencing simultaneously the individual visual axis between the surgeon's eye and his hands. Therefore, the surgeon's line of vision was restricted and the field of vision became smaller and limited. In addition, the line of vision of a microscope is perpendicular to the surgical area to be operated on.

Consequently, the configuration of surgical instruments had to be modified (e.g., bayonet-shaped), as well as their basic dimensions (e.g., smaller and longer), in order to fulfill the specific requirements of microscope-assisted surgery. Depending on the anatomical area and the number of segments being approached, surgery can be started with either microscopic or macroscopic techniques. Usually, mono- or bisegmental pathologies on the lumbar spine (disc herniation, lumbar spinal stenosis) can be done by a skin-to-skin technique with microscope assistance from beginning to end.

In multisegmental decompression surgery, for example due to lumbar spinal stenosis, initial macroscopic preparation down to the interlaminar windows and subsequent use of the microscope might save time.

4.1 Classification of Instruments
Instruments for spinal microsurgery can usually be divided into two major groups:

1. The first group is especially related to the approach from the skin down to the spinal canal, including skin opening, traversing soft tissue subcutaneous, transfascial, and paravertebral to the interlaminar window, and entering the spinal canal.

2. The second group is related to surgical procedures within the spinal canal and within the intervertebral disc space. Some instruments are effective in both groups (cautery, high-speed drills, suction devices), as ismentioned later on.

4.1.1 Instruments Related to the Approach

4.1.1.1 Instruments for Wound Opening
There is basically no big difference betweenmicroscopic and macroscopic instruments for opening the skin even when using the microscope from the beginning. Standardized incision scalpels serve to open the skin and to traverse the subcutaneous tissue. Forceps of standard size and length can be used for skin and tissue retraction, however, delicate forceps such as Adson forceps are more comfortable under microscope assistance.mehr

Bitte warten - die Druckansicht der Seite wird vorbereitet.

Minimally Invasive Spine Surgery

Verfügbare Formate

Produkt

Inhalt/Kritik

Schlagworte

Autor

Surgery for Low Back Pain

Arthroplasty of the Spine

The Artificial Disc

Surgery for Low Back Pain

Surgery for Low Back Pain

Services

Infos

Über uns

Leistungen

Newsletter

Zahlung