Spinal Deformities The Comprehensive Text Thieme Spinal Deformities The Comprehensive Text Ronald L. Professor of Orthopaedic Surgery Rush Medical College Chicago, Illinois Vincent Arlet, M. Associate Professor of Orthopaedic Surgery McGill University Montreal, Canada Allen L. Associate Professor of Orthopaedic Surgery Albany Medical College Albany, New York Michael F.
Assistant Professor of Orthopaedic Surgery Colorado Health Sciences Center Denver, Colorado Thieme New York Stuttgart Thieme Medical Publishers, Inc. New York, NY 10001 Consulting Editor: Esther Gumpert Assistant Editor: Owen Zurhellen Director, Production and Manufacturing: Anne Vinnicombe Production Editor: Becky Dille Marketing Director: Phyllis Gold Sales Manager: Ross Lumpkin Chief Financial Officer: Peter van Woerden President: Brian D. Scanlan Compositor: Thomson Press (India) Limited Printer: Maple-Vail Book Manufacturing Group Library of Congress Cataloging-in-Publication Data Spinal deformities : the comprehensive text / [edited by] Ronald L. Includes bibliographical references.
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Readers are encouraged to confirm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text.
Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. Printed in the United States of America 5 4 3 2 1 TMP ISBN 1-58890-089-4 GTV ISBN 3 13 130551 7 CONTENTS Foreword 1 xi Foreword 2 xii Preface xiii Acknowledgments xiii Dedication xiii List of Contributors xiv SECTION 1 Gross Anatomy—John E. Lonstein, section editor 1 1 Surgical Anatomy of the Sacrum and Pelvis 2 Vincent Arlet 2 Surgical Anatomy of the Lumbar Spine 14 Vincent Arlet 3 Surgical Anatomy of the Thoracic Spine 25 Michael F. O’Brien 4 Surgical Anatomy of the Cervical Spine 33 Michael F.
O’Brien 5 Muscles and Ligaments 46 John E. Lonstein SECTION 2 Microanatomy—Vincent Arlet, section editor 53 6 Development and Maturation of the Spine and Spinal Cord 54 John A. Ogden and Timothy M. Ganey 7 Microscopic Anatomy of Bone 72 Harvinder S.
Sandhu 8 Macro- and Microscopic Anatomy of the Disk and End Plate 78 Vincent Arlet and John Antoniou 9 Nervous System 90 Michael F. O’Brien SECTION 3 Physiology—Lawrence G. Lenke, section editor 115 10 Physiology of Bone 116 Harvinder S. Sandhu v vi Contents 11 Nerve and Muscle Physiology 121 Daniel E.
Gelb 12 Pulmonary and Chest Cage Physiology 126 Lawrence G. Lenke 13 Electrophysiology 135 Anne P. Padberg 14 Cerebral Spinal Fluid Physiology 149 Lawrence G. Lenke SECTION 4 Biomechanics—Thomas R.
Haher, section editor 153 15 Biomechanics 154 Thomas R. Haher and Steven Caruso 16 Biomechanics of the Intervertebral Disk 172 Andrew Merola, Andrew Castro, Steven Enguidanos, and Thomas R. Haher 17 Spine Testing Modalities 176 Amy Yeung, Danielle Ottaviano, Dennis Lee, and Thomas R. Haher SECTION 5 Pharmacology—George H.
Thompson, section editor 187 18 Antibiotic Therapy in Spine Surgery 188 Robert P. Huang and George H. Thompson 19 Osteoporosis: Evaluation and Pharmacologic Treatment 195 Edgar G. DeWald, and Aurelia Nattiv 20 Pharmacologic Agents that Minimize Perioperative Blood Loss in Spine Surgery 200 George H.
Thompson and Laurel C. Blakemore 21 Common Medications in Spinal Afflictions 206 Christopher J. Bergin SECTION 6 Pathology—John P. Kostuik, section editor 211 22 Pathophysiology of Lumbar Degenerative Disk Disease 212 Mesfin Lemma and John P.
Kostuik 23 Spinal Inflammatory Arthritides 216 Uri M. Ahn, Khaled Kebaish, Nicholas Ahn, and John P. Kostuik 24 Spinal Neuroarthropathy (Charcot’s Spine) 218 Khaled M. Kebaish and John P.
Kostuik 25 Pyogenic Vertebral Infection 221 Cameron Bruce Huckell and John P. Kostuik 26 Coagulation Disorders in Spine Surgery 237 Uri M. Ahn, and Khaled Kebaish, Nicholas Ahn, and John P. Kostuik Contents vii 27 Blood Conservation Strategies in Spine Surgery 239 Michael G.
Roye, and David P. Roye 28 Management of Metastatic Disease to the Spine 249 Lee H. Riley III, David B. Cohen, Khaled Kebaish, and John P.
Kostuik SECTION 7 Clinical Evaluation—Robert W., section editor 257 29 Evaluation of the Patient with Congenital Spine Deformity 258 Robert B. Winter 30 Clinical Evaluation of the Patient with a Spine Deformity (Scoliosis, Kyphosis) 267 Robert W. Gaines 31 Clinical Evaluation for Neuromuscular Scoliosis and Kyphosis 272 Vernon T. Tolo 32 Evaluation of Back Pain in the Spinal Deformity Patient 284 Mark B.
Dekutoski SECTION 8 Neurology—James W. Ogilvie, section editor 301 33 Spinal Cord Injury, Reflexes, and Syndromes 302 Kirkham B. Wood 34 Anterior Horn Cell Disease: Poliomyelitis, Spinal Muscular Atrophy, Acute Transverse Myelitis 307 James W. Ogilvie 35 Congenital and Developmental Spinal Cord Abnormalities: Syringomyelia, Tethered Cord, Diastematomyella, Diplomyelia 311 James W.
Ogilvie 36 The Spine in Friedrich’s Ataxia, Charcot-Marie-Tooth Disease, and Familial Dysautonomia 313 John P. Lubicky 37 Cerebral Palsy, Myelodysplasia, Hydrosyringomyelia, Rett Syndrome, and Muscular Dystrophies 316 John V. Banta SECTION 9 Anesthesia—Kim W. Hammerberg, section editor 327 38 Anesthetic Considerations for Spinal Surgery 328 Timothy W.
Starck, Daniel Levinthal, and Yvonne Lomax Burnett SECTION 10 Radiology—Mark Weidenbaum, section editor 349 39 Radiology 350 Mark Weidenbaum and Richard M. Shore viii Contents SECTION 11 Rehabilitation—John P. Lubicky, section editor 383 40 Rehabilitation 384 John P. Lubicky SECTION 12 Treatment of the Adult Spine—Donald P.
Chan, section editor 391 41 Operative Management of Degenerative Lumbar Stenosis 392 Donald P. Erik Westerlund 42 Degenerative Disk Disease and Degenerative Spondylolisthesis of the Lumbar Spine 397 Thomas G. Lowe 43 Adult Spine Trauma 406 Allen L. Carl 44 Inflammatory Arthritis of the Spine 424 Sanford E.
Emery 45 Vertebral Osteomyelitis 443 Sanford E. Emery 46 Neoplasms of the Spinal Column 450 Allen L. Carl, Tipu Nazeer, and David Prybyla SECTION 13 Surgical Techniques—Keith H. Bridwell, section editor 477 47 Tables and Positioning 478 Christopher L.
Hamill and Vincent Arlet 48 Halo and Cranial Traction 487 K. Daniel Riew, Timothy R. Kuklo, and Lawrence G. Lenke 49 Approaches to the Cervical Spine 497 K.
Daniel Riew and Timothy R. Kuklo 50 Open Thoracic and Lumbar Spine Surgical Approaches 506 Peter O. Newton 51 Cervical Decompression 517 K. Daniel Riew and Timothy R.
Kuklo 52 Decompression for Lumbar Spinal Stenosis 528 K. Daniel Riew and Stephen Lewis 53 Spine Fusion 540 Christopher L. Hamill 54 Spine Osteotomy and Resection 551 Keith H. Bridwell 55 Staging Plus Complications of Approaches 562 Keith H.
Bridwell Contents ix 56 Thoracoplasty 568 Peter O. Newton 57 Endoscopic and Mini-Open Approaches to the Spine 571 Peter O. Newton SECTION 14 Instrumentation and Complications—Denis S. Drummond, section editor 577 58 Basic Principles of Deformity Correction 578 Marc A.
Asher 59 A Biomechanical Approach to Posterior Spinal Instrumentation: Principles and Applications 588 Bryan W. Cunningham 60 Sacropelvic Fixation in Spinal Deformity 601 Michael F. O’Brien 61 Neurological Injury Complicating Surgery 615 Denis S. Johnston, and James F.
Farmer 62 Postoperative Complications 626 B. Stephens Richards 63 Revision Surgery 634 Jean-Pierre C. Farcy and Frank J. Schwab SECTION 15 Pediatric Spine—Dennis R.
Wenger, section editor 655 64 Etiology of Scoliosis 656 Thomas G. Lowe, Michael Edgar, Joseph Y. James Raso, and Kent A. Reinker 65 Idiopathic Scoliosis: Prevalence and Natural History 669 James O.
Moreland, and George S. Bassett 66 Congenital Scoliosis and Kyphosis 684 Randall T. Loder 67 Inflammatory and Infectious Disorders of the Child’s Spine 694 Paul Sponseller 68 The Spine in Skeletal Syndromes and Dysplasias 701 Paul Sponseller 69 Neuromuscular Scoliosis 718 Peter O. Newton 70 Pediatric Spine Trauma 730 Behrooz A.
Akbarnia 71 Spine Tumors in Childhood and Adolescence 743 Dennis R. Wenger x Contents SECTION 16 Deformities—Michael G. Neuwirth, section editor 751 72 Idiopathic Scoliosis: General Considerations, Natural History, and Treatment Guidelines 752 Jose A. Morcuende and Stuart L.
Weinstein 73 Bracing in Scoliosis 755 William A. Carr 74 Spinal Deformities Associated with Metabolic Diseases 761 John B. Emans 75 Perioperative Blood and Blood Product Management for Spinal Deformity Surgery 771 David W. Kuklo 76 Scheuermann’s Kyphosis 777 Oheneba Boachie-Adjei and Vishal Sarwahi 77 Spondylolysis and Spondylolisthesis 787 Kim W.
Hammerberg 78 Intraoperative and Immediate Postoperative Complications of Spinal Deformity Surgery 801 Vincent Arlet Glossary 809 Allen L. Carl Index 819 FOREWORD 1 The impetus and purpose of this text is to define and describe The purpose of development of this core curriculum goes the core curriculum of the subspecialty of spinal deformity far beyond meetings and textbooks. The philosophy and surgery. The definition of the focus of the core, spinal nature of the text support the evolution of spinal deformity as deformity, is necessarily and correctly broad.
A general a unique body of knowledge, and a separate discipline. This definition of spinal deformity is ‘‘any condition which alters leads to additional possibilities, particularly designation of the anatomy or functional integrity of the spinal motion spinal deformity surgery as a certified subspecialty.’’ The central theme of this text is spinal deformity, development of the core curriculum is the first and major and all other sections are subordinate to the focus. step to realizing this goal. The genesis of ‘‘The Comprehensive Text’’ lies in the The Board of the Scoliosis Research Society has supported vision of Dr.
Ron DeWald, desiring spinal deformity to be seen continual action towards attaining the recognition of spinal as a unique body of knowledge. During his presidency of the deformity surgery as an approved subspecialty. Considerable Scoliosis Research Society, Don Chan needed a core curricu- work remains to attain the approval of the American Board of lum to present to the residency review committee for approval Medical Specialties. The application process is lengthy, with of his spinal fellowship.
Chan realized the lack of existence well-defined requirements. It is evident that this core is a of a core curriculum, and appointed a Scoliosis Research unique body of information, and meets the criteria for a Society ad hoc committee to develop a core curriculum. It remains the work of the Scoliosis Research Dr. Ron DeWald was the choice to head up this effort, a Society to continue this effort to gain subspecialty natural.
The needs of Dr. Don Chan met with the vision of Dr. Ron DeWald, resulting in this text, ‘‘Spinal Deformities: The The final goal remains years away, and thousands of hours Comprehensive Text’’. The SRS will continue to support this effort.
With the support of the Board of the Scoliosis Research Unification of the many splintered groups in the care of the Society, Dr.