By Florian Ringel MD, Jimmy Villard MD, Yu-Mi Ryang MD, Bernhard Meyer MD (auth.), Johannes Schramm (eds.)
This quantity of Advances and Technical criteria in Neurosurgery is dedicated solely to the backbone. Like different volumes within the sequence, it provides very important contemporary development within the box and provides unique descriptions of normal tactics to aid younger neurosurgeons. one of the advances thought of are ways to spinal navigation, together with intraoperative imaging established navigation, and ideas of spinal robotics. the price of sagittal stability as a parameter for the neurosurgeon is tested, and a singular surgical method of longitudinal pathologies in the spinal canal is gifted. advancements in surgical procedure for kyphosis also are mentioned, with a spotlight on pedicle subtraction osteotomy. The technical criteria part seriously reports the most recent facts concerning cervical disc arthroplasty and pedicle-based non-fusion stabilization units. The ebook concludes by way of discussing the remedy of craniovertebral junction instability due to juvenile persistent arthritis.
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Extra resources for Advances and Technical Standards in Neurosurgery: Volume 41
7 Postoperative axial CT scan image shows the distracted spinous process and the PEEK cage between the facing bony parts in the cervical region allowing moderate enlargement of the spinal canal 53 54 P. Banczerowski et al. a b Fig. 8 The intraoperative photograph shows the spinous process splitting in the midline (a) with a specially lengthened craniotome blade (laminotome) (b) of the vertebral arch immediately above the dura. This is facilitated by visualizing the epidural space and opening the retractor with gentle but progressive force in order to prevent the fracture of the spinous process during distraction.
Roussouly and Pinheiro-Franco  proposed a functional segmentation of the spine curve in the sagittal plane, where the Sagittal Balance, a Useful Tool for Neurosurgeons? 27 limits of the curves are defined by the point where the orientation of the curves changes. As a consequence, there can be short and long lumbar lordosis, when the lumbar curvature extends to the lower thoracic area for instance. The contribution of each lumbar vertebra increases progressively from L1 to S1, therefore 2/3 of the overall lordosis is shown in the lower lumbar spine L4–S1 [11, 12], which is a crucial parameter to take into account when instrumenting the lumbar spine.
The lower PI values are around 30°, which implies a vertical position of the pelvis and a short pelvic ring with femoral heads just below the sacral plate . Patients with a low PI have therefore a small capacity to compensate their sagittal imbalance through pelvis retroversion and are more prone to spinal pathologies. On the other hand, patients with high PI need a big LL to be balanced and are more prone to post-fusion problems related to an insufficient lordosis in the instrumented segments.
Advances and Technical Standards in Neurosurgery: Volume 41 by Florian Ringel MD, Jimmy Villard MD, Yu-Mi Ryang MD, Bernhard Meyer MD (auth.), Johannes Schramm (eds.)