Degenerative Cervical Myelopathy and Radiculopathy: Treatment Approaches and Options

ISBN-13: 9783319979519 / Angielski / Twarda / 2019 / 431 str.

Kaiser, Michael G.

Opis

Degenerative disorders of the cervical spine are among the more common reasons why patients seek medical attention or consult with a spine specialist. These conditions can lead to neck pain and/or neurological deficit that can significantly compromise an individual's quality of life. Despite the regularity of these conditions, there remains both uncertainty and controversy regarding optimal management. No standard of care exists, however there are nuances related to a patients history, clinical presentation, and imaging that may make one approach more conducive to clinical success. This text is intended to serve as a comprehensive, up-to-date resource for clinicians involved in the management of patients with cervical degenerative disease. The text is divided into sections, organized in a clinically strategic manner. The initial chapters address the basics of cervical spine anatomy and biomechanics as well as the pathophysiology leading to various cervical degenerative disorders and the possible neurological sequelae. Subsequent chapters outline characteristics of the clinical presentation and the various diagnostic modalities to evaluate these patients. Key elements involved in the surgical-decision making process are covered, providing the necessary elements to establish a solid foundation for treatment planning. The final sections discusses specific procedures; including traditional approaches as well as more recent developments such as motion preservation surgery and minimally invasive techniques. The last section focuses on challenging clinical scenarios that require advanced surgical consideration. Individual chapters are organized with an introductory outline containing key chapter elements. Chapters focusing on specific pathological entities include discussions regarding pathophysiology, genetics, and risk factors. Those describing surgical procedures include a discussion on indications/contraindications, pre-operative planning, surgical technique, post-operative care, and complication avoidance. Chapter authors present their personal experience enhancing the information from current, evidence-based, referenced material. When appropriate, case presentations are added to provide a practical application of chapter's key points. This text, based on relevant, up-to-date clinical information and the cumulative experience of current spine experts, offers physicians the necessary tools involved in the decision-making process to formulate the optimal treatment plan for an individual patient. In addition, identification of knowledge gaps will hopefully stimulate future research and the evolution of cervical spondylotic treatments.

Recenzje

"The book is beautifully written ... allowing the readers to have a very experienced view in all aspects related to cervical degenerative disease from anatomy to surgical techniques." (Jesus Lafuente, Operative Neurosurgery, Vol. 86 (2), February, 2020)

Spis treści

Part I The Basics

Functional Anatomy of the Spinal Cord

Cervical Spine Biomechanics

Cervical Alignment and Sagittal Balance

Degenerative Cervical Myelopathy: A Spectrum of Degenerative Spondylopathies

Pathobiology of Cervical Radiculopathy and Myelopathy

Natural History of Cervical Degenerative Disorders

Part II Evaluation and Diagnosis of Cervical Spondylotic Disorders

Fundamentals of Cervical Neurological Exam

Clinical Assessment Tools

Radiographic Modalities

Alternative Diagnostic Tools

Part III Surgical Decision-Making

Failure of Nonoperative Management

Timing of Operative Intervention

Surgical Approach Decision-Making

Utility of Intraoperative Neuromonitoring

Factors Predictive of Operative Outcome

The Cost-Effectiveness of Various Surgical Procedures in the Cervical Spine

An Overview of Various Surgical Approaches

Part IV Motion Preservation Surgery for Cervical Degenerative Disorders

Posterior Laminoforaminotomy for Radiculopathy

Cervical Laminoplasty

Cervical Disc Arthroplasty

MIS Approaches for Cervical Spondylotic Disease

Part V Fusion Techniques for Cervical Degenerative Disorders

Degenerative Cervical Myelopathy and Radiculopathy: Treatment Approaches and Options—Anterior Cervical Discectomy and Fusion

Anterior Cervical Corpectomy

Multilevel ACDF Versus Corpectomy

Options for Interbody Grafting

Anterior Fixation Plating

Cervical Laminectomy and Fusion

Biological Enhancers of Fusion

Part VI Challenges of Cervical Fixation

Occipitocervical Stabilization

Alternative Means of Posterior Cervical Stabilization

Atlantoaxial Stabilization

Reconstructive Procedures in the Osteoporotic Patient

The Cervicothoracic Junction

Osteotomy for Cervical Kyphosis.

O autorze

Michael G. Kaiser

The Neurological Institute 

Columbia University   

New York, NY

USA

Regis W. Haid

Atlanta Brain and Spine Care

Atlanta, GE

USA

Christopher I. Shaffrey

University of Virginia Health System

Charlottesville, VA

USA

Micheal G. Fehlings

Department of Surgery and Spine Program

University of Toronto

Division of Neurosurgery

Toronto Western Hospital

Toronto, Ontario

Canada

Blurb

This book is intended to serve as a comprehensive, up-to-date resource for clinicians involved in the management of patients with cervical degenerative disease. The text is divided into sections, organized in a clinically strategic manner. Initial chapters address the basics of cervical spine anatomy and biomechanics as well as the pathophysiology leading to various cervical degenerative disorders and the possible neurological sequelae. Subsequent chapters outline characteristics of the clinical presentation and the various diagnostic modalities to evaluate these patients. Key elements involved in the surgical-decision making process are covered, providing the necessary elements to establish a solid foundation for treatment planning. The final sections discuss specific procedures; including traditional approaches as well as more recent developments such as motion preservation surgery and minimally invasive techniques. Individual chapters are organized with an introductory outline containing key chapter elements. Chapters focusing on specific pathological entities include discussions regarding pathophysiology, genetics, and risk factors. Those describing surgical procedures include a discussion on indications/contraindications, pre-operative planning, surgical technique, post-operative care, and complication avoidance. Chapter authors present their personal experience enhancing the information from current, evidence-based, referenced material. When appropriate, case presentations are added to provide a practical application of chapter’s key points.