Spinal disorders are a priority for healthcare systems internationally. Offering unparalleled, comprehensive coverage of the pathogenesis, evaluation and management of spinal disorders, Benzel’s Spine Surgery: Techniques, Complication Avoidance, and Management, 6th Edition, remains the definitive text in this challenging field. Written and edited by world-renowned experts, this two-volume masterwork covers everything a practicing spine surgeon, non-operative provider, and trainee needs to know—from fundamentals, biomechanics, applied anatomy, instrumentation, and pathophysiology of spinal disorders to all types of spine techniques, motion preservation strategies, non-surgical management, complication avoidance and management, and controversies. Nearly 200 fully revised, well-illustrated chapters keep you up to date with the latest advancements in spine surgery.
"This book is a must-have and a gold standard in textbooks on spine surgery…. Compared to other textbooks, the thoroughness, variety of information and resources, and in-depth expert discussion of topics is unique… 5 Stars!" —Doody's Review Service, review of the previous edition
1. Title of Book - p. i 2. Cover image - p. i 3. Title page - p. i 4. Table of Contents - p. i 5. Copyright - p. ii 6. Dedication - p. iii 7. List of Contributors - p. v 8. Preface - p. xix 9. Volume 1 - p. V1 10. Fundamentals of the Spine - p. P1 11. Section 1.1 Implant Properties - p. P1 12. 1 History of Spine Surgery - p. 1 13. 2 History of Spine Biomechanics - p. 18 14. 3 History of Spinal Instrumentation: The Modern Era - p. 29 15. 4 Functional Anatomy of the Spine - p. 40 16. 5 Biomechanical Modeling of the Spine - p. 54 17. 6 The Intervertebral Disc: Anatomy, Physiology, and Aging - p. 61 18. 7 Muscles and the Spine: Dynamic Stabilization - p. 66 19. 8 Bone Physiology and Osteoporosis - p. 74 20. 9 Applied Anatomy of the Thoracolumbar Spine - p. 85 21. 10 Fundamentals of Spinal Alignment and Balance: Key Radiographic Measurements and a Practical Guide to Understanding Spinal Deformity and Alignment - p. 106 22. 11 Applied Anatomy of the Spinal Cord - p. 119 23. 12 Molecular and Anatomic Mechanisms of Nerve Root, Spinal Nerve, and Peripheral Nerve Injury - p. 131 24. 13 Spine Fusion: Biology and Biomechanics - p. 136 25. 14 Complications in Spine Surgery: Expected Rates and Classification - p. 144 26. Section 1.2 Biomechanics and Biology - p. 152.e2 27. 15 Osteointegration: The Bone and Implant Interface - p. 153 28. 16 Biomechanics and Implant Materials: The Anterior Column - p. 159 29. 17 Biomechanics and Implant Materials: The Posterior Column - p. 165 30. 18 Biomechanics of Motion Preservation Techniques - p. 171 31. 19 Biologic Response to Spinal Instrumentation Particulate Wear Debris–Emphasis on Implant Wear Degradation, and Breakage - p. 177 32. 20 Tribology and Material Contact Science in Spine Surgery: Implications for Implant Design - p. 185 33. Pathophysiology of Spinal Disorders - p. P2 34. Section 2.1 Pathophysiology of Congenital and Developmental Disorders - p. P2 35. 21 Spinal Cord Dysraphisms and Myelodysplasia - p. 192 36. 22 Congenital Spinal Deformity - p. 205 37. 23 Early-Onset Scoliosis - p. 224 38. 24 Late-Onset Idiopathic Scoliosis - p. 235 39. 25 Scheuermann Disease - p. 241 40. 26 Developmental Spondylolisthesis - p. 266 41. 27 Craniovertebral Junction and Atlantoaxial Alterations - p. 274 42. 28 Congenital and Developmental Deformities of the Cervical Spine - p. 287 43. 29 Dural and Meningeal Pathologies - p. 295 44. 30 Tarlov Cysts - p. 303 45. 31 Chiari Malformations and Syringomyelia - p. 310 46. Section 2.2 Pathophysiology of Degenerative Disorders - p. 317.e3 47. 32 Pathophysiology of Intervertebral Disc Degeneration and Pain - p. 318 48. 33 Pathophysiology of Cervical Spondylosis, Radiculopathy, and Myelopathy - p. 329 49. 34 Pathophysiology of Thoracic Spondylosis, Radiculopathy, and Myelopathy - p. 338 50. 35 Amyloid Deposition Syndromes - p. 347 51. Section 2.3 Deformity - p. 352.e2 52. 36 Deformity in the Cervical Spine - p. 353 53. 37 Pathophysiology, Evaluation, and Management of Adult Degenerative Scoliosis - p. 360 54. 38 Surgical Treatment for Lumbar Spondylolisthesis - p. 369 55. Section 2.4 Pathophysiology of Traumatic Disorders - p. 373.e2 56. 39 Neuromuscular Disorders in the Pediatric Spine - p. 374 57. 40 Neuromuscular Disorders and Deformity in the Adult Spine - p. 383 58. 41 Occipitocervical Injuries - p. 392 59. 42 Subaxial Cervical Spine Injuries - p. 401 60. 43 Thoracic and Lumbar Spine Injuries - p. 416 61. 44 Peripheral Nerve Injury - p. 426 62. 45 Spinal Cord Injury - p. 441 63. 46 Spinal Injuries in Sports - p. 450 64. Section 2.5 Pathophysiology of Inflammatory and Infectious Disorders - p. 458.e3 65. 47 Rheumatoid Arthritis - p. 459 66. 48 Ankylosing Spondylitis and Other Disorders - p. 477 67. 49 Ossification of the Posterior Longitudinal Ligament - p. 485 68. 50 Primary Infections of the Spine - p. 492 69. Spinal Infections - p. 492 70. Pyogenic Infections: Spondylodiscitis, Vertebral Osteomyelitis, and Epidural Abscess - p. 493 71. Epidemiology - p. 493 72. Etiology - p. 493 73. Pathophysiology - p. 493 74. Clinical Presentation and Course - p. 493 75. Diagnostic Modalities and Imaging - p. 493 76. Classification System - p. 495 77. Treatment - p. 495 78. Spinal Epidural Abscess - p. 502 79. Modic Changes and Subclinical Infections - p. 502 80. Clinical Outcome, Treatment Failure, and Relapse - p. 502 81. Tubercular Spondylodiscitis - p. 502 82. History and Background - p. 502 83. Epidemiology - p. 503 84. Etiopathogenesis - p. 503 85. Histopathology of Tubercular Lesions - p. 503 86. Pathogenesis of Deformity Progression in Adults versus Children - p. 504 87. Clinical Presentation - p. 504 88. Atypical Presentations - p. 506 89. Diagnostic Investigations - p. 506 90. Treatment - p. 507 91. Other Granulomatous Spinal Lesions - p. 514 92. Brucellosis - p. 514 93. Fungal Infections - p. 514 94. Conclusion - p. 515 95. 51 Secondary Infections of the Spine - p. 517 96. Section 2.6 Pathophysiology of Neoplastic Disorders - p. 521.e2 97. 52 Primary Tumors of the Spine - p. 522 98. 53 Metastatic Tumors of the Spine - p. 538 99. 54 Intradural Extramedullary Spine Tumors - p. 546 100. 55 Intramedullary Spinal Cord Lesions - p. 555 101. 56 Tumors of the Peripheral Nerve Including Brachial Plexus - p. 567 102. Section 2.7 Pathophysiology of Syndromic Disorders Affecting the Spine: Connective Tissue and Vascular - p. 572.e2 103. 57 Spinal Disorders Associated with Connective Tissue Disorders - p. 573 104. 58 Osteoporosis, Osteomalacia, and Metabolic Bone Disease - p. 581 105. 59 Vascular Malformations of the Spine - p. 594 106. Section 2.8 Pathophysiology of Postoperative Spinal Disorders - p. 604.e4 107. 60 Postoperative Spinal Disorders—Cervical - p. 605 108. 61 Postoperative Spinal Deformity - p. 611 109. 62 Adjacent Segment Degeneration and Disease of the Cervical Spine - p. 622 110. 63 Adjacent Segment Degeneration and Disease of the Lumbar Spine - p. 627 111. 64 Proximal and Distal Junctional Kyphosis and Failure - p. 633 112. Evaluation of Patients with Spinal Disorders - p. P3 113. 65 Physical and Neurological Examination - p. 640 114. 66 Sagittal Spinal Alignment: An Evolutionary Perspective - p. 649 115. 67 Spinal Alignment: Significance and Preoperative Planning - p. 659 116. 68 Overview of Imaging Procedures Available for Spinal Diagnosis - p. 664 117. 69 Electrodiagnostic Studies - p. 670 118. 70 Differential Diagnosis of Surgical Disorders of the Spine - p. 680 119. 71 Patient Selection for Spine Surgery: Preoperative Optimization - p. 698 120. 72 Evaluation of the Aging Patient - p. 704 121. 73 Preoperative Evaluation of Psychosocial Aspects and Work-Related Issues - p. 709 122. 74 Preoperative Evaluation of Patients with Tumors Affecting the Spine - p. 713 123. 75 Measuring Preoperative Health-Related Quality of Life: What Metrics Matter - p. 724 124. Volume 2 - p. V2 125. Management of Spinal Disorders - p. P4 126. Section 4.1 Nonoperative Approaches - p. P4 127. 76 Rehabilitation and Interventions in Management of Spinal Disorders - p. 729 128. 77 Spine Injections - p. 734 129. 78 Cognitive Behavioral Therapy and Back Pain - p. 753 130. 79 Regenerative Strategies and Intervertebral Disc Degeneration - p. 761 131. 80 Neuromodulation and Rehabilitative Interventions for the Spine - p. 765 132. 81 Pain Management: Opioids and Alternatives - p. 772 133. Section 4.2 Operative Management of Spinal Disorders: Overview and Principles - p. 775 134. 82 Fundamentals of Spine Surgery - p. 776 135. 83 Perioperative Management Protocols: Enhanced Recovery After Surgery - p. 780 136. 84 Surgical Incisions, Positioning, and Retraction - p. 788 137. 85 Intraoperative Imaging Protocols - p. 809 138. 86 Anesthesia for Spine Surgery and the Prevention of Complications - p. 818 139. 87 Intraoperative Neurophysiologic Monitoring in Routine and Complex Surgery - p. 837 140. 88 Perioperative Management of Blood Loss in Complex Spine Surgery - p. 846 141. 89 Intraoperative Crisis Management in Spine Surgery: What to Do When Things Go Bad - p. 857 142. 90 Biologics in Spine Fusion Surgery - p. 867 143. 91 Common Complications in Spine Surgery: Pseudarthrosis - p. 873 144. 92 Postoperative Medical Complications - p. 883 145. 93 Preventing Postoperative Infections: An Evidence-Based Approach - p. 889 146. 94 Neurological Complications of Common Spine Operations - p. 894 147. 95 Cerebrospinal Fluid Leak: Repair and Outcomes - p. 899 148. 96 Arachnoiditis and Syringomyelia - p. 904 149. 97 Posttraumatic and Idiopathic Syringomyelia - p. 909 150. 98 Vascular and Soft Tissue Complications - p. 914 151. 99 Thromboembolic Disease in Spine Surgery - p. 925 152. 100 Postoperative Spinal Deformities - p. 930 153. 101 Revision of Cervical Disk Arthroplasty - p. 939 154. 102 Readmissions and Reoperation in Spine Surgery: The Use of Predictive Analytics - p. 945 155. Section 4.3 Operative Management of Spinal Disoders: Occipital and Cervical - p. 950 156. 103 Cervical Spine Construct Design - p. 952 157. 104 Occipitocervical Spine Approaches for Decompression - p. 961 158. 105 Upper Cervical Screw Fixation Techniques - p. 972 159. 106 Endoscopic and Transnasal Approaches to the Craniocervical Junction - p. 986 160. 107 Cervical Spine and Cervicothoracic Junction—Posterior - p. 997 161. 108 Posterior Cervical Decompressions: Cervical Laminectomy and Laminoforaminotomy - p. 1007 162. 109 Cervical Laminoplasty - p. 1010 163. 110 Dorsal Subaxial Cervical Instrumentation Techniques - p. 1015 164. 111 Posterior Percutaneous and Minimally Invasive Approaches to Decompression and Arthrodesis of the Cervical Spine - p. 1022 165. 112 Cervical Spine and Cervicothoracic Junction—Anterior Approach - p. 1030 166. 113 Anterior Cervical Discectomy and Corpectomy - p. 1043 167. 114 Management of Soft Cervical Disc Herniation: Controversies and Complication Avoidance - p. 1054 168. 115 Anterior Subaxial Cervical Fixation and Fusion Techniques - p. 1058 169. 116 Cervical Total Disc Arthroplasty - p. 1064 170. 117 Combined Ventral-Dorsal Surgery - p. 1068 171. Section 4.4 Operative Management of Spinal Disorders: Thoracolumbar - p. 1072.e1 172. 118 Thoracic and Lumbar Spine Construct Design - p. 1073 173. 119 Posterior Approaches to the Thoracic Spine - p. 1082 174. 120 Anterior and Lateral Approaches to the Thoracic Spine - p. 1089 175. 121 Posterolateral Thoracolumbar Fusion - p. 1100 176. 122 Transforaminal Lumbar Interbody Fusion - p. 1105 177. 123 Posterior Thoracolumbar Fixation Techniques - p. 1116 178. 124 Midline Lumbar Interbody Fusion With Cortical-Bone-Trajectory Pedicle Screw Placement - p. 1130 179. 125 Dorsal Semirigid Stabilization - p. 1138 180. 126 Lumbar Total Disc Arthroplasty - p. 1148 181. 127 Minimally Invasive Spinal Decompression and Stabilization Techniques: Philosophy and Rationale - p. 1160 182. 128 Posterior Approaches to the Lumbar Spine: Minimally Invasive Decompression - p. 1169 183. 129 Endoscopic Approaches to the Cervical Spine - p. 1178 184. 130 Endoscopic Surgical Approaches to the Lumbar Spine - p. 1185 185. 131 Posterior Approaches to the Lumbar Spine: Minimally Invasive Fusion - p. 1193 186. 132 Anterior Lumbar Interbody Fusion - p. 1201 187. 133 Minimally Invasive Surgery Approaches: Anterior and Anterolateral Lumbar Spine Interbody Fusion - p. 1212 188. 134 Complex Lumbosacropelvic Fixation Techniques - p. 1224 189. 135 Spinopelvic Fixation for Posterior Pelvic and Lumbosacral Injuries - p. 1235 190. 136 Spinal Augmentation for Vertebral Compression Fractures - p. 1244 191. Operative Management of Specific Disorders of the Spine - p. P5 192. Section 5.1 Degenerative Pathologies - p. P5 193. 137 Indications for Spine Fusion for Axial Pain - p. 1250 194. 138 Cervical Disc Herniation - p. 1259 195. 139 Cervical Spondylotic Myelopathy - p. 1266 196. 140 Lumbar Disc Herniation - p. 1272 197. 141 Thoracic Discectomy - p. 1277 198. 142 Degenerative Spondylolisthesis - p. 1285 199. 143 Spondylolysis and Low-Grade Spondylolisthesis - p. 1288 200. 144 Sacroiliac Joint Pain - p. 1295 201. Section 5.2 Spinal Deformity - p. 1302.e2 202. 145 Surgical Principles for Spinal Deformity - p. 1303 203. 146 An Approach for Treatment of Complex Adult Spinal Deformity - p. 1310 204. 147 Pediatric Spinal Deformity - p. 1318 205. 148 Cervicothoracic Deformity: The Role of Anterior Surgery - p. 1335 206. 149 The Role of Anterior Surgery for Thoracolumbar Deformity - p. 1344 207. 150 Anterior Column Realignment in Deformity - p. 1359 208. 151 Posterior-Based Osteotomies for Management of Spinal Deformity - p. 1364 209. 152 Minimally Invasive Approaches to Spinal Deformity - p. 1368 210. 153 Surgical Management of High-Grade Dysplastic Spondylolisthesis - p. 1376 211. 154 Failed Back Surgery Syndrome - p. 1387 212. Section 5.3 Tumors of the Spine - p. 1392 213. 155 Oncological Approaches and Outcomes for Primary Spine Tumors - p. 1393 214. 156 Staging, Classification, and Oncologic Approaches for Metastatic Tumors Involving the Spine - p. 1403 215. 157 Tumors at the Foramen Magnum and Craniocervical Junction - p. 1422 216. 158 Cervicothoracic Junction Tumors - p. 1436 217. 159 Thoracic and Thoracolumbar Spinal Tumors—Regional Challenges - p. 1442 218. 160 Sacral Tumors: Regional Challenges - p. 1459 219. 161 Radiosurgery for Spinal Tumors - p. 1471 220. Section 5.4 Trauma and the Spine - p. 1479.e4 221. 162 The Acute Management of Traumatic Spinal Cord Injury and Polytrauma - p. 1480 222. 163 Timing of Surgery Following Traumatic Spinal Cord Injury - p. 1485 223. 164 Medical Management of Adult and Pediatric Spinal Cord Injury - p. 1491 224. 165 Spinal Traction - p. 1501 225. 166 Medical Management of Fractures Without Spinal Cord Injury - p. 1507 226. 167 Anterior Surgery for Cervical Trauma - p. 1520 227. 168 Posterior Surgery for Cervical Trauma - p. 1533 228. 169 Surgical Approaches to Thoracolumbar Trauma - p. 1539 229. 170 Surgical Approaches for Sacral Fractures and Sacropelvic Injuries - p. 1557 230. 171 Rehabilitation and Recovery After Spinal Cord Injury - p. 1564 231. 172 Regenerative Techniques of Spinal Cord Injury - p. 1581 232. Section 5.5 General Surgical Technique - p. 1585 233. 173 Harvest of Autograft for Spinal Fusion - p. 1586 234. 174 Vascularized Bone Grafts in Spine Surgery - p. 1593 235. 175 Navigation and Robotics in Spine Surgery - p. 1599 236. Evidence Development and Guidance of Informed Choice for Optimal Outcomes - p. P6 237. 176 Big Data in Healthcare - p. 1602 238. 177 Spine Registries - p. 1615 239. 178 Conflicts of Interest in Spine Surgery - p. 1621 240. 179 Art of the Clinical Trial - p. 1626 241. 180 Meaningful Retrospective Analysis - p. 1634 242. 181 Art and Science of Guideline Formation - p. 1638 243. 182 Appropriate Use Criteria in Spine Surgery - p. 1644 244. 183 Precision Medicine: Artificial Intelligence Applied to Evaluation and Management of Spinal Disorders - p. 1650 245. 184 Healthcare Reform and Spine Surgery: Economic Impact and the Shift to Value-Based Care - p. 1661 246. 185 Development of New Technologies in Spine Surgery - p. 1670
Spinal disorders are a priority for healthcare systems internationally. Offering unparalleled, comprehensive coverage of the pathogenesis, evaluation and management of spinal disorders, Benzel’s Spine Surgery: Techniques, Complication Avoidance, and Management, 6th Edition, remains the definitive text in this challenging field. Written and edited by world-renowned experts, this two-volume masterwork covers everything a practicing spine surgeon, non-operative provider, and trainee needs to know—from fundamentals, biomechanics, applied anatomy, instrumentation, and pathophysiology of spinal disorders to all types of spine techniques, motion preservation strategies, non-surgical management, complication avoidance and management, and controversies. Nearly 200 fully revised, well-illustrated chapters keep you up to date with the latest advancements in spine surgery.
"This book is a must-have and a gold standard in textbooks on spine surgery…. Compared to other textbooks, the thoroughness, variety of information and resources, and in-depth expert discussion of topics is unique… 5 Stars!" —Doody's Review Service, review of the previous edition
1. Title of Book - p. i 2. Cover image - p. i 3. Title page - p. i 4. Table of Contents - p. i 5. Copyright - p. ii 6. Dedication - p. iii 7. List of Contributors - p. v 8. Preface - p. xix 9. Volume 1 - p. V1 10. Fundamentals of the Spine - p. P1 11. Section 1.1 Implant Properties - p. P1 12. 1 History of Spine Surgery - p. 1 13. 2 History of Spine Biomechanics - p. 18 14. 3 History of Spinal Instrumentation: The Modern Era - p. 29 15. 4 Functional Anatomy of the Spine - p. 40 16. 5 Biomechanical Modeling of the Spine - p. 54 17. 6 The Intervertebral Disc: Anatomy, Physiology, and Aging - p. 61 18. 7 Muscles and the Spine: Dynamic Stabilization - p. 66 19. 8 Bone Physiology and Osteoporosis - p. 74 20. 9 Applied Anatomy of the Thoracolumbar Spine - p. 85 21. 10 Fundamentals of Spinal Alignment and Balance: Key Radiographic Measurements and a Practical Guide to Understanding Spinal Deformity and Alignment - p. 106 22. 11 Applied Anatomy of the Spinal Cord - p. 119 23. 12 Molecular and Anatomic Mechanisms of Nerve Root, Spinal Nerve, and Peripheral Nerve Injury - p. 131 24. 13 Spine Fusion: Biology and Biomechanics - p. 136 25. 14 Complications in Spine Surgery: Expected Rates and Classification - p. 144 26. Section 1.2 Biomechanics and Biology - p. 152.e2 27. 15 Osteointegration: The Bone and Implant Interface - p. 153 28. 16 Biomechanics and Implant Materials: The Anterior Column - p. 159 29. 17 Biomechanics and Implant Materials: The Posterior Column - p. 165 30. 18 Biomechanics of Motion Preservation Techniques - p. 171 31. 19 Biologic Response to Spinal Instrumentation Particulate Wear Debris–Emphasis on Implant Wear Degradation, and Breakage - p. 177 32. 20 Tribology and Material Contact Science in Spine Surgery: Implications for Implant Design - p. 185 33. Pathophysiology of Spinal Disorders - p. P2 34. Section 2.1 Pathophysiology of Congenital and Developmental Disorders - p. P2 35. 21 Spinal Cord Dysraphisms and Myelodysplasia - p. 192 36. 22 Congenital Spinal Deformity - p. 205 37. 23 Early-Onset Scoliosis - p. 224 38. 24 Late-Onset Idiopathic Scoliosis - p. 235 39. 25 Scheuermann Disease - p. 241 40. 26 Developmental Spondylolisthesis - p. 266 41. 27 Craniovertebral Junction and Atlantoaxial Alterations - p. 274 42. 28 Congenital and Developmental Deformities of the Cervical Spine - p. 287 43. 29 Dural and Meningeal Pathologies - p. 295 44. 30 Tarlov Cysts - p. 303 45. 31 Chiari Malformations and Syringomyelia - p. 310 46. Section 2.2 Pathophysiology of Degenerative Disorders - p. 317.e3 47. 32 Pathophysiology of Intervertebral Disc Degeneration and Pain - p. 318 48. 33 Pathophysiology of Cervical Spondylosis, Radiculopathy, and Myelopathy - p. 329 49. 34 Pathophysiology of Thoracic Spondylosis, Radiculopathy, and Myelopathy - p. 338 50. 35 Amyloid Deposition Syndromes - p. 347 51. Section 2.3 Deformity - p. 352.e2 52. 36 Deformity in the Cervical Spine - p. 353 53. 37 Pathophysiology, Evaluation, and Management of Adult Degenerative Scoliosis - p. 360 54. 38 Surgical Treatment for Lumbar Spondylolisthesis - p. 369 55. Section 2.4 Pathophysiology of Traumatic Disorders - p. 373.e2 56. 39 Neuromuscular Disorders in the Pediatric Spine - p. 374 57. 40 Neuromuscular Disorders and Deformity in the Adult Spine - p. 383 58. 41 Occipitocervical Injuries - p. 392 59. 42 Subaxial Cervical Spine Injuries - p. 401 60. 43 Thoracic and Lumbar Spine Injuries - p. 416 61. 44 Peripheral Nerve Injury - p. 426 62. 45 Spinal Cord Injury - p. 441 63. 46 Spinal Injuries in Sports - p. 450 64. Section 2.5 Pathophysiology of Inflammatory and Infectious Disorders - p. 458.e3 65. 47 Rheumatoid Arthritis - p. 459 66. 48 Ankylosing Spondylitis and Other Disorders - p. 477 67. 49 Ossification of the Posterior Longitudinal Ligament - p. 485 68. 50 Primary Infections of the Spine - p. 492 69. Spinal Infections - p. 492 70. Pyogenic Infections: Spondylodiscitis, Vertebral Osteomyelitis, and Epidural Abscess - p. 493 71. Epidemiology - p. 493 72. Etiology - p. 493 73. Pathophysiology - p. 493 74. Clinical Presentation and Course - p. 493 75. Diagnostic Modalities and Imaging - p. 493 76. Classification System - p. 495 77. Treatment - p. 495 78. Spinal Epidural Abscess - p. 502 79. Modic Changes and Subclinical Infections - p. 502 80. Clinical Outcome, Treatment Failure, and Relapse - p. 502 81. Tubercular Spondylodiscitis - p. 502 82. History and Background - p. 502 83. Epidemiology - p. 503 84. Etiopathogenesis - p. 503 85. Histopathology of Tubercular Lesions - p. 503 86. Pathogenesis of Deformity Progression in Adults versus Children - p. 504 87. Clinical Presentation - p. 504 88. Atypical Presentations - p. 506 89. Diagnostic Investigations - p. 506 90. Treatment - p. 507 91. Other Granulomatous Spinal Lesions - p. 514 92. Brucellosis - p. 514 93. Fungal Infections - p. 514 94. Conclusion - p. 515 95. 51 Secondary Infections of the Spine - p. 517 96. Section 2.6 Pathophysiology of Neoplastic Disorders - p. 521.e2 97. 52 Primary Tumors of the Spine - p. 522 98. 53 Metastatic Tumors of the Spine - p. 538 99. 54 Intradural Extramedullary Spine Tumors - p. 546 100. 55 Intramedullary Spinal Cord Lesions - p. 555 101. 56 Tumors of the Peripheral Nerve Including Brachial Plexus - p. 567 102. Section 2.7 Pathophysiology of Syndromic Disorders Affecting the Spine: Connective Tissue and Vascular - p. 572.e2 103. 57 Spinal Disorders Associated with Connective Tissue Disorders - p. 573 104. 58 Osteoporosis, Osteomalacia, and Metabolic Bone Disease - p. 581 105. 59 Vascular Malformations of the Spine - p. 594 106. Section 2.8 Pathophysiology of Postoperative Spinal Disorders - p. 604.e4 107. 60 Postoperative Spinal Disorders—Cervical - p. 605 108. 61 Postoperative Spinal Deformity - p. 611 109. 62 Adjacent Segment Degeneration and Disease of the Cervical Spine - p. 622 110. 63 Adjacent Segment Degeneration and Disease of the Lumbar Spine - p. 627 111. 64 Proximal and Distal Junctional Kyphosis and Failure - p. 633 112. Evaluation of Patients with Spinal Disorders - p. P3 113. 65 Physical and Neurological Examination - p. 640 114. 66 Sagittal Spinal Alignment: An Evolutionary Perspective - p. 649 115. 67 Spinal Alignment: Significance and Preoperative Planning - p. 659 116. 68 Overview of Imaging Procedures Available for Spinal Diagnosis - p. 664 117. 69 Electrodiagnostic Studies - p. 670 118. 70 Differential Diagnosis of Surgical Disorders of the Spine - p. 680 119. 71 Patient Selection for Spine Surgery: Preoperative Optimization - p. 698 120. 72 Evaluation of the Aging Patient - p. 704 121. 73 Preoperative Evaluation of Psychosocial Aspects and Work-Related Issues - p. 709 122. 74 Preoperative Evaluation of Patients with Tumors Affecting the Spine - p. 713 123. 75 Measuring Preoperative Health-Related Quality of Life: What Metrics Matter - p. 724 124. Volume 2 - p. V2 125. Management of Spinal Disorders - p. P4 126. Section 4.1 Nonoperative Approaches - p. P4 127. 76 Rehabilitation and Interventions in Management of Spinal Disorders - p. 729 128. 77 Spine Injections - p. 734 129. 78 Cognitive Behavioral Therapy and Back Pain - p. 753 130. 79 Regenerative Strategies and Intervertebral Disc Degeneration - p. 761 131. 80 Neuromodulation and Rehabilitative Interventions for the Spine - p. 765 132. 81 Pain Management: Opioids and Alternatives - p. 772 133. Section 4.2 Operative Management of Spinal Disorders: Overview and Principles - p. 775 134. 82 Fundamentals of Spine Surgery - p. 776 135. 83 Perioperative Management Protocols: Enhanced Recovery After Surgery - p. 780 136. 84 Surgical Incisions, Positioning, and Retraction - p. 788 137. 85 Intraoperative Imaging Protocols - p. 809 138. 86 Anesthesia for Spine Surgery and the Prevention of Complications - p. 818 139. 87 Intraoperative Neurophysiologic Monitoring in Routine and Complex Surgery - p. 837 140. 88 Perioperative Management of Blood Loss in Complex Spine Surgery - p. 846 141. 89 Intraoperative Crisis Management in Spine Surgery: What to Do When Things Go Bad - p. 857 142. 90 Biologics in Spine Fusion Surgery - p. 867 143. 91 Common Complications in Spine Surgery: Pseudarthrosis - p. 873 144. 92 Postoperative Medical Complications - p. 883 145. 93 Preventing Postoperative Infections: An Evidence-Based Approach - p. 889 146. 94 Neurological Complications of Common Spine Operations - p. 894 147. 95 Cerebrospinal Fluid Leak: Repair and Outcomes - p. 899 148. 96 Arachnoiditis and Syringomyelia - p. 904 149. 97 Posttraumatic and Idiopathic Syringomyelia - p. 909 150. 98 Vascular and Soft Tissue Complications - p. 914 151. 99 Thromboembolic Disease in Spine Surgery - p. 925 152. 100 Postoperative Spinal Deformities - p. 930 153. 101 Revision of Cervical Disk Arthroplasty - p. 939 154. 102 Readmissions and Reoperation in Spine Surgery: The Use of Predictive Analytics - p. 945 155. Section 4.3 Operative Management of Spinal Disoders: Occipital and Cervical - p. 950 156. 103 Cervical Spine Construct Design - p. 952 157. 104 Occipitocervical Spine Approaches for Decompression - p. 961 158. 105 Upper Cervical Screw Fixation Techniques - p. 972 159. 106 Endoscopic and Transnasal Approaches to the Craniocervical Junction - p. 986 160. 107 Cervical Spine and Cervicothoracic Junction—Posterior - p. 997 161. 108 Posterior Cervical Decompressions: Cervical Laminectomy and Laminoforaminotomy - p. 1007 162. 109 Cervical Laminoplasty - p. 1010 163. 110 Dorsal Subaxial Cervical Instrumentation Techniques - p. 1015 164. 111 Posterior Percutaneous and Minimally Invasive Approaches to Decompression and Arthrodesis of the Cervical Spine - p. 1022 165. 112 Cervical Spine and Cervicothoracic Junction—Anterior Approach - p. 1030 166. 113 Anterior Cervical Discectomy and Corpectomy - p. 1043 167. 114 Management of Soft Cervical Disc Herniation: Controversies and Complication Avoidance - p. 1054 168. 115 Anterior Subaxial Cervical Fixation and Fusion Techniques - p. 1058 169. 116 Cervical Total Disc Arthroplasty - p. 1064 170. 117 Combined Ventral-Dorsal Surgery - p. 1068 171. Section 4.4 Operative Management of Spinal Disorders: Thoracolumbar - p. 1072.e1 172. 118 Thoracic and Lumbar Spine Construct Design - p. 1073 173. 119 Posterior Approaches to the Thoracic Spine - p. 1082 174. 120 Anterior and Lateral Approaches to the Thoracic Spine - p. 1089 175. 121 Posterolateral Thoracolumbar Fusion - p. 1100 176. 122 Transforaminal Lumbar Interbody Fusion - p. 1105 177. 123 Posterior Thoracolumbar Fixation Techniques - p. 1116 178. 124 Midline Lumbar Interbody Fusion With Cortical-Bone-Trajectory Pedicle Screw Placement - p. 1130 179. 125 Dorsal Semirigid Stabilization - p. 1138 180. 126 Lumbar Total Disc Arthroplasty - p. 1148 181. 127 Minimally Invasive Spinal Decompression and Stabilization Techniques: Philosophy and Rationale - p. 1160 182. 128 Posterior Approaches to the Lumbar Spine: Minimally Invasive Decompression - p. 1169 183. 129 Endoscopic Approaches to the Cervical Spine - p. 1178 184. 130 Endoscopic Surgical Approaches to the Lumbar Spine - p. 1185 185. 131 Posterior Approaches to the Lumbar Spine: Minimally Invasive Fusion - p. 1193 186. 132 Anterior Lumbar Interbody Fusion - p. 1201 187. 133 Minimally Invasive Surgery Approaches: Anterior and Anterolateral Lumbar Spine Interbody Fusion - p. 1212 188. 134 Complex Lumbosacropelvic Fixation Techniques - p. 1224 189. 135 Spinopelvic Fixation for Posterior Pelvic and Lumbosacral Injuries - p. 1235 190. 136 Spinal Augmentation for Vertebral Compression Fractures - p. 1244 191. Operative Management of Specific Disorders of the Spine - p. P5 192. Section 5.1 Degenerative Pathologies - p. P5 193. 137 Indications for Spine Fusion for Axial Pain - p. 1250 194. 138 Cervical Disc Herniation - p. 1259 195. 139 Cervical Spondylotic Myelopathy - p. 1266 196. 140 Lumbar Disc Herniation - p. 1272 197. 141 Thoracic Discectomy - p. 1277 198. 142 Degenerative Spondylolisthesis - p. 1285 199. 143 Spondylolysis and Low-Grade Spondylolisthesis - p. 1288 200. 144 Sacroiliac Joint Pain - p. 1295 201. Section 5.2 Spinal Deformity - p. 1302.e2 202. 145 Surgical Principles for Spinal Deformity - p. 1303 203. 146 An Approach for Treatment of Complex Adult Spinal Deformity - p. 1310 204. 147 Pediatric Spinal Deformity - p. 1318 205. 148 Cervicothoracic Deformity: The Role of Anterior Surgery - p. 1335 206. 149 The Role of Anterior Surgery for Thoracolumbar Deformity - p. 1344 207. 150 Anterior Column Realignment in Deformity - p. 1359 208. 151 Posterior-Based Osteotomies for Management of Spinal Deformity - p. 1364 209. 152 Minimally Invasive Approaches to Spinal Deformity - p. 1368 210. 153 Surgical Management of High-Grade Dysplastic Spondylolisthesis - p. 1376 211. 154 Failed Back Surgery Syndrome - p. 1387 212. Section 5.3 Tumors of the Spine - p. 1392 213. 155 Oncological Approaches and Outcomes for Primary Spine Tumors - p. 1393 214. 156 Staging, Classification, and Oncologic Approaches for Metastatic Tumors Involving the Spine - p. 1403 215. 157 Tumors at the Foramen Magnum and Craniocervical Junction - p. 1422 216. 158 Cervicothoracic Junction Tumors - p. 1436 217. 159 Thoracic and Thoracolumbar Spinal Tumors—Regional Challenges - p. 1442 218. 160 Sacral Tumors: Regional Challenges - p. 1459 219. 161 Radiosurgery for Spinal Tumors - p. 1471 220. Section 5.4 Trauma and the Spine - p. 1479.e4 221. 162 The Acute Management of Traumatic Spinal Cord Injury and Polytrauma - p. 1480 222. 163 Timing of Surgery Following Traumatic Spinal Cord Injury - p. 1485 223. 164 Medical Management of Adult and Pediatric Spinal Cord Injury - p. 1491 224. 165 Spinal Traction - p. 1501 225. 166 Medical Management of Fractures Without Spinal Cord Injury - p. 1507 226. 167 Anterior Surgery for Cervical Trauma - p. 1520 227. 168 Posterior Surgery for Cervical Trauma - p. 1533 228. 169 Surgical Approaches to Thoracolumbar Trauma - p. 1539 229. 170 Surgical Approaches for Sacral Fractures and Sacropelvic Injuries - p. 1557 230. 171 Rehabilitation and Recovery After Spinal Cord Injury - p. 1564 231. 172 Regenerative Techniques of Spinal Cord Injury - p. 1581 232. Section 5.5 General Surgical Technique - p. 1585 233. 173 Harvest of Autograft for Spinal Fusion - p. 1586 234. 174 Vascularized Bone Grafts in Spine Surgery - p. 1593 235. 175 Navigation and Robotics in Spine Surgery - p. 1599 236. Evidence Development and Guidance of Informed Choice for Optimal Outcomes - p. P6 237. 176 Big Data in Healthcare - p. 1602 238. 177 Spine Registries - p. 1615 239. 178 Conflicts of Interest in Spine Surgery - p. 1621 240. 179 Art of the Clinical Trial - p. 1626 241. 180 Meaningful Retrospective Analysis - p. 1634 242. 181 Art and Science of Guideline Formation - p. 1638 243. 182 Appropriate Use Criteria in Spine Surgery - p. 1644 244. 183 Precision Medicine: Artificial Intelligence Applied to Evaluation and Management of Spinal Disorders - p. 1650 245. 184 Healthcare Reform and Spine Surgery: Economic Impact and the Shift to Value-Based Care - p. 1661 246. 185 Development of New Technologies in Spine Surgery - p. 1670