Ao Asif Principles in Spine Surgery (Hardcover)

1 Aims and Principles.- 1.1 Introduction.- 1.2 Stable Internal Fixation.- 1.3 Preservation of Blood Supply.- 1.4 Anatomical Alignment.- 1.5 Early Pain-Free Mobilization.- 2 Biomechanics of the Spine and Spinal Instrumentation.- 2.1 Introduction.- 2.2 Mechanical Principles.- 2.3 Mechanical Properties of Materials.- 2.4 Implant Materials.- 2.5 Principles of Surgical Stabilization.- 2.5.1 Buttressing Principle.- 2.5.2 Neutralization Principle.- 2.5.3 Tension Band Principle.- 2.5.4 Bridge Fixation Principle.- 2.6 Instrumentation Application.- 2.7 Cervical Spinal Instrumentation.- 2.8 Lumbar and Thoracolumbar Spinal Instrumentation.- 2.9 Spinal Deformity.- 2.10 Lumbar Reconstruction.- 2.11 Spondylolysis.- 2.12 Implant Failure - Biomechanics.- References.- 3 Biology of Spinal Fusions.- 3.1 Introduction.- 3.2 Local Host Factors.- 3.2.1 Host Soft Tissue Bed.- 3.2.2 Host Graft Recipient Site.- 3.2.3 Growth Factors.- 3.2.4 Electrical Stimulation.- 3.3 Sytemic Host Factors.- 3.3.1 Hormones.- 3.3.2 Host Nutrition and Homeostasis.- 3.4 Bone Graft Materials.- 3.4.1 Properties of Graft Material.- 3.5 Types of Graft Materials.- 3.5.1 Autograft.- 3.5.2 Allograft.- 3.5.3 Xenograft.- 3.5.4 Synthetic Bone Graft Substitutes.- 3.5.5 Effect of Instrumentation on the Biology of Spine Fusions.- 3.6 Conclusion.- References.- 4 A Comprehensive Classification of Thoracic and Lumbar Injuries.- 4.1 Introduction.- 4.2 Concept of the Classification.- 4.3 Classification of Thoracic and Lumbar Injuries.- 4.3.1 Type A: Vertebral Body Compression.- 4.3.1.1 Group A1: Impaction Fractures.- 4.3.1.2 Group A2: Spilt Fractures.- 4.3.1.3 Group A3: Burst Fractures.- 4.3.1.4 Common Local Clinical Findings and Radiological Signs of Type A Injuries.- 4.3.2 Type B: Anterior and Posterior Element Injuries with Distraction.- 4.3.2.1 Group B1: Posterior Disruption Predominantly Ligamentous.- 4.3.2.2 Group B2: Posterior Disruption Predominantly Osseous.- 4.3.2.3 Common Local Clinical Findings and Radiological Signs of B1 and B2 Injuries.- 4.3.2.4 Group B3: Anterior Disruption Through the Disk.- 4.3.2.5 Common Local Clinical Findings and Radiological Signs of B3 Injuries.- 4.3.3 Type C: Anterior and Posterior Element Injuries with Rotation.- 4.3.3.1 Group Cl: Type A with Rotation.- 4.3.3.2 Group C2: Type B with Rotation.- 4.3.3.3 Group C3: Rotational Shear Injuries.- 4.3.3.4 Common Clinical Findings and Radiological Signs of Type C Injuries.- 4.4 Epidemiological Data.- 4.4.1 Level of Main Injury.- 4.4.2 Frequency and Distribution of Types and Groups.- 4.4.3 Incidence of Neurological Deficit.- 4.5 Discussion.- 4.5.1 Type A.- 4.5.2 Type B.- 4.5.2.1 B1 and B2 Injuries.- 4.5.2.2 B3 Injuries.- 4.5.3 Type C.- 4.6 Conclusions.- References.- 5 Stabilization Techniques: Upper Cervical Spine.- 5.1 Posterior Wiring Techniques.- 5.1.1 Standard Technique (After Gallie).- 5.1.2 Wedge Compression Technique (After Brooks and Jenkins).- 5.2 Transarticular Screw Fixation.- 5.2.1 Standard Technique.- 5.2.2 Cannulated Screw Technique.- 5.3 Anterior Screw Fixation of Odontoid (Dens) Fractures.- 5.3.1 Standard Lag Screw Technique.- 5.3.2 Cannulated Screw Technique.- 6 Stabilization Techniques: Lower Cervical Spine.- 6.1 Posterior Techniques.- 6.1.1 Wiring Technique.- 6.1.2 Plate Technique.- 6.1.2.1 Screw Placement.- 6.1.2.1.1 Mid and Lower Cervical Spine.- 6.1.2.1.2 Upper Cervical Spine.- 6.1.2.1.3 Upper Thoracic Spine from T1 - T3.- 6.1.2.1.4 Occiput Screws.- 6.1.2.2 3.5-mm Cervical Titanium Plate.- 6.1.2.2.1 Plate Fixation in the Middle and Lower Cervical Vertebrae (C2-C7).- 6.1.2.2.2 Occipitocervical Plate Fixation.- 6.1.2.2.3 Cervicothoracic Plate Fixation.- 6.1.2.3 One-Third Tubular Plate Fixation.- 6.1.2.4 Hook Plates.- 6.1.3 Cervical Spine Titanium Rod System (Cervifix).- 6.1.3.1 Implants and Instruments.- 6.1.3.2 Occipitocervical Stabilization.- 6.1.3.3 Cervicothoracic Fixation from C2 to Th2 (as for Occipitocervical Fixation).- 6.1.3.4 Connection of the Cervical Spine Rod System to the 6-mm USS Rod (Occipitocervical Fixation).- 6.2 Anterior Techniques.- 6.2.1 Plating Techniques.- 6.2.1.1 Standard H Plate.- 6.2.1.2 Titanium Cervical Spine Locking Plate (CSLP).- 7 Stabilization Techniques: Thoracolumbar Spine.- 7.1 Anterior Techniques.- 7.1.1 Plate Techniques.- 7.1.1.1 Fixation with the Large Dynamic Compression Plate (DCP).- 7.1.1.2 Anterior Titanium Thoracolumbar Locking Plate.- 7.1.2 Rod Systems.- 7.1.2.1 Fixation with the Anterior USS.- 7.1.2.1.1 Anterior Construct.- 7.1.2.1.2 Anterior Vertebral Body Construct.- 7.1.2.2 Fixation with the Anterior Titanium Rod System (VentroFix).- 7.1.2.2.1 Double-Rod Clamp Configuration.- 7.1.2.2.2 Fracture Clamp Configuration.- 7.1.2.2.3 Single-Clamp ? Double-Rod Configuration.- 7.1.2.2.4 Single-Clamp ? Single-Rod Configuration.- 7.2 Posterior Techniques.- 7.2.1 Translaminar Screw Fixation.- 7.2.2 Pedicle Fixation.- 7.2.2.1 Notched Thoracolumbar Plates.- 7.2.2.2 Fracture Module of the USS.- 7.2.2.2.1 Anterior Vertebral Body Fracture with Intact Posterior Wall (Type A-1 and A-2).- 7.2.2.2.2 Anterior Vertebral Body Fracture with Fractured Posterior Wall (Type A-3).- 7.2.2.2.3 Posterior Element Fractures or Disruption with Distraction (Type B).- 7.2.2.2.4 Complete Disruption of the Anterior and Posterior Elements with Rotation (Type C).- 8 Modular Stabilization System: The Universal Spine System.- 8.1 Basic Concepts.- 8.2 The System.- 8.2.1 Instruments and Implants.- 8.2.1.1 Fracture Module.- 8.2.1.2 Low Back Surgery Module.- 8.2.1.3 Scoliosis and Deformity Module.- 8.2.1.4 Specific Implants and Instruments.- 8.2.1.4.1 USS Side-Opening Pedicle Screws.- 8.2.1.4.2 USS Hooks: Laminar Hooks.- 8.2.1.4.3 USS Hooks: Specialized Pedicle Hook.- 8.2.1.4.4 USS Hooks: Transverse Process Hook.- 8.2.1.4.5 USS Rod Introduction into Side-Opening Implants.- 8.2.1.4.6 Complex Reduction Forceps ? the “Persuader”.- 8.2.1.4.7 Rod Connectors.- 8.2.1.4.8 USS Cross-link System.- 8.2.2 USS for Deformity.- 8.2.2.1 Basic Principles.- 8.2.2.1.1 Basic Principle of Construct.- 8.2.2.1.2 The Concave Curve.- 8.2.2.1.3 The Convex Side.- 8.2.2.1.4 Insertion of Rod and Reduction of Spine.- 8.2.2.2 Scoliosis: Postrior Correction and Stabilization.- 8.2.2.2.1 Right Thoracic Late Onset Scoliosis.- 8.2.2.2.2 Double Curve.- 8.2.2.3 Scoliosis: Anterior Correction and Stabilization.- 8.2.2.4 Kyphosis: Posterior Correction and Stabilization.- 8.2.3 USS for the Degenerative Lumbosacral Spine.- 8.2.3.1 Standard Fixation.- 8.2.3.2 Sacral Fixation.- 8.2.4 USS for Spondylolisthesis Reduction and Stabilization.- 8.2.4.1 Spondylolisthesis.- 9 Other Fixation Systems.- 9.1 Hook-Screw System for Spondylolysis Treatment.- 9.2 External Spinal Skeletal Fixation B. Jeanneret.- 9.2.1 Principles and Technique.- 9.2.1.1 Technique of Percutaneous Insertion of Schanz Screws.- 9.2.1.2 Postoperative Care.- 9.2.1.3 Insertion of Thoracic Screws.- 9.2.1.4 Treatment of Complications.- 9.2.1.5 Removal of Schanz Screws.- 9.2.2 External Fixation as a Diagnostic Tool in Low-Back Pain.- 9.2.2.1 Gradual Reduction of Severe Spondylolisthesis.- 9.2.3 Percutaneous Treatment of Osteomyelitis of the Spine.- 9.2.4 External Fixation for Spinal Fractures.- 9.2.5 Stabilization of Unstable Malgaigne Fractures.- 9.3 Cage Systems.- 9.3.1 Fixation with the Titanium Interbody Spacer.- 9.3.2 Anterior Titanium Interbody Spacer (SynCage).- 9.3.3 Contact Fusion Cage.- 9.3.2.1 Mounting the Cage on the Implant Holder.- 9.3.2.2 Filling the Cage with Bone Graft.- 9.3.3.3 Removal of the Cage.