Handbook of Spine Surgery (eBook)

Ali A. Baaj, Praveen Mummaneni, Juan S. Uribe, Alexander R. Vaccaro, Mark S. Greenberg (Herausgeber)

eBook Download: EPUB

2024 | 3. Auflage
1141 Seiten
Thieme Medical Publishers (Verlag)
978-1-68420-678-0 (ISBN)

Infos

<p><strong><em>The go-to handbook on the current evaluation and surgical management of spinal disorders</em></strong></p> <p><cite>Handbook of Spine Surgery, Third Edition</cite> edited by renowned spine surgeons Ali A. Baaj, Praveen V. Mummaneni, Juan S. Uribe, Alexander R. Vaccaro, and Mark S. Greenberg reflects new techniques introduced into the practice since publication of the last edition, along with four-color images and videos.</p> <p>The book is organized into four parts and 66 chapters, starting with basic spinal anatomy. Part II covers the physical exam, electrodiagnostic testing, imaging, safety issues, intraoperative monitoring, bedside procedures, and the use of orthotics, pharmacology, and biologics. Part III discusses a full range of spinal pathologies and the final section concludes with 34 succinct procedural chapters.</p> <p><strong>Key Highlights</strong></p> <ul> <li>Contributions from an expanded 'who's who' of spine surgery experts</li> <li>New chapters cover state-of-the-art techniques, including endoscopy, CT-guided navigation, robotics, augmented reality, and vertebral body tethering</li> <li>Procedural chapters include key points, indications, diagnosis, preoperative management, anatomic considerations, techniques, surgical pearls, and more</li> </ul> <p>This is an invaluable resource for neurosurgical and orthopaedic residents, spinal surgical fellows, and practicing orthopaedic surgeons and neurosurgeons who specialize in spine surgery.</p> <p>This print book includes complimentary access to a digital copy on <a href='https://medone.thieme.com/'>https://medone.thieme.com</a>.</p> <p><strong>Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product.</strong></p>

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The go-to handbook on the current evaluation and surgical management of spinal disordersHandbook of Spine Surgery, Third Edition edited by renowned spine surgeons Ali A. Baaj, Praveen V. Mummaneni, Juan S. Uribe, Alexander R. Vaccaro, and Mark S. Greenberg reflects new techniques introduced into the practice since publication of the last edition, along with four-color images and videos.The book is organized into four parts and 66 chapters, starting with basic spinal anatomy. Part II covers the physical exam, electrodiagnostic testing, imaging, safety issues, intraoperative monitoring, bedside procedures, and the use of orthotics, pharmacology, and biologics. Part III discusses a full range of spinal pathologies and the final section concludes with 34 succinct procedural chapters.Key HighlightsContributions from an expanded "e;who's who"e; of spine surgery expertsNew chapters cover state-of-the-art techniques, including endoscopy, CT-guided navigation, robotics, augmented reality, and vertebral body tetheringProcedural chapters include key points, indications, diagnosis, preoperative management, anatomic considerations, techniques, surgical pearls, and moreThis is an invaluable resource for neurosurgical and orthopaedic residents, spinal surgical fellows, and practicing orthopaedic surgeons and neurosurgeons who specialize in spine surgery.

Textauszug

1 Craniovertebral Junction

Nader S. Dahdaleh

Summary

The craniocervical junction is composed of two joints, the atlanto-occipital and atlantoaxial joints along with their surrounding ligamentous and muscular attachments.

1.1 Key Points

• The craniovertebral junction (CVJ) is composed of the occiput (O), atlas (C1), and axis (C2) along with the atlantoaxial and atlantooccipital joints ( ▶ Fig. 1.1).

  Fig. 1.1 Craniovertebral junction (CVJ) anterior (top) and lateral (bottom) views.

• The CVJ is a very flexible junction accounting for at least 50% of the range of motion of the cervical spine in all planes. The joint orientation determines the direction of motion, and the ligaments determine the biomechanical stability of this junction ( ▶ Fig. 1.2).

  Fig. 1.2 Craniovertebral junction (CVJ) range of motion.

1.2 Bony Anatomy

• The CVJ consists of the base of the occiput, the atlas (C1), and the axis (C2).

• The foramen magnum boundaries consist of the basion anteriorly, the opisthion posteriorly, and the occipital condyles anterolaterally.

• The atlas (C1) is composed of an anterior arch, a posterior arch, and two lateral masses ( ▶ Fig. 1.3).

  Fig. 1.3 The atlas.

• The atlantooccipital joint is cup like in the coronal and sagittal plane allowing for flexion/extension and little axial rotation.

• The C1 anterior tubercle is the attachment site of the anterior longitudinal ligament (ALL) and the longus coli muscle.

• The vertebral artery (VA) and C1 nerve run along the superior lateral groove on C1 (sulcus arteriosus). In less than 15% of the population, the groove is roofed, forming the arcuate foramen.

• The axis (C2) consists of the body, odontoid process (dens), articulating surfaces, pedicles, pars interarticularis lamina, and large, bifid spinous process ( ▶ Fig. 1.4).

  Fig. 1.4 The axis.

• The atlantoaxial joint is convex in orientation allowing for axial rotation about the dens.

1.3 Neural Anatomy

• Cervical nerve roots exit above their corresponding level (e.g., the C2 nerve root exits above the C2 pedicle).

• C1 nerve root: The posterior division (suboccipital nerve) is more prominent than the anterior division. It innervates suboccipital muscles and occasionally branches to the lesser/greater occipital nerve.

• C2 nerve root: Posterior, medial (greater occipital nerve), and lateral divisions innervate suboccipital muscles and scalp from occiput to vertex. It may be sacrificed during atlantoaxial or occipitocervical fusions to enhance the exposure of the lateral mass for lateral mass screw placement and/or to access the atlantoaxial joint for direct arthrodesis.

• The lesser occipital nerve is formed by dorsal divisions of C2 and C3.

1.4 Vascular Anatomy

• The voluminous vertebral venous plexus that surrounds the horizontal portion of the V3 segment of the VA is encased in the suboccipital fascia. If the planes of dissection are respected, the plexus can be preemptively coagulated during exposure of the CVJ.

• The VA leaves the C2 transverse foramen (becoming V3). It takes a 45 degrees lateral projection and ascends (vertical portion of V3) into the C1 transverse foramen.

• The VA then courses medially (horizontal portion of V3) along the C1 sulcus arteriosus and then anteriorly through the atlantooccipital membrane, where it becomes intradural (beginning of V4 segment).

• Blood is supplied to the CVJ primarily through branches of the vertebral and occipital arteries.

• Blood supply to the CVJ emanate from extensions of the VA from the subaxial spine. The anterior and posterior ascending arteries branch from the VA at C2–C3, entering the vertebral column supplying the axis before anastomosing to form the apical odontoid arcade that supplies the atlas and dens.

The occipital artery completes the superior portion of the arcade.

• Lymphatic drainage of the CVJ is through retropharyngeal and deep cervical nodes.

1.5 Muscular Anatomy ( ▶ Table 1.1 )

Table 1.1  Craniovertebral junction musculature: their attachments and modes of action

Muscle

Attachments

Action

Trapezius

Origin: Occipital bone, the ligamentum nuchae, and the spinous processes of T01–T12 Insertion: Lateral third of the clavicle and the scapula (acromion and scapular spine)

Stabilize and move the scapula

Sternocleidomastoid muscle (SCM)

Origin: Sternum, clavicle Insertion: Temporal bone (mastoid process), occipital bone

Contralateral head rotation, neck flexion

Splenius capitis

Origin: Lower half of the nuchal ligament and the spinous processes of C7–T3 vertebrae Insertion: Temporal bone (mastoid process), occipital bone

Unilaterally: Lateral bending and rotation of head to ipsilateral side Bilaterally: Extension of the head and cervical spine

Semispinalis capitis

Origin: Transverse and articular processes of C4–C7, transverse processes of T1–T6 Insertion: Between superior and inferior nuchal lines of occipital bone

Unilaterally: Lateral bending and rotation of head to ipsilateral side Extension, rotation, and lateral bending of head and cervical spine

Rectus capitis posterior major and minor

Origin: Posterior tubercle of atlas (minor), spinous process of C2 (major) Insertion: Medial part of inferior nuchal line of occipital bone

Bilateral contraction at the atlantooccipital joint: Head extension Unilateral contraction at the atlantoaxial joint: Head rotation (ipsilateral)

Obliquus capitis superior muscle of occipital bone (between superior and inferior nuchal lines)

Origin: Transverse process of atlas Insertion: Occipital bone (between superior and inferior nuchal lines)

Bilateral contraction at atlantooccipital joint: Head extension Unilateral...

Produkt-Details

• Erscheint lt. Verlag: 4.12.2024
• Sprache: englisch
• Themenwelt: Medizinische Fachgebiete ► Chirurgie ► Neurochirurgie
• Themenwelt: Medizinische Fachgebiete ► Chirurgie ► Unfallchirurgie / Orthopädie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Neurologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Orthopädie
• Themenwelt: Naturwissenschaften ► Biologie ► Humanbiologie
• Themenwelt: Naturwissenschaften ► Biologie ► Zoologie
• Schlagworte: Deformity • Innovation • neurosurgery • Oncology • Orthopedics • spine • Surgery • technique • Technology • Trauma
• ISBN-10: 1-68420-678-2 / 1684206782
• ISBN-13: 978-1-68420-678-0 / 9781684206780