The Textbook of Spinal Surgery

Third Edition Volume 1

The Textbook of Spinal Surgery

Third Edition Volume 1Editors in Chief

KEITH H. BRIDWELLJ. Albert Key Distinguished Professor of Orthopaedic Surgery and

Professor of Neurological SurgeryChief, Pediatric/Adult Spinal Deformity Service

Director, Washington University Spine FellowshipWashington University Orthopaedics

Washington University School of MedicineSaint Louis, Missouri

RONALD L. DEWALDProfessor Emeritus

Department of Orthopedic SurgeryRush Medical College

Chicago, Illinois

Associate EditorsPeter D. Angevine

Jacob M. BuchowskiCharles C. Edwards IIChristopher L. Hamill

Timothy R. KukloRonald A. Lehman, Jr.

Scott J. LuhmannLawrence G. Lenke

John M. RheeK. Daniel Riew

Managing Editor for Dr. BridwellTheresa M. Iffrig

Acquisitions Editor: Robert HurleyProduct Manager: Elise M. PaxsonProduction Manager: Alicia JacksonSenior Manufacturing Manager: Benjamin RiveraMarketing Manager: Lisa LawrenceDesign Coordinator: Doug SmockProduction Service: Aptara, Inc.

2011 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business

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All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, includ-ing photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their offi cial duties as U.S. government employees are not covered by the above-mentioned copyright.

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Library of Congress Cataloging-in-Publication Data

The textbook of spinal surgery / editors in chief, Keith H. Bridwell,Ronald L. DeWald ; associate editors, Peter Angevine . . . [et al.];administrative assistant to Dr. Bridwell, Theresa M. Iffrig.3rd ed. p. ; cm. Spinal surgery Includes bibliographical references and index. ISBN 978-0-7817-8620-1 (alk. paper) 1. SpineSurgery. I. Bridwell, Keith H. II. Dewald, Ronald L., 1934-III. Title: Spinal surgery. [DNLM: 1. Spinal Diseasessurgery. 2. Biomechanics. 3. Spinesurgery. WE 725] RD768.T448 2011 617.56059dc23 2011024927

Care has been taken to confi rm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner.

The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant fl ow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new or infrequently employed drug.

Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care providers to ascertain the FDA status of each drug or device planned for use in their clinical practice.

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10 9 8 7 6 5 4 3 2 1

To the patients who will benefi t from our evolving understanding of surgical indications, techniques, and

complications.

vii

Foreword

I fi rst met Dr. Bridwell in the early 1980s at a spine meeting in Minneapolis, where we were introduced by our good friend and host, Dr. Robert Winter. I was a newcomer to St. Louis and Dr. Bridwell was thinking about moving to the area from Cincinnati. We had a conversation at that meeting, which led to more exchanges afterwards and planted the seeds for a life-long friendship.

Eventually, Dr. Bridwell moved to St. Louis where I had the pleasure of closely following his career. I learned that his dream was to establish a superb academic center for the treat-ment of spinal deformities and to provide education at a global level. During the quarter of a century that I have known him, I have seen Dr. Bridwell realize this dream with great success and benefi tted from his contributions both as a colleague and as a friend. In that time, Dr. Bridwell has not only created a world class institution for the treatment of spi-nal disorders, he has done an extraordinary job of providing ongoing research activities and creating an educational envi-ronment from which everyone can benefi t. This textbook stands as a testament to his commendable efforts to achieve these goals.

The fi rst edition of this book quickly became a classic, fi lling the gap of resources needed for the education of spine sur-geons. Prior to this publication, not a single book existed to address all aspects of spine surgery. Within this rapidly expand-ing fi eld, the need for a standard and reliable resource became even greater. This book thus covers a spectrum of topics from the simple to the most complex, dealing with all regions of the

spine from occiput to pelvis, offering diagnoses for all ages from very young children to adults, and sharing all current and up-to-date surgical approaches and techniques.

Dr. Bridwell and his respected associate editors and authors have taken every measure to produce an outstanding work addressing all basic principles and techniques of modern spine surgery. The chapters are detailed yet simultaneously to the point. They are also well illustrated and supplemented by use-ful references for those seeking additional information.

The third edition of The Textbook of Spinal Surgery represents signifi cant revisions to accommodate fresh and relevant infor-mation on new outcomes, technology, and clinical research. The material covers knowledge needed for a readership com-prising medical students, allied health professionals, residents and fellows to pediatric orthopaedic surgeons and spine care specialists.

The editors and authors of this publication stand at the fore-front of the fi eld. They are to be congratulated for consolidat-ing the topic of spine surgery into one readily accessible text-book, a reference source that should appear in all libraries and on the shelves of those who provide care for patients with spinal disorders.

Behrooz A. Akbarnia, MDClinical Professor, Department of Orthopaedics

University of California, San DiegoMedical Director, San Diego Center for Spinal Disorders

Past President, Scoliosis Research Society

Kuniyoshi Abumi, MDProfessorDepartment of Spinal ReconstructionHokkaido University Graduate School of MedicineKita-Ku, Sapporo, Japan

Frank L. Acosta, Jr., MDAssistant ProfessorDepartment of Neurological SurgeryCedars-Sinai Medical CenterLos Angeles, California

Steven S. Agabegi, MDAssistant ProfessorDepartment of Orthopaedic SurgeryUniversity of Cincinnati College of MedicineCincinnati, Ohio

Raheel Ahmed, MD, PhDDepartment of NeurosurgeryUniversity of Iowa Hospitals and ClinicsIowa City, Iowa

Michael C. Ain, MDAssociate ProfessorDepartment of Orthopaedics and NeurosurgeryJohns Hopkins UniversityBaltimore, Maryland

Behrooz A. Akbarnia, MDClinical ProfessorDepartment of OrthopaedicsUniversity of California, San DiegoSan Diego, California Medical DirectorSan Diego Center for Spinal DisordersLa Jolla, California

Todd J. Albert, MDRichard H. Rothman Professor and ChairmanDepartment of Orthopaedic SurgeryProfessor of NeurosurgeryThomas Jefferson University and HospitalsPhiladelphia, Pennsylvania

Howard S. An, MDProfessor of Orthopaedic SurgeryRush University Medical CenterChicago, Illinois

Neel Anand, MDDirector, Orthopaedic Spine Surgery, Minimally

Invasive Spine SurgerySpine CenterCedars Sinai Medical CenterLos Angeles, California

Paul A. Anderson, MDProfessorDepartment of Orthopedic Surgery and RehabilitationUniversity of WisconsinMadison, Wisconsin

Peter D. Angevine, MD, MPHAssistant ProfessorNeurological SurgeryColumbia University College of Physicians and SurgeonsNew York, New York

Toomas Anton, MDDepartment of Neurological SurgeryWilloughby Hills Medical CenterWilloughby Hills, Ohio

Joshua D. Auerbach, MDOrthopaedic SurgeonDepartment of Orthopaedic SurgeryBronx-Lebanon Hospital CenterBronx, New York

Kelley Banagan, MDUniversity of Maryland OrthopaedicsBaltimore, Maryland

Eli M. Baron, MDNeurosurgeon and Spine SurgeonCedars Sinai Spine CenterCedars Sinai Medical CenterLos Angeles, California

Sushil K. Basra, MDClinical InstructorOrthopaedic Spine SurgeryEmory University School of MedicineThe Emory Spine CenterAtlanta, Georgia

Carlo Bellabarba, MDDepartment of Orthopaedics and Sports MedicineHarborview Medical CenterUniversity of WashingtonSeattle, Washington

Contributing Authors

ix

x Contributing Authors

Edward C. Benzel, MDChairmanDepartment of NeurosurgeryCleveland ClinicCleveland, Ohio

Mark Bernhardt, MDClinical ProfessorDepartment of Orthopaedic SurgeryUniversity of Missouri Kansas City School of MedicineKansas City Orthopaedic InstituteDickson-Diveley Midwest Orthopaedic ClinicLeawood, Kansas

Rudolf Bertagnoli, MDPro SpineStraubing, Germany

Sigurd H. Berven, MDAssociate Professor in ResidenceDepartment of Orthopaedic SurgeryUniversity of California San FranciscoSan Francisco, California

Robert Shay Bess, MDOrthopaedic SurgeryRocky Mountain Hospital for ChildrenDenver, Colorado

Jason T. Bessey, MDThe Rothman InstituteThomas Jefferson UniversityPhiladelphia, Pennsylvania

Randal R. Betz, MDChief of StaffShriners Hospitals for Children, PhiladelphiaPhiladelphia, Pennsylvania

Mark H. Bilsky, MDProfessorNeurosurgeryWeill Cornell Medical College;AttendingNeurosurgeryMemorial Sloan-Kettering Cancer CenterNew York, New York

Oheneba Boachie-Adjei, MDThe Scoliosis ServiceHospital for Special SurgeryNew York, New York

Scott D. Boden, MDProfessorOrthopaedic SurgeryEmory University School of Medicine;DirectorThe Emory Orthopaedics & Spine CenterAtlanta, Georgia

Shelly M. Bolon, BS, CNIMDepartment of Perioperative ServicesBJC HealthcareSaint Louis, Missouri

David S. Bradford, MDProfessor and Chair EmeritusDepartment of Orthopedic SurgeryUniversity of California, San FranciscoSan Francisco, California

Keith H. Bridwell, MDJ. Albert Key Distinguished Professor of Orthopaedic Surgery and

Professor of Neurological SurgeryChief, Pediatric/Adult Spinal Deformity ServiceDirector, Washington University Spine FellowshipWashington University OrthopaedicsWashington University School of MedicineSaint Louis, Missouri

Darrel S. Brodke, MDProfessor and Vice ChairmanDepartment of OrthopedicsUniversity of UtahSalt Lake City, Utah

Jacob M. Buchowski, MD, MSAssistant Professor of Orthopaedic and Neurological SurgeryDirectorCenter for Spinal TumorsDepartment of Orthopaedic SurgeryWashington University School of MedicineSaint Louis, Missouri

Douglas C. Burton, MDMarc and Elinor Asher Spine ProfessorDepartment of Orthopedic SurgeryUniversity of Kansas School of MedicineKansas City, Kansas

Danielle B. Cameron, BAClinical Research CoordinatorOrthopaedic SurgeryChildrens Hospital of PhiladelphiaPhiladelphia, Pennsylvania

Robert M. Campbell, Jr., MDDirectorThe Center for Thoracic Insuffi ciency SyndromeChildrens Hospital of Philadelphia;Attending PhysicianDivision of OrthopaedicsChildrens Hospital of PhiladelphiaPhiladelphia, Pennsylvania

Victoria A. Campbell, ENS, MC, USNWalter Reed Army Medical CenterWashington, DC

Mauricio A. Campos Daziano, MDAssociate InstructorDepartment of Orthopaedic SurgeryPontifi cia Universidad Catlica de ChileSantiago, Chile

Contributing Authors xi

Eugene J. Carragee, MDProfessor and Vice ChairmanDepartment of Orthopaedic SurgeryStanford University School of MedicineStanford, California;Division Chief, Spinal SurgeryDepartment of Orthopaedic SurgeryStanford Medicine Outpatient CenterRedwood City, California

Gilbert Chan, MDResearch FellowDepartment of OrthopedicsChildrens Hospital of PhiladelphiaPhiladelphia, Pennsylvania

Jens R. Chapman, MDProfessor and Acting Chairman, HansJoerg Wyss Endowed ChairDepartment of Orthopaedic Surgery and Sports MedicineUniversity of Washington;Joint Professor of Neurological SurgeryDepartment of Neurological SurgeryUniversity of WashingtonSeattle, Washington

Michelle J. Clarke, MDSenior Associate ConsultantNeurologic SurgeryMayo ClinicRochester, Minnesota

David H. Clements III, MDAssociate Professor, Attending PhysicianDepartment of Orthopaedic SurgeryShriners Hospital for ChildrenPhiladelphia, Pennsylvania

Brendan J. Collins, MDInstructor in SurgeryDivision of Plastic and Reconstructive SurgeryJohns Hopkins HospitalAttending Plastic and Reconstructive SurgeonDivision of Plastic and Reconstructive SurgeryMercy Medical CenterBaltimore, Maryland

Paul Richard Cooper, MDRicciardi Professor Emeritus of NeurosurgeryDepartment of NeurosurgeryNew York University School of MedicineNew York, New York

Paul A. Craig, RN, JDChief Risk & Human Resources Offi cerUniversity of California San Diego Health SciencesSan Diego, California

Alvin H. Crawford, MD, FACSProfessor of Orthopaedic SurgeryPediatrics and Orthopaedic SurgeryDirector of Spine FellowshipDirector of Pediatric Orthopaedic FellowshipCincinnati Childrens HospitalCincinnati, Ohio

Charles H. Crawford III, MDAssistant ProfessorDepartment of Orthopaedic SurgeryUniversity of LouisvilleLouisville, Kentucky

Geoffrey A. Cronen, MDOrthopaedic Spine SurgeonFlorida Medical ClinicTampa, Florida

Matthew E. Cunningham, MD, PhDAssistant ProfessorOrthopaedic SurgeryWeill-Cornell Medical College, Cornell University;Assistant AttendingOrthopaedic SurgeryHospital for Special SurgeryNew York, New York

Linda Park DAndrea, MDDivision of Spinal Disorders and SurgeryBrandywine Institute of OrthopaedicsPhoenixville, Pennsylvania

Alexis B.C. Dang, MDDepartment of Orthopaedic SurgeryDivision of Sports MedicineUniversity of RochesterRochester, New York

Michael D. Daubs, MDAssistant ProfessorDepartment of Orthopaedic SurgeryUniversity of UtahSalt Lake City, Utah

John G. DeVine, MDAssistant ProfessorDepartment of SurgeryUniformed Services University of the Health SciencesBethesda, Maryland

Ronald L. DeWald, MDProfessor EmeritusDepartment of Orthopedic SurgeryRush Medical College Chicago, Illinois

John R. Dimar II, MDClinical ProfessorDepartment of OrthopedicsUniversity of LouisvilleChiefPediatric OrthopedicsKosairs Childrens HospitalStaff PhysicianLeatherman Spine CenterLouisville, Kentucky

Anton E. Dmitriev, PhD, MScDirectorSpine Research CenterIntegrated Department of Orthopaedics and RehabilitationWalter Reed Army Medical CenterWashington, DC

xii Contributing Authors

Angus S. Don, MD, FRACSVisiting Assistant ProfessorDepartment of Orthopaedic SurgeryStanford University Medical CenterStanford, CaliforniaOrthopaedic and Spinal SurgeonDepartment of Orthopaedic SurgeryAuckland City HospitalAuckland, New Zealand

John P. Dormans, MDProfessorDepartment of Orthopaedic SurgeryUniversity of Pennsylvania School of Medicine;ChiefDepartment of Orthopaedic SurgeryThe Childrens Hospital of PhiladelphiaPhiladelphia, Pennsylvania

Denis S. Drummond, MDProfessor EmeritusOrthopaedic SurgeryUniversity of Pennsylvania School of Medicine;Chief EmeritusOrthopaedic SurgeryThe Childrens Hospital of PhiladelphiaPhiladelphia, Pennsylvania

Atiq Durrani, MDOrthopaedic Surgery Spine Specialist Center for Advanced Spine Technologies (CAST)Cincinatti, Ohio

Tobin Eckel, MDPrivate PracticeWashington, DC

Charles C. Edwards, MDThe Maryland Spine CenterMercy Medical CenterBaltimore, Maryland

Charles C. Edwards II, MDThe Maryland Spine CenterMercy Medical CenterBaltimore, Maryland

Frank J. Eismont, MDDepartment of Orthopaedic SurgeryUniversity of MiamiJackson Memorial HospitalUniversity of Miami Miller School of Medicine Spine CenterRehabilitation CenterMiami, Florida

Michael B. Ellman, MDResidentDepartment of Orthopedic SurgeryRush University Medical CenterChicago, Illinois

John B. Emans, MDProfessorOrthopedic SurgeryHarvard Medical SchoolDirectorDivision of Spine SurgeryDepartment of Orthopedic SurgeryChildrens HospitalBoston, Massachusetts

Sanford E. Emery, MD, MBAProfessor and ChairDepartment of OrthopaedicsWest Virginia UniversityMorgantown, West Virginia

Jack R. Engsberg, PhDAssociate ProfessorOccupational TherapyWashington University School of MedicineSaint Louis, Missouri

Jean-Pierre Farcy, MDClinical ProfessorOrthopaedicsNew York University Hospital for Joint DiseasesNew York, New York

David S. Feldman, MDAssociate ProfessorOrthopedic SurgeryNew York University Hospital for Joint Diseases;ChiefDivision of Pediatric Orthopedic SurgeryNew York University Hospital for Joint DiseasesNew York, New York

Richard G. Fessler, MD, PhDProfessorNeurosurgeryNorthwestern UniversityChicago, Illinois

Brett Freedman, MDU.S. ArmyLandstuhl Regional Medical CenterLandstuhl, Germany

Christopher G. Furey, MDAssociate ProfessorDepartment of Orthopedic SurgeryCase Western Reserve UniversityCase Medical CenterCleveland, Ohio

Keith R. Gabriel, MDAssociate Professor of SurgeryDivision of Orthopaedics and RehabilitationSouthern Illinois University School of MedicineSpringfi eld, Illinois

Robert W. Gaines, Jr., MDSenior Spine SurgeonColumbia Orthopaedic GroupColumbia, Missouri

Contributing Authors xiii

Steven R. Garfi n, MDProfessor and ChairDepartment of Orthopaedic SurgeryUniversity of California, San DiegoSan Diego, California

Sumeet Garg, MDAssistant ProfessorOrthopaedic SurgeryUniversity of Colorado Denver School of MedicineSurgeonPediatric Orthopaedic SurgeryThe Childrens HospitalAurora, Colorado

Gregory P. Gebauer, MD, MSSpine FellowThe Rothman InstituteThomas Jefferson UniversityPhiladelphia, Pennsylvania

Daniel E. Gelb, MDAssociate Professor and Vice ChairmanDepartment of OrthopaedicsUniversity of Maryland School of MedicineBaltimore, Maryland

Sergio A. Glait, MDOrthopaedic Surgery ResidentNew York UniversityHospital for Joint DiseasesNew York, New York

R. Christopher Glattes, MDElite Orthopaedic CenterNashville, Tennessee

Ryan T. Gocke, MDDepartment of OrthopaedicsWest Virginia UniversityMorgantown, West Virgina

Ziya L. Gokaslan, MD, FACSDonlin M. Long ProfessorNeurosurgery, Oncology and Orthopaedic SurgeryJohns Hopkins University;Vice-ChairmanDirector of Spine ProgramDepartment of NeurosurgeryJohns Hopkins University School of MedicineBaltimore, Maryland

Joseph Gondusky, MDNaval Medical Center San Diego San Diego, California

Christopher R. Good, MDDirectorScoliosis and Spinal Deformity SurgeryVirginia Spine InstituteReston, Virginia

Matthew F. Gornet, MDStaff PhysicianSpine Research CenterThe Orthopedic Center of Saint LouisSaint Louis, Missouri

Oren N. Gottfried, MDActing InstructorDepartment of OrthopedicsUniversity of UtahSalt Lake City, Utah

Munish C. Gupta, MDProfessorCo-Director of Spine CenterChief of Orthopaedic Spinal Disorders ServiceVice Chair of AcademicsDepartment of Orthopaedic SurgeryUniversity of California, Davis Health SystemSacramento, California

Purnendu Gupta, MDAssociate Professor of SurgerySection of Orthopaedic Surgery and Rehabilitation MedicineUniversity of Chicago, Pritzker School of MedicineUniversity of Chicago Medical CenterShriners Hospital for ChildrenChicago, Illinois

Hartmann Habbicht, PhDPro SpineStraubing, Germany

Christopher L. Hamill, MDAssociate Clinical ProfessorDepartment of OrthopaedicsState University of New York at BuffaloBuffalo, New York

D. Kojo Hamilton, MDAssistant ProfessorDepartment of NeurosurgeryUniversity of Maryland Medical CenterBaltimore, Maryland

Kim W. Hammerberg, MDAssistant ProfessorOrthopaedicsRush University Medical CenterConsultantOrthopedicsShriners Hospital for ChildrenChicago, Illinois

Heather Hansen, Esq.PartnerOBrien & Ryan, LLCPlymouth Meeting, Pennsylvania

Jrgen Harms, MDProfessorSpine Surgery CenterSRH Klinikum Karlsbad-LangensteinbachKarlsbad, Germany

xiv Contributing Authors

Eric Harris, MDNaval Medical Center San DiegoSan Diego, California

Daniel J. Hedequist, MDAssistant Professor of Orthopedic SurgeryChildrens Hospital BostonHarvard Medical SchoolBoston, Massachusetts

Melvin D. Helgeson, MDDepartment of Orthopaedics and RehabilitationWalter Reed Army Medical CenterWashington, DC

Harry N. Herkowitz, MDChairmanDepartment of Orthopaedic SurgeryWilliam Beaumont HospitalRoyal Oak, Michigan

Kazutoshi Hida, MD, PhDClinical ProfessorDepartment of NeurosurgeryGraduate School of Medicine, Hokkaido UniversitySapporo City, Japan

Alan S. Hilibrand, MDProfessor of Orthopaedic Surgery and NeurosurgeryDirector of Medical EducationJefferson Medical CollegeThe Rothman InstitutePhiladelphia, Pennsylvania

Jessica Hillyer, PhDPost-Doctoral FellowInternational Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouver, British Columbia, Canada

Harish S. Hosalkar, MDAttending Orthopedic SurgeonDepartment of OrthopaedicsUniversity of California, San DiegoSan Diego, California

M. Timothy Hresko, MDAssociate ProfessorOrthopaedic SurgeryHarvard Medical SchoolDepartment of Orthopaedic SurgeryChildrens Hospital BostonBoston, Massachussetts

Brian C. Hsu, MBBS, FRACSOrthopaedic Spinal SurgeonVisiting Medical Offi cerDepartment of OrthopaedicsChildrens Hospital at WestmeadSydney, AustraliaOrthopaedic Spinal SurgeonOrthopaedic & Arthritis Specialist CentreChatswood, Sydney, Australia

Wellington K. Hsu, MDAssistant ProfessorDepartments of Orthopaedic Surgery and Neurological SurgeryNorthwestern UniversityChicago, Illinois

Serena S. Hu, MDProfessor and Vice ChairDepartment of Orthopedic SurgeryUniversity of California, San FranciscoSan Francisco, California

Manabu Ito, MDProfessorDeparment of Advanced Medicine for Spine and Spinal Cord

DisordersHokkaido University Graduate School of MedicineSapporo, Japan

Christine Jacob, MDPrivate PracticeSLUCare PhysiciansSaint Louis, Missiouri

Charles E. Johnston II, MDProfessorOrthopedic SurgeryUniversity of Texas Southwestern Medical School;Assistant Chief of StaffTexas Scottish Rite HospitalDallas, Texas

James D. Kang, MDProfessorOrthopaedic and Neurological SurgeryVice ChairDepartment of Orthopedic SurgeryUniversity of Pittsburgh School of MedicinePittsburgh, Pennsylvania

Bruce A. Kaufman, MDProfessorNeurosurgeryMedical College of WisconsinChiefPediatric NeurosurgeryChildrens Hospital of WisconsinMilwaukee, Wisconsin

Kathryn A. Keeler, MDAssistant ProfessorDepartment of Orthopaedic SurgerySaint Louis Childrens HospitalShriners Hospital for Children, Saint LouisWashington University School of MedicineSaint Louis, Missouri

Mustafa H. Khan, MDRush University Medical CenterChicago, Illinois

A. Jay Khanna, MDAssociate ProfessorOrthopaedic Surgery and Biomedical EngineeringJohns Hopkins UniversityJohns Hopkins Center for Bioengineering Innovation and DesignBaltimore, Maryland

Contributing Authors xv

Lawrence T. Khoo, MDDirectorSpinal NeurosurgeryLos Angeles Spine ClinicGood Samaritan Hospital and ClinicsLos Angeles, California

David H. Kim, MDAssistant Clinical ProfessorOrthopaedic SurgeryTufts University School of Medicine;Director of Medical EducationDepartment of Orthopaedic SurgeryNew England Baptist HospitalBoston, Massachussetts

Sung-Soo Kim, MDAssistant ProfessorSeoul Spine InstituteInje University Sanggye Paik HospitalSeoul, Korea

Yongjung J. Kim, MDAssistant ProfessorOrthopedic SurgeryColumbia UniversityNew York, New York

Andrew G.S. King, MB, ChB, FRACS, FACSRobert DAmbrosia Professor of Orthopedic SurgeryLouisiana State University Health Sciences CenterNew Orleans, Louisiana

Tyler R. Koski, MDAssistant ProfessorNeurological SurgeryNorthwestern University Feinberg School of MedicineChicago, Illinois

Yoshihisa Kotani, MDAssistant ProfessorDepartment of Orthopaedic SurgeryHokkaido University HospitalSapporo, Japan

William E. Krauss, MDAssociate ProfessorNeurological SurgeryMayo Medical SchoolRochester, Minnesota

Timothy R. Kuklo, MD, JDOrthopaedic SurgeonColorado Comprehensive Spine InstituteEnglewood, Colorado

Brian K. Kwon, MD, PhD, FRCSCAssociate ProfessorDepartment of OrthopaedicsUniversity of British ColumbiaVancouver, British Columbia, Canada

Hubert Labelle, MDProfessorSurgeryUniversity of MontrealChiefOrthopaedicsSainte-Justine University Center HospitalMontreal, Canada

Sue Min Lai, PhD, MS, MBAProfessor and Director of Kansas Cancer RegistryDepartment of Preventive Medicine and Public HealthUniversity of Kansas Medical CenterKansas City, Kansas

Manish P. Lambat, MS DNBFellowPediatric OrthopaedicsLouisiana State University Health Sciences CenterDepartment of Orthopaedic SurgeryChildrens HospitalNew Orleans, Louisiana

James E. Lashley, MDOrthopaedic & Spine SurgeonHamilton Medical CenterDalton, Georgia

William C. Lauerman, MDProfessor and ChiefDivision of Spine SurgeryDepartment of Orthopaedic SurgeryGeorgetown University HospitalWashington, DC

Ilya Laufer, MDDepartment of Neurological SurgeryWeill Cornell Medical CollegeNew York Presbyterian HospitalNew York, New York

Brandon Lawrence, MDAssistant ProfessorDepartment of OrthopaedicsUniversity of UtahSalt Lake City, Utah

James Lawrence, MDThomas Jefferson University Medical CollegePhiladelphia, Pennsylvania

Mark C. Lee, MDAssistant ProfessorOrthopaedicsConnecticut Childrens Medical CenterHartford, Connecticut

Ronald A. Lehman, Jr., MDDirectorPediatric and Adult Spine SurgeryDepartment of Orthopaedics and RehabilitationWalter Reed Army Medical CenterWashington, DC

xvi Contributing Authors

Lawrence G. Lenke, MDThe Jerome J. Gilden Professor of Orthopedic SurgeryProfessor of Neurological SurgeryCo-Director of Adult/Pediatric Scoliosis and Reconstructive

Spinal SurgeryChief of Spinal Surgery Shriners Hospital for Children, Saint LouisWashington University School of MedicineSaint Louis, Missouri

Jeffrey R. Leonard, MDAssistant ProfessorNeurological Surgery and PedaitricsWashington University School of MedicineSaint Louis, Missouri

John C. Liu, MDAssociate ProfessorDepartment of NeurosurgeryNorthwestern UniversityChicago, Illinois

John Louis-Ugbo, MDDepartment of Orthopaedic SurgeryEmory UniversityAtlanta, Georgia

John P. Lubicky, MD, FAAOS, FAAPProfessor of Orthopaedic Surgery & PediatricsWest Virginia University School of MedicineMorgantown, West Virginia

Steven C. Ludwig, MDAssociate Professor and ChiefSpine SurgeryDepartment of OrthopaedicsUniversity of Maryland Medical CenterBaltimore, Maryland

Scott J. Luhmann, MDAssociate ProfessorDepartment of Orthopaedic SurgeryWashington University School of MedicineAttending Orthopaedic SurgeonShriners Hospital for Children, Saint LouisSaint Louis, Missouri

Angel E. Macagno, MDResidentDepartment of Orthopedic SurgerySUNY Downstate Medical CenterBrooklyn, New York

Andrew W. Mack, MDOrthopaedic Surgery ResidentDepartment of Orthopaedics and RehabilitationWalter Reed Army Medical CenterWashington, DC

Jean-Marc Mac-Thiong, MD, PhDAssistant ProfessorSurgerySainte-Justine University Center HospitalUniversity of MontrealMontreal, Canada

Kamran Majid, MDFellow, Orthopaedic Spine SurgeryWilliam Beaumont HospitalRoyal Oak, Michigan

Steven M. Mardjetko, MD, FAAPAssociate ProfessorOrthopedic Surgery Rush UniversityChicago, Illinois;Illinois Bone & Joint InstituteMorton Grove, Illinois

Richard E. McCarthy, MDProfessorChief of Spinal DeformitiesDepartment of OrthopaedicsUniversity of Arkansas for Medical Sciences;ProfessorChief of Spinal DeformitiesDepartment of OrthopaedicsArkansas Childrens HospitalLittle Rock, Arkansas

Paul C. McCormick, MD, MPHDepartment of Neurological SurgeryThe Neurological InstituteColumbia UniversityNew York, New York

Gegory S. McLoughlin, MD, FRCSCNeurosurgeryUniversity of SaskatchewanSaskatoon, Saskatchewan, Canada

Michael John McMaster, MD, FRCSClinical DirectorScottish National Paediatric Spine Deformity CentreRoyal Hospital for Sick Children;Consultant Orthopaedic Spine SurgeonDepartment of OrthopaedicsRoyal Infi rmary of EdinburghEdinburgh, Scotland, United Kingdom

Thomas G. McPartland, MDClinical InstructorDepartment of Orthopaedic SurgeryUniversity of Medicine and Dentistry of New Jersey, Robert Wood

Johnson Medical SchoolNew Brunswick, New Jersey

Jwalant S. Mehta, MS, MCh, FRCSConsultant Spine SurgeonCentre for Spinal Studies and SurgeryQueens Medical Centre, Nottingham University HospitalsNottingham, United Kingdom

Arnold H. Menezes, MD, FACS, FAAPProfessor and Vice ChairmanDepartment of NeurosurgeryUniversity of Iowa Hospitals and ClinicsIowa City, Iowa

Richard B. Meyrat, MDMethodist Dallas Medical CenterDallas, Texas

Contributing Authors xvii

Fred Mo, MDOrthopaedic SurgeryYale New Haven HospitalNew Haven, Connecticut

David J. Moller, MDAssistant ProfessorDepartment of Neurological SurgeryUniversity California Davis, Medical CenterSacramento, California

David M. Montgomery, MDOrthopaedic Spine SurgeonWilliam Beaumont HospitalRoyal Oak, Michigan

Janice F. Mulligan, Esq.Law Offi ces of Mulligan & BanhamSan Diego, California

Gregory M. Mundis, Jr., MDPediatric and Adult Deformity SurgeryCervical Spine SurgerySpine SurgerySan Diego Center for Spinal DisordersLa Jolla, California

Fadi Nasr, MDNorthwestern UniversityDepartment of NeurosurgeryChicago, Illinois

Ahmad N. Nassr, MDAssistant Professor of Orthopaedic SurgeryDepartment of Orthopedic SurgeryMayo ClinicRochester, Minnesota

Chris J. Neal, MDDepartment of Neurosurgery Northwestern UniversityChicago, Illinois

Clarke Nelson, MDDepartment of Neurological SurgeryJohns Hopkins UniversityBaltimore, Maryland

Peter O. Newton, MDAssociate Clinical ProfessorDepartment of Orthopedic SurgeryUniverstiy of California, San DiegoRady Childrens HospitalSan Diego, California

Douglas D. Nowak, MDOrthopaedic Surgery ResidentDepartment of OrthopaedicsNew York Presbyterian HospitalColumbia University Medical CenterNew York, New York

Michael F. OBrien, MDSouthwest Scoliosis InstituteBaylor Scoliosis CenterPlano, Texas

Alfred T. Ogden, MDDepartment of Neurological SurgeryThe Neurological InstituteColumbia UniversityNew York, New York

Elena B. Okon, PhDResearch AssociateInternational Collaboration on Repair DiscoveriesUniversity of British ColumbiaVancouver, British Columbia, Canada

Gbolahan O. Okubadejo, MDOrthopaedic Spine SurgeonActive Joints OrthopedicsStaff PhysicianEnglewood HospitalEnglewood, New Jersey

Stephen L. Ondra, MDProfessor of Neurological SurgeryDepartment of Neurological SurgeryNorthwestern University Feinberg School of MedicineChicago, Illinois

LTC Joseph R. Orchowski, MDChiefOrthopaedic Spine SectionTripler Army Medical CenterHonolulu, Hawaii

Brian A. OShaughnessy, MDNeurosurgeonHowell Allen ClinicNashville, Tennessee

Timothy S. Oswald, MDAssistant Clinical ProfessorDepartment of Orthopaedic SurgeryEmory University;Pediatric Orthopaedic AssociatesAtlanta, Georgia

Anne M. Padberg, MS, CCC-ADirector of Intraoperative MonitoringDepartment of Perioperative ServicesBJC HealthcareSt. Louis, Missouri

Daniel K. Park, MDSpinal Surgery FellowEmory UniversityAtlanta, Georgia

Alpesh A. Patel, MDAssistant ProfessorDepartment of OrthopaedicsUniversity of Utah School of MedicineSalt Lake City, Utah

Ashish Patel, MDNew York University Hospital for Joint DiseasesDepartment of Orthopaedic SurgeryNew York, New York

xviii Contributing Authors

Joseph H. Perra, MDStaff SurgeonTwin Cities Spine CenterMinneapolis, Minnesota

Mark A. Pichelmann, MDDepartment of NeurosurgeryMayo ClinicRochester, Minnesota

Kornelis A. Poelstra, MDAssistant Professor of OrthopaedicsDepartment of OrthopaedicsUniversity of Maryland Medical CenterBaltimore, Maryland

David W. Polly, Jr., MDProfessor and Chief of Spine SurgeryOrthopaedic SurgeryUniversity of MinnesotaMinneapolis, Minnesota;Professor of SurgeryUniformed Services University of the Health SciencesBethesda, Maryland

Ravi K. Ponnappan, MDAssistant ProfessorOrthopaedic SurgeryThomas Jefferson UniversityPhiladelphia, Pennsylvania

RaKerry K. Rahman, MDOrthopaedic SurgeonDepartment of OrthopaedicsSouthern Illinois University Medical CenterSpringfi eld, Illinois

Sharad Rajpal, MDDepartment of NeurosurgeryUniversity of Wisconsin Medical SchoolMadison, Wisconsin

Alexander Rasouli, MDUniversity of Miami/Jackson Memorial HospitalDepartment of Orthopaedic SurgeryUniversity of Miami Miller School of Medicine Spine CenterRehabilitation Center Miami, Florida

Barry L. Raynor, BA, CNIMDepartment of Perioperative ServicesBJC HealthcareSaint Louis, Missouri

David L. Reames, MDDepartment of Neurological SurgeryUniversity of Virginia School of MedicineCharlottesville, Virginia

Richard Redett, MDAssociate Professor and DirectorPediatric Plastic SurgeryPlastic and Reconstructive SurgeryJohns Hopkins University School of MedicineBaltimore, Maryland

John J. Regan, MDFellowship-Trained Spine SurgeonPrivate PracticeBeverly Hills, California

Daniel K. Resnick, MD, MSAssociate Professor and Vice ChairmanNeurosurgeryUniversity of Wisconsin School of Medicine and Public HealthMadison, Wisconsin

John M. Rhee, MDAssociate ProfessorDepartment of Orthopaedic SurgeryEmory UniversityEmory Spine CenterAtlanta, Georgia

B. Stephens Richards III, MDProfessorDepartment of OrthopaedicsUniversity of Texas Southwestern Medical Center at DallasAssistant Chief of StaffTexas Scottish Rite Hospital for ChildrenDallas, Texas

K. Daniel Riew, MDMildred B. Simon Distinguished Professor of Orthopedic SurgeryProfessor of Neurological SurgeryChief, Cervical Spine Surgery & Director, Orthopedic & Rehab

Institute for Cervical Spine Surgery Washington University School of MedicineSaint Louis, Missouri

Jeffrey A. Rihn, MDOrthopaedic Spine SurgeonThe Rothman InstituteMedia, Pennsylvania

Joseph Riina, MDSpine SurgeonIndiana Orthopaedic HospitalIndianapolis, Indiana

Anthony S. Rinella, MDSpine and Scoliosis SurgeonFounderIllinois Spine and Scoliosis CenterHomer Glen, Illinois

Keith M. Rinkus, MD, MSSurgeonOrthopaedic Sports Medicine and RehabilitationRed Bank, New Jersey

Brandon G. Rocque, MDDepartment of NeurosurgeryUniversity of Wisconsin Medical SchoolMadison, Wisconsin

Julian A. Romagnoli, MDSpine FellowSpine SurgeryColumbia Orthopaedic GroupColumbia, Missouri

Contributing Authors xix

Peter S. Rose, MDSenior Associate ConsultantDepartment of Orthopedic SurgeryMayo ClinicRochester, Minnesota

Rebecca Rosemann, MS, PA-CPhysician AssistantSpine CenterCedars Sinai Medical CenterLos Angeles, California

Michael K. Rosner, MDAssociate Professor in SurgerySurgery DepartmentUniformed University of the Health SciencesBethesda, MarylandDirector of Neurosurgery, Complex SpineNeurosurgery ServiceWalter Reed Army Medical CenterWashington, DC

Pierre Roussouly, MDChiefDepartment of Orthopedic and Spine SurgeryCentre Medico-Chirurgical De Readaptation des MassuesLyon, France

ML Chip Routt, MDDepartment of Orthopaedics and Sports MedicineHarborview Medical CenterUniversity of WashingtonSeattle, Washington

Michael Ruf, MDOrthopedics and TraumatologySRH-Zentralklinikum SuhlSuhl, Germany

Debra A. SalaResearch CoordinatorCenter for ChildrenNew York University Hospital for Joint DiseasesNew York, New York

Amer F. Samdani, MDShriners Hospital for ChildrenPhiladelphia, Pennsylvania

James O. Sanders, MDProfessor of Orthopaedics and PediatricsDepartment of Orthpaedics and RehabilitationUniversity of RochesterRochester, New York

Edward R.G. Santos, MDAssistant ProfessorOrthopaedic SurgeryUniversity of MinnesotaMinneapolis, Minnesota

Rick C. Sasso, MD, FACSAssociate ProfessorChief of Spine SurgeryClinical Orthopaedic SurgeryIndiana University School of MedicineIndianapolis, Indiana

Steven Scherping, MDAssociate ProfessorOrthopaedic SurgeryGeorgetown University HospitalWashington, DC

Thomas A. Schildhauer, MDSurgical Clinic and PolyclinicBergmannsheil University HospitalRuhr-Universitt BochumBochum, Germany

Frank J. Schwab, MDChief of Spinal Deformity ServiceOrthopaedicsNew York University Hospital for Joint DiseasesNew York, New York

David G. Schwartz, MDSpine SurgeonIndiana Orthopaedic HospitalIndianapolis, Indiana

James D. Schwender, MDTwin Cities Spine CenterMinneapolis, Minnesota

Daniel M. Sciubba, MDAssistant ProfessorNeurosurgery, Oncology, and Orthopaedic Surgery DirectorMinimally Invasive Spine SurgeryDirectorSpine ResearchJohns Hopkins UniversityBaltimore, Maryland

Christopher I. Shaffrey, MD, FACSHarrison Distinquished Teaching ProfessorDepartment of Neurological SurgeryUniversity of VirginiaCharlottesville, Virginia

M. Mohsin Shah, MDNeurosurgical FellowSeattle Neuroscience InstituteSwedish Medical CenterSeattle, Washington

Eric D. Shirley, MD, LCDR, MC, USNAttending PhysicianDepartment of Pediatric Orthopaedic SurgeryNemours Childrens ClinicJacksonville, Florida

Harry L. Shuffl ebarger, MDChiefDivision of Spinal SurgeryDepartment of Orthopedic SurgeryMiami Childrens HospitalMiami, Florida

Kern Singh, MDAssistant ProfessorOrthopaedic SurgeryRush University Medical CenterChicago, Illinois

David L. Skaggs, MDAssociate ProfessorOrthopaedic SurgeryUniversity of Southern California School of MedicineEndowed ChairPediatric Spinal DisordersAssociate DirectorChildrens Orthopaedic CenterChildrens Hospital Los AngelesLos Angeles, California

Jason E. Smith, MDSpine Surgery FellowIndiana Orthopaedic HospitalIndianapolis, Indiana

Zachary A. Smith, MDFellow in Spinal SurgeryNorthwestern Memorial HospitalChicago, Illinois

David L. Spencer, MDClinical Associate ProfessorOrthopedic SurgeryUniversity of Illinois College of MedicineChicago, Illinois

David A. Spiegel, MDAssistant ProfessorOrthopaedic SurgeryThe University of Pennsylvania School of MedicineDivision of Orthopaedic SurgeryChildrens Hospital of PhiladelphiaPhiladelphia, Pennsylvania

Paul D. Sponseller, MDProfessorChief Pediatric OrthopaedicsChildrens Orthopaedics and Spine SurgeryDepartment of Orthopaedic SurgeryJohns Hopkins MedicineBaltimore, Maryland

Daniel J. Sucato, MD, MSAssociate ProfessorDepartment of Orthopaedic SurgeryUniversity of Texas at Southwestern Medical CenterDirectorOrthopaedic SurgeryCenter for Excellence in Spine ResearchTexas Scottish Rite HospitalDallas, Texas

Se-Il Suk, MD, PhDProfessor and DirectorSeoul Spine InstituteInje University Sanggye Paik HospitalSeoul, Korea

Ganesh Swamy, MDClinical LecturerDivision of Orthopaedic SurgeryUniversity of CalgaryCalgary, Alberta, Canada

Ufuk Talu, MDProfessorDepartment of Orthopaedic SurgeryIstanbul UniversityIstanbul, Turkey

H. Thomas Temple, MDProfessor and Vice ChairmanDepartment of Orthopaedic SurgeryUniversity of Miami Miller School of MedicineMiami, Florida

Andelle L. Teng, MD, MSOrthopaedic Spine SurgeonCascade OrthopaedicsAuburn, Washington

George H. Thompson, MDProfessorOrthopaedic Surgery and PediatricsCase Western Reserve University;DirectorPediatric OrthopaedicsRainbow Babies and Childrens HospitalCleveland, Ohio

Earl D. Thuet, BS, CNIMDepartment of Perioperative ServicesBJC HealthcareSaint Louis, Missouri

John E. Tis, MDAssistant ProfessorDepartment of Orthopaedic SurgeryJohns Hopkins UniversityBaltimore, Maryland

Vincent C. Traynelis, MDDepartment of NeurosurgeryUniversity of Iowa Hospitals and ClinicsIowa City, Iowa

Kene T. Ugokwe, MDClinical Instructor and Spine FellowDepartment of NeurosurgeryUniversity of WisconsinMadison, Wisconsin

Jessica J. Uitto, Esq.OBrien & Ryan, LLPPlymouth Meeting, Pennsylvania

Vidyadhar V. Upasani, MDResidentOrthopedic SurgeryUniversity of California San DiegoSan Diego, California

Fulya stnkan, MDDepartment of Pediatric Orthopaedic Surgery New York University Hospital for Joint DiseasesNew York, New York

xx Contributing Authors

Alexander R. Vaccaro, MDDepartment of Orthopaedic SurgeryThomas Jefferson University HospitalPhiladelphia, Pennsylvania

Corey J. Wallach, MDOrthopaedic Spine SurgeonThe Anderson ClinicArlington, Virginia

Jeffrey C. Wang, MDAssociate ProfessorOrthopaedics and NeurosurgeryChief of Spine SurgeryUniversity of California Los Angeles Comprehensive Spine CenterSanta Monica, California

Mark Weidenbaum, MDDepartment of Orthopaedic SurgeryNew York Presbyterian HospitalColumbia UniversityNew York, New York

Stuart L. Weinstein, MDIgnacio V. Ponseti Chair and Professor of Orthopaedic SurgeryDepartment of Orthopaedics and RehabilitationUniversity of Iowa Hospitals and ClinicsIowa City, Iowa

Jean-Paul Wolinsky, MDAssistant ProfessorNeurosurgery and OncologyClinical DirectorJohns Hopkins Spine ProgramDepartment of NeurosurgeryJohns Hopkins UniversityBaltimore, Maryland

Adam L. Wollowick, MDAssistant ProfessorDepartment of Orthopaedic SurgeryAlbert Einstein College of MedicineAttending SurgeonDepartment of Orthopaedic SurgeryMontefi ore Medical CenterBronx, New York

Yoshiya Yamada, MDDepartment of Radiation OncologyMemorial Sloan-Kettering Cancer CenterNew York, New York

Jason P. Young, MDResidentDepartment of Orthopaedic SurgeryLoyola University Medical CenterMaywood, Illinois

Paul H. Young, MDClinical ProfessorSection of NeurosurgeryDepartment of SurgeryCenter for Anatomical Science and EducationSaint Louis University School of MedicineSaint Louis, Missouri

James J. Yue, MDAssociate ProfessorDivision of Spine SurgeryDepartment of Orthopaedic SurgeryYale School of MedicineNew Haven, Connecticut

Lukas P. Zebala, MDAssistant ProfessorDepartment of Orthopaedic SurgeryWashington University School of MedicineSaint Louis, Missouri

Reinhard D. Zeller, MD, ScD, FRCSCAssociate ProfessorDivision of Orthopaedic SurgeryUniversity of TorontoHead, Spine ProgramThe Hospital for Sick ChildrenToronto, Ontario, Canada

Amer Zeni, MDIndiana University School of MedicineRiley Hospital for ChildrenIndianapolis, Indiana

Hong Zhang, MDAssociate ProfessorDepartment of Orthopaedic SurgeryThe University of Texas Southwestern Medical CenterTexas Scottish Rite Hospital for ChildrenDallas, Texas

Contributing Authors xxi

In this, the third edition of The Textbook of Spinal Surgery, we attempt to cover all important etiologies (deformity, degenera-tive, traumatic and neoplastic) of pediatric and adult spinal surgery, as well as all pathologies from the skull to the sacrum. It has now been 13 years since we published the second edition. In the fi rst edition we had 45 chapters and 60 contributors. In the second edition we had 130 chapters and 182 contributors. In this edition we have 156 chapters and 60 contributors.

As in the fi rst two editions, we have a blend of orthopaedic and neurosurgical colleagues from all over the world contribut-ing chapters.

With this edition, we have more heavily peer-reviewed the chapters. Each chapter was reviewed by an associate and a senior editor before publication. Most chapters were returned to the author for revision before submitting to the publisher. Therein, we believe these chapters will impress you with their quality and excellence.

Rather than bombard the reader with a 200-list bibliogra-phy, we decided to condense the reference list to a more man-ageable size. Therein, with each chapter we attempted to refer-ence a small number of classic articles and otherwise the most current and pertinent ones.

Since the second edition, spinal surgery has grown tremen-dously. More surgeons are specializing in spinal surgery and training with fellowships than was the case when the second edition was published. Neurosurgeons are also far more con-tributory to the fi eld than was the case many years ago. We feel this will be refl ected in the current edition.

We are also in the process of producing several techniques videos which we feel will be helpful to the readers. The topics include adult thoracic vertebral column resection for scoliosis deformity, posterior vertebral column resection, cervical corpectomy and reconstruction, disc arthroplasty in the cervical spine, and extracavitary metastatic tumor resection and reconstruction.

As with the past editions, this textbook will be of great value to medical students, select physical therapists and physiatrists who are particularly interested in the study of spinal pathology and surgical treatment, orthopaedic and neurosurgery resi-dents and fellows and practicing orthopaedic surgeons and neurosurgeons.

Keith H. Bridwell, MDRonald L. DeWald, MD

Preface

xxiii

As stated in the preface, our associate editors have done a tre-mendous amount of work, peer-reviewing all chapters before they were submitted to the publisher. I would like to particu-larly thank those associate editors, Peter D. Angevine, Jacob M. Buchowski, Charles C. Edwards II, Christopher L. Hamill, Timothy R. Kuklo, Ronald A. Lehman Jr., Lawrence G. Lenke, Scott J. Luhmann, John M. Rhee, and K. Daniel Riew; their wives, Anne Angevine, Katherine Buchowski, Ann Edwards, Vikki Hamill, Linda Kuklo, Marina Lehman, Beth Lenke, Jan Luhmann, Marcia Ko, and Mary Riew; and their families for allowing them to devote extra time to advancing the knowledge of spinal surgery for all students of the fi eld.

We would very much like to thank Terri Iffrig. She was the managing editor for the second edition for which her job was twice as big as it was for the fi rst edition and for this edition it

was twice as big again. Without her hard work and organiza-tion, the textbook would never have come to fruition.

Also, we would like to thank the Lippincott Williams & Wilkins staff, including Robert Hurley, David Murphy, Elise Paxson, Eileen Wolfberg, and Sarah Granlund, for working so hard with us on this project.

As with the other two editions, Dr. Bridwell thanks and acknowledges Dr. Ronald L. DeWald for his guidance and teachings over the years. Most of the associate editors and a very high percentage of the contributing authors were either trained by Dr. DeWald or by the people he trained. We thank him for his guidance and inspiration.

Keith H. Bridwell, MD

Acknowledgments

xxv

Foreword viiContributing Authors ixPreface xxiiiAcknowledgments xxv

SECTION I: General Considerations

SECTION EDITOR: JOHN M. RHEE

1. The Evolution of Spine Surgery since the Second Edition of The Textbook of Spinal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1RONALD L. DEWALD

2. Spinal Cord and Nerve Root Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6ANNE M. PADBERG, BARRY L. RAYNOR, EARL D. THUET, AND SHELLY M. BOLON

3. Bone Grafting and Spine Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41JOHN LOUIS-UGBO AND SCOTT D. BODEN

4. Medical Complications in the Adult Spinal Patient . . . . . . . . . . . . . . . . . . . . . . . 49ALEXIS B.C. DANG AND SERENA S. HU

5. Trunk Range of Motion and Gait Considerations in Patients with Spinal Deformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57JACK R. ENGSBERG, LAWRENCE G. LENKE, AND KEITH H. BRIDWELL

SECTION II: Biomechanics

SECTION EDITOR: TIMOTHY R. KUKLO

6. General Considerations of Biomechanical Testing . . . . . . . . . . . . . . . . . . . . . . . . 65ANTON E. DMITRIEV

7. Basic Pedicle Screw and Construct Biomechanics . . . . . . . . . . . . . . . . . . . . . . . . . 74C.H. CRAWFORD III, B.A. OSHAUGHNESSY, AND T.R. KUKLO

8. Biomechanics of Three-Dimensional Scoliosis Correction . . . . . . . . . . . . . . . . . . 79ANDREW G. S. KING AND MANISH P. LAMBAT

9. Treatment Considerations and Biomechanics of the Lumbosacral Spine . . . . . . . . 86GEOFFREY CRONEN AND TIMOTHY R. KUKLO

10. Normal Spinal Anatomy: Normal Sagittal Plane Alignment . . . . . . . . . . . . . . . . . 93MARK BERNHARDT

Contents

xxvii

xxviii Contents

SECTION III: Anatomic Approaches

SECTION EDITOR: RONALD A. LEHMAN, JR.

11. Microscopic Approach to the Posterior Lumbar Spine for Decompression . . . 101JASON P. YOUNG AND PAUL H. YOUNG

12. Minimal Access Techniques Using Tubular Retractors for Disc Herniations and Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110NEEL ANAND AND ELI M. BARON

13. Anterior Cervical Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118RONALD A. LEHMAN JR AND K. DANIEL K. RIEW

14. Jaw-Splitting Approaches to the Upper Cervical Spine . . . . . . . . . . . . . . . . . . . 127DANIEL M. SCIUBBA, GREGORY S. MCLOUGHLIN, ZIYA L. GOKASLAN, AND JEAN-PAUL WOLINSKY

15. The Modifi ed Anterior Approach to the Cervicothoracic Junction . . . . . . . . . . . 140KAMRAN MAJID AND HARRY N. HERKOWITZ

16. Transsternal Approaches to the Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147DANIEL M. SCIUBBA, CLARKE NELSON, JEAN-PAUL WOLINSKY, AND ZIYA L. GOKASLAN

17. Anterior Exposure of the Thoracic and Lumbar Spine Down to L4 . . . . . . . . . . 158MELVIN D. HELGESON AND RONALD A. LEHMAN JR

18. Anterior Approaches to the Distal Lumbar Spine and Sacrum . . . . . . . . . . . . . . 165JOHN E. TIS AND RONALD A. LEHMAN JR

19. Direct Lateral Approach to the Lumbar Spine . . . . . . . . . . . . . . . . . . . . . . . . . . 175NEEL ANAND AND ELI M. BARON

SECTION IV: The Cervical Degenerative Spine

SECTION EDITOR: JOHN M. RHEE

20. Cervical State of the Art . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183JOHN M. RHEE

21. Evaluation of Axial Neck Pain. Who is a Surgical Candidate and Who Isnt: How to Manage the Nonoperative Treatment, How to Work Up the Pathology . . . 185KEITH RINKUS AND JOHN M. RHEE

22. Cervical Radiculopathy: Clinical Evaluation and Nonoperative Treatment . . . . . 196PETER S. ROSE, JOHN M. RHEE, AND K. DANIEL RIEW

23. Cervical Spondylosis and Radiculopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203ANDELLE L. TENG, COREY WALLACH, AND JEFFREY C. WANG

24. Cervical Myelopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212JOHN M. RHEE, SUSHIL K. BASRA, AND K. DANIEL RIEW

Contents xxix

25. Occipitocervical and Atlantoaxial Methods of Fusion: C1-2 Fixation, Harms Screw, Magerl Screw, Wiring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225RAHEEL AHMED, VINCENT C. TRAYNELIS, AND ALEXANDER R. VACCARO

26. Anterior Decompression, Instrumentation, Fusion Techniques: Corpectomy, Strut Grafting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236AHMAD NASSR, RAVI K. PONNAPPAN, AND JAMES D. KANG

27. Anterior Decompression, Instrumentation, Fusion Techniques: Discectomy, Foraminotomy, Disc Space Carpentry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253RAVI K. PONNAPPAN, AHMAD NASSR, AND JAMES D. KANG

28. Anterior Cervical Plating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268ANDREW W. MACK, RONALD A. LEHMAN III, AND TIMOTHY R. KUKLO

29. Indications and Techniques for Transoral and Foramen Magnum Decompression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276ARNOLD H. MENEZES

30. Subaxial Posterior Decompression and Fusion Techniques . . . . . . . . . . . . . . . . . 293DOUGLAS D. NOWAK, KORNELIS A. POELSTRA, AND STEVEN C. LUDWIG

31. Subaxial Posterior Foraminotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301DOUGLAS D. NOWAK, RAKERRY K. RAHMAN, KORNELIS A. POELSTRA, AND STEVEN C. LUDWIG

32. Subaxial Posterior Laminoplasty and Laminectomy . . . . . . . . . . . . . . . . . . . . . . 307DOUGLAS D. NOWAK, KORNELIS A. POELSTRA, AND STEVEN C. LUDWIG

33. Subaxial Posterior Lateral Mass Fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313MELVIN D. HELGESON AND RONALD A. LEHMAN JR.

34. Subaxial Cervical Pedicle Screw Fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321KUNIYOSHI ABUMI, MANABU ITO, AND HIDEKI SUDO

35. Revision Cervical Spine Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335BRIAN A. OSHAUGHNESSY, CHARLES H. CRAWFORD III, RONALD L. LEHMAN, AND TIMOTHY R. KUKLO

36. Cervical Disc Arthroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 344WELLINGTON K. HSU AND PAUL A. ANDERSON

SECTION V: The Thoracic and Lumbar Degenerative Spine

SECTION EDITOR: TIMOTHY R. KUKLOW

37. Thoracic and Lumbar Degenerative Disorders: State of the Art . . . . . . . . . . . . . 353JACOB M. BUCHOWSKI

38. Evaluation of Thoracic and Lumbar Axial Back Pain . . . . . . . . . . . . . . . . . . . . . 355KATHRYN KEELER AND JACOB M. BUCHOWSKI

xxx Contents

39. Evaluation of Thoracic and Lumbar Radicular Pathology. Who Is a Surgical Candidate and Who Isnt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367KATHRYN A. KEELER AND JACOB M. BUCHOWSKI

40. Use of Discography to Evaluate Lumbar Back Pain with an Eye Toward Surgical Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 376EUGENE J. CARRAGEE AND ANGUS S. DON

41. Surgical Treatment of Lumbar Disc Herniation . . . . . . . . . . . . . . . . . . . . . . . . . 387DAVID LEE SPENCER

42. Surgical Treatment of Lumbar Spinal Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . 394GBOLAHAN O. OKUBADEJO AND JACOB M. BUCHOWSKI

43. Revision Laminectomy: Indications and Techniques . . . . . . . . . . . . . . . . . . . . . 402PETER D. ANGEVINE

44. Strategies and Techniques for Dural Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . 411CHRIS J. NEAL, TYLER KOSKI, AND STEPHEN L. ONDRA

45. When to Consider ALIF, TLIF, PLIF, PSF, or Motion-Preserving Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 418DAVID W. POLLY AND EDWARD RAINIER G. SANTOS

46. Motion-Preservation Techniques (Other Than Disc Arthroplasty) . . . . . . . . . . . 428JOHN G. DEVINE

47. Transforaminal Lumbar Interbody Fusion/Posterior Lumbar Interbody Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 436CHRISTOPHER R. GOOD AND TIMOTHY R. KUKLO

48. Anterior Lumbar Interbody Fusion Techniques . . . . . . . . . . . . . . . . . . . . . . . . . 445MICHAEL K. ROSNER AND VICTORIA A. CAMPBELL

49. Minimally Invasive Posterior Surgery for the Lumbar Spine . . . . . . . . . . . . . . . 452JAMES D. SCHWENDER AND BRIAN C. HSU

50.1. Total Disc Replacement: Concepts/Design Strategy/Indications/Contraindications/Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463JAMES J. YUE, BRANDON LAWRENCE, AND FRED MO

50.2. Total Disc ReplacementMaverick . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471MATTHEW F. GORNET

50.3. Lumbar Total Disc Replacement: CHARITE Artifi cial Disc . . . . . . . . . . . . . . . . 483OREN N. GOTTFRIED AND DARREL S. BRODKE

50.4. Total Disc Replacement: ProDisc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 493UFUK TALU, RUDOLF BERTAGNOLI, HARTMANN HABBICHT, GANESH SWAMY, AND SERENA S. HU

51. Revision Lumbar Spine Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503JOSHUA D. AUERBACH AND TIMOTHY R. KUKLO

52. Complications of Lumbosacral Spine Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . 513JOHN R. DIMAR II

Contents xxxi

53. The Future: Disc Regeneration and Other Technologies . . . . . . . . . . . . . . . . . . 525DANIEL K. PARK, MICHAEL B. ELLMAN, KERN SINGH, AND HOWARD S. AN

54. Posterior Dynamic Stabilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 534ZACHARY A. SMITH AND LARRY T. KHOO

55. Thoracic Discectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 539DAVID J. MOLLER AND JOHN C. LIU

56. Thoracic Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 546TYLER KOSKI AND FADI NASR

SECTION VI: Spondylolisthesis

SECTION EDITOR: CHARLES C. EDWARDS II

57. Spondylolisthesis: Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 553CHARLES EDWARDS II AND MARK WEIDENBAUM

58. Wiltse and Marchetti/Bartolozzi Classifi cations of SpondylolisthesisGuidelines for Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . 556RAKERRY K. RAHMAN, JOSEPH PERRA, AND MARK WEIDENBAUM

59. Sacro-Pelvic Morphology, Spino-Pelvic Alignment, and the Spinal Deformity Study Group Classifi cation . . . . . . . . . . . . . . . . . . . . . . . . 563HUBERT LABELLE AND JEAN-MARC MAC-THIONG

60. The Natural History of Spondylolisthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576KIM HAMMERBERG AND MUSTAFA KHAN

61. Pars Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 581PURNENDU GUPTA AND MUNISH C. GUPTA

62.1. Low-Grade Spondylolisthesis in Children and Adolescents . . . . . . . . . . . . . . . . 590M. TIMOTHY HRESKO

62.2. Low-Grade Spondylolisthesis in Adults: Surgical Management . . . . . . . . . . . . . 596STEVEN MARDJETKO

63. Adult Degenerative Spondylolisthesis Without Lysis . . . . . . . . . . . . . . . . . . . . . 617STEVEN S. AGABEGI, DAVID M. MONTGOMERY, AND HARRY N. HERKOWITZ

64. High-Grade Spondylolisthesis: Fusion In Situ . . . . . . . . . . . . . . . . . . . . . . . . . . 633MAURICIO CAMPOS AND STUART WEINSTEIN

65. High-Grade Spondylolisthesis: Partial Reduction . . . . . . . . . . . . . . . . . . . . . . . 638PIERRE ROUSSOULY AND RICHARD B. MEYRAT

66. High-Grade Spondylolisthesis: Posterior Decompression and Spanning/Dowel Fibula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 646RICK C. SASSO AND JAMES E. LASHLEY

67. High Dysplastic Spondylolisthesis: Anatomic Reduction. The Harms/Shuffl ebarger Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 660HARRY L. SHUFFLEBARGER

xxxii Contents

68. Reduction of High-Grade Spondylolisthesis: The Edwards Technique . . . . . . . . 668CHARLES C. EDWARDS AND CHARLES C. EDWARDS II

69. The L5 Vertebrectomy Approach for the Treatment of Spondyloptosis with Reduction of L4 onto S1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686JULIAN A. ROMAGNOLI, JWALANT S. MEHTA, AND ROBERT W. GAINES

70. Complications of Spondylolysis/Spondylolisthesis Surgery . . . . . . . . . . . . . . . . 701JOHN P. LUBICKY AND AMER ZENI

SECTION VII: Idiopathic Scoliosis

SECTION EDITOR: CHARLES C. EDWARDS II

71. Introduction to Adolescent Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . 709CHARLES C. EDWARDS II AND KEITH H. BRIDWELL

72. Natural History Including Measures of Maturity . . . . . . . . . . . . . . . . . . . . . . . . 711JAMES O. SANDERS

73. Clinical Assessment and ParentPatient Expectations . . . . . . . . . . . . . . . . . . . . . 721ANTHONY RINELLA

74. Spinal Deformity Outcomes Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 728RUDOLPH CHRISTOPHER GLATTES, DOUGLAS C. BURTON, AND SUE MIN LAI

75. Radiographic Classifi cation Scheme: Lenke Classifi cation . . . . . . . . . . . . . . . . . . 738LAWRENCE G. LENKE

76. Fusionless Surgery and Growing Rod Techniques for Infantile and Juvenile Idiopathic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 754BEHROOZ A. AKBARNIA, GEORGE H. THOMPSON, AND GREGORY M. MUNDIS JR

77. Stapling Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 766TIMOTHY S. OSWALD, PATRICK J. CAHILL, AMER F. SAMDANI, AND RANDAL R. BETZ

78. Open and Thoracoscopic Anterior Thoracic Surgery . . . . . . . . . . . . . . . . . . . . . 778PETER O. NEWTON AND VIDYADHAR V. UPASANI

79. Thoracoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 792DAVID H. CLEMENTS, AMER F. SAMDANI, AND RANDAL R. BETZ

80. Evolution of Instrumentation for Adolescent Idiopathic Scoliosis . . . . . . . . . . . 800GBOLAHAN O. OKUBADEJO AND KEITH H. BRIDWELL

81. Short Segment Bone-on-Bone Fusion for Adolescent Idiopathic Scoliosis . . . 808JULIAN A. ROMAGNOLI AND ROBERT W. GAINES

82. Posterior Spinal Deformity Correction Techniques . . . . . . . . . . . . . . . . . . . . . . 823BRIAN A. OSHAUGHNESSY AND LAWRENCE G. LENKE

83. Anterior Lumbar and Thoracolumbar Correction and Fusion for AIS . . . . . . . . 848DANIEL J. SUCATO, HONG ZHANG, AND CHARLES E. JOHNSTON

84. Treatment of Thoracic Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 866KEITH H. BRIDWELL

Contents xxxiii

85. Selective Thoracic Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 889BRETT FREEDMAN, CHARLES EDWARDS II, AND KEITH H. BRIDWELL

86. Complications Associated with Adolescent Idiopathic Scoliosis Surgery . . . . . . . 905MARK C. LEE, B. STEPHENS RICHARDS, AND CHARLES E. JOHNSTON

SECTION VIII: Adult Spinal Deformity

SECTION EDITOR: CHRISTOPHER L. HAMILL

87. Adult Spinal DeformityIntroduction/State of the Art . . . . . . . . . . . . . . . . . . 919CHRISTOPHER L. HAMILL

88. Adult Spinal Deformity Classifi cation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 921FRANK SCHWAB, SIGURD BERVEN, AND KEITH H. BRIDWELL

89. De Novo Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 929ASHISH PATEL, FRANK SCHWAB, AND JEAN-PIERRE FARCY

90. Sagittal Imbalance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 938CHRISTOPHER L. HAMILL, PETER D. ANGEVINE, AND KEITH H. BRIDWELL

91. Fixed Coronal Imbalance of the Spine: Clinical Signifi cance and Operative Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 948BRIAN HSU AND SIGURD BERVEN

92. Spinal Deformity in the Older Patient With Kyphosis . . . . . . . . . . . . . . . . . . . . 962FRANK L. ACOSTA JR, TYLER KOSKI, AND STEPHEN L. ONDRA

93. Revision Surgeries for Adult Spinal Deformity . . . . . . . . . . . . . . . . . . . . . . . . . 970MATTHEW E. CUNNINGHAM AND OHENEBA BOACHIE-ADJEI

94. Smith-Petersen Osteotomy of the Spine. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 982DOUGLAS C. BURTON

95. Pedicle Subtraction Procedures for Complex Spinal Deformity . . . . . . . . . . . . . 987BRIAN A. OSHAUGHNESSY, JACOB M. BUCHOWSKI, AND KEITH H. BRIDWELL

96. Vertebral Column Resection for Complex Spinal Deformity: Posterior Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 999SE-IL SUK

97. Vertebral Column Resection for Complex Spinal Deformity: Anterior and Posterior Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1015SIGURD BERVEN AND DAVID S. BRADFORD

98. Minimally Invasive Deformity Surgery: Future Directions . . . . . . . . . . . . . . . . 1021FADI NASR, TYLER KOSKI, JOHN LIU, STEPHEN ONDRA, AND RICHARD FESSLER

99. Fusion to the Sacrum and Fixation Techniques of the Sacropelvic Junction . . . 1031ANGEL E. MACAGNO AND MICHAEL F. OBRIEN

100. Structural Grafting for Adult Spinal Deformity . . . . . . . . . . . . . . . . . . . . . . . . 1052PETER D. ANGEVINE AND KEITH H. BRIDWELL

xxxiv Contents

SECTION IX: Dysplastic and Congenital Deformities

SECTION EDITOR: SCOTT J. LUHMANN

101. Introduction/State of the Art in the Care of Dysplastic and Congenital Spine Deformities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1059SCOTT J. LUHMANN

102. Dysplastic Scoliosis: Neurofi bromatosis Spinal Pathology . . . . . . . . . . . . . . . . 1062ALVIN H. CRAWFORD, AND KEITH R. GABRIEL

103. Spinal Deformities in Marfan Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1078PAUL D. SPONSELLER

104. Spinal Deformity in Skeletal Dysplasia Conditions . . . . . . . . . . . . . . . . . . . . . 1084ERIC D. SHIRLEY AND MICHAEL C. AIN

105. The Spine in Osteogenesis Imperfecta . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1099PAUL D. SPONSELLER AND SERGIO A. GLAIT

106. Spinal Deformity in Familial Dysautonomia . . . . . . . . . . . . . . . . . . . . . . . . . . 1107DAVID S. FELDMAN, FULYA STNKAN, AND DEBRA A. SALA

107. Congenital Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1118MICHAEL J. MCMASTER

108. Hemivertebra Resection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1139MICHAEL RUF AND JRGEN HARMS

109. Congenital Intraspinal Anomalies: Spinal DysraphismEmbryology, Pathology, and Treatment . . . . . . . . . . . . . . . . . . . 1149JEFFREY LEONARD, M. MOHSIN SHAH, AND BRUCE KAUFMAN

110. Thoracic Insuffi ciency Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1179ROBERT M. CAMPBELL JR.

111. Congenital Anomalies of the Cervical Spine in Children: Management of Segmental Instability and Spinal Canal Encroachment . . . . . . 1194HARISH S. HOSALKAR, DANIELLE B. CAMERON, AND DENIS S. DRUMMOND

SECTION X: Paralytic Deformity

SECTION EDITOR: SCOTT J. LUHMANN

112. Introduction/State of the Art in the Care of the Paralytic and Neuromuscular Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1209SCOTT J. LUHMANN

113. Paralytic Scoliosis and the Spastic Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1214THOMAS G. MCPARTLAND AND JOHN B. EMANS

114. Surgical Treatment of Flaccid Neuromuscular Scoliosis . . . . . . . . . . . . . . . . . . 1229GILBERT CHAN, DAVID A. SPIEGEL, AND DENIS S. DRUMMOND

115. Surgical Treatment of Myelomeningocele Deformities . . . . . . . . . . . . . . . . . . . 1244RICHARD E. MCCARTHY

Contents xxxv

116. Management of Paralytic Neuromuscular Disorders with an Emphasis on Pelvic Obliquity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1252DANIEL J. HEDEQUIST

117. Role of Halo Traction and Halo-Femoral Traction in Paralytic/Neuromuscular Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1265SCOTT J. LUHMANN AND DAVID L. SKAGGS

SECTION XI: Kyphosis and Postlaminectomy Deformities

SECTION EDITOR: PETER D. ANGEVINE

118. Introduction and Current State of the Art . . . . . . . . . . . . . . . . . . . . . . . . . . . 1279PETER ANGEVINE

119. Cervical Instability and Kyphosis (Rheumatoid, Dwarfi sm, Degenerative, Others) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1281ERIC HARRIS, JAMES LAWRENCE, JEFFREY RIHN, JOSEPH GONDUSKY, AND ALAN HILIBRAND

120. Surgical Treatment of Scheuermanns Kyphosis . . . . . . . . . . . . . . . . . . . . . . . . 1295ANGEL E. MACAGNO, MICHAEL F. OBRIEN, AND HARRY L. SHUFFLEBARGER

121. Short-Segment Anterior Fusion of Symptomatic Scheuermanns Disease . . . . . 1312JWALANT S. MEHTA AND ROBERT W. GAINES

122. Postlaminectomy Deformities in the Thoracic and Lumbar Spine . . . . . . . . . . 1326BRANDON G. ROCQUE, SHARAD RAJPAL, AND DANIEL K. RESNICK

123. Posttraumatic Deformity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1332JACOB M. BUCHOWSKI

124. Ankylosing Spondylitis/Thoracolumbar Deformities . . . . . . . . . . . . . . . . . . . . 1340CHRISTOPHER L. HAMILL

125. Cervicothoracic Extension Osteotomy for Chin-On-Chest Deformity . . . . . . . 1345CHRISTOPHER G. FUREY

126. The Role of Osteotomies in the Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . 1355K. DANIEL RIEW AND ADAM L. WOLLOWICK

SECTION XII: Trauma

SECTION EDITOR: RONALD A. LEHMAN, JR.

127. Trauma State of the Art . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1377RONALD A. LEHMAN, JR. AND TOBIN ECKEL

128. Classifi cation of Cervical Spine Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1381ALPESH A. PATEL, ALEXANDER R. VACCARO, AND PAUL A. ANDERSON

129. Classifi cation of Thoracic and Lumbar Fractures . . . . . . . . . . . . . . . . . . . . . . . 1390RONALD A. LEHMAN, JR., JASON T. BESSEY, AND ALEXANDER R. VACCARO

xxxvi Contents

130. Surgical Management of Cervical Spine Fractures . . . . . . . . . . . . . . . . . . . . . . 1399KELLEY BANAGAN AND DANIEL GELB

131. Anterior and Posterior Instrumentation Techniques Used in the Thoracic Spine for Treatment of Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . 1411DAVID H. KIM, JEFFREY A. RIHN, AND TODD J. ALBERT

132. Surgical Treatment of Thoracolumbar and Lumbar Fractures . . . . . . . . . . . . . 1424MICHAEL D. DAUBS AND SHAY BESS

133. Anterior Decompression Techniques for Thoracic and Lumbar Fractures . . . . . 1439DAVIS L. REAMES, D. KOJO HAMILTON, ANTON TOOMAS, AND CHRISTOPHER I. SHAFFREY

134. Minimal Access Techniques for Spine Trauma . . . . . . . . . . . . . . . . . . . . . . . . . 1449JOSEPH RIINA, DAVID G. SCHWARTZ, JASON E. SMITH, AND KATHY J. FLINT

135. Management and Surgical Treatment of Fractures of the Lumbosacral Region and the Sacrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1460CARLO BELLABARBA, THOMAS A. SCHILDHAUER, M.L. CHIP ROUTT, AND JENS R. CHAPMAN

136. Novel Approaches to Neural Repair and Regeneration After Spinal Cord Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1474ELENA OKON, JESSICA HILLYER, AND BRIAN K. KWON

SECTION XIII: Tumor and Osteomyelitis

SECTION EDITOR: PETER D. ANGEVINE

137. Introduction and State of the Art . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1485PETER D. ANGEVINE

138. Benign Tumors of the Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1487SUMEET GARG AND JOHN P. DORMANS

139. Primary Malignant Tumors of the Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1499GREGORY S. MCLOUGHLIN, DANIEL M. SCIUBBA, AND JEAN-PAUL WOLINSKY

140. The Surgical Treatment of Metastatic Spine Disease . . . . . . . . . . . . . . . . . . . . 1511ILYA LAUFER, PETER S. ROSE, AND MARK H. BILSKY

141. Intramedullary Spinal Cord Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1520KAZUTOSHI HIDA

142. Intradural, Extramedullary Spinal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . 1535ALFRED T. OGDEN AND PAUL C. MCCORMICK

143. Spinal Vascular Malformations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1544MICHELLE J. CLARKE, WILLIAM E. KRAUSS, AND MARK A. PICHELMANN

14 4. Spinal Infection/Osteomyelitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1553SANFORD E. EMERY AND RYAN T. GOCKE

Contents xxxvii

145. Tumors of the Sacrum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1560ALEXANDRE RASOULI, H. THOMAS TEMPLE, AND FRANK J. EISMONT

146. Adjuvant Therapy of Spinal Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1575ILYA LAUFER, YOSHIYA YAMADA, AND MARK H. BILSKY

SECTION XIV: Complications

SECTION EDITOR: JACOB M. BUCHOWSKI

147. Introduction/State-of-the-Art . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1581JACOB M. BUCHOWSKI

148. Neurological Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1584LUKAS P. ZEBALA AND JACOB M. BUCHOWSKI

149. Reconstruction of Complex Spinal Wounds . . . . . . . . . . . . . . . . . . . . . . . . . . . 1591BRENDAN COLLINS AND RICHARD J. REDETT

150. Vascular Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1598GREGORY GEBAUER AND A. JAY KHANNA

151. Postoperative Early and Late Wound/Implant Infections . . . . . . . . . . . . . . . . 1608SUMEET GARG AND JACOB M. BUCHOWSKI

152. Cerebrospinal Fluid Fistula and Pseudomeningocele . . . . . . . . . . . . . . . . . . . . 1617KENE UGOKWE AND EDWARD C. BENZEL

153. Pseudarthrosis in Spinal Deformity Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . 1622YONGJUNG J. KIM AND PETER D. ANGEVINE

154. Legal Implications and Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1633JANICE F. MULLIGAN, HEATHER HANSEN, JESSICA UITTO, PAUL CRAIG, AND STEVEN R. GARFIN

155. Unresolved Postoperative Spine Pain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1649WILLIAM C. LAUERMAN AND STEVEN C. SCHERPING

156. Medical Complications Associated with Spinal Surgery . . . . . . . . . . . . . . . . . . 1665ELI M. BARON AND TODD J. ALBERT

Index 1675