00_14347.qxp 11/20/06 3:44 PM Page i Decision Making in Spinal Care 00_14347.qxp 11/20/06 3:44 PM Page ii 00_14347.qxp 11/20/06 3:44 PM Page iii Decision Making in Spinal Care D. Greg Anderson, M.D. Associate Professor Department of Orthopaedic Surgery Thomas Jefferson University Jefferson Medical College Thomas Jefferson University Hospital The Rothman Institute Philadelphia, Pennsylvania Alexander R. Vaccaro, M.D. Professor Department of Orthopaedic Surgery Thomas Jefferson University Jefferson Medical College Thomas Jefferson University Hospital The Rothman Institute Philadelphia, Pennsylvania Thieme New York • Stuttgart 00_14347.qxp 11/20/06 3:44 PM Page iv Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Consulting Medical Editor: Esther Gumpert Associate Editor: J. Owen Zurhellen Editorial Assistant: Judith Tomat Vice President, Production and Electronic Publishing: Anne T. Vinnicombe Production Editor: Print Matters, Inc. Sales Director: Ross Lumpkin Associate Marketing Manager: Verena Diem ChiefFinancial Officer: Peter van Woerden President: Brian D. Scanlan Compositor: Alden Prepress Services Printer: Maple-Vail Book Manufacturing Group Medical Illustrator: Anthony M. Pazos Library ofCongress Cataloging-in-Publication Data Decision making in spinal care / [edited by] D. Greg Anderson, Alexander R. Vaccaro. p. ; cm. Includes bibliographical references and index. ISBN 1-58890-415-6 (US-SC) — ISBN 3-13-140481-7 (GTV-SC) 1. Spine—Diseases. 2. Decision making. 3. Medical care—Decision making. I. Anderson, D. Greg. II. Vaccaro, Alexander R. [DNLM: 1. Spinal Diseases—therapy. 2. Decision Making. 3. Orthopedic Procedures. WE 725 D294 2006] RD768.D43 2006 616.7’3—dc22 2006045564 Copyright ©2007 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. 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However, in view ofthe possibility ofhuman error by the authors, editors, or publisher ofthe work herein or changes in medical knowledge, neither the authors, editors, or publisher, nor any other party who has been involved in the preparation ofthis work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use ofsuch information. Readers are encouraged to confirm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package ofeach drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is ofparticular importance in connection with new or infrequently used drugs. Some ofthe product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance ofa name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. Printed in the United States. 5 4 3 2 1 The Americas ISBN 1-58890-415-6 978-1-58890-415-7 Rest ofWorld ISBN 3-13-140481-7 978-3-13-140481-7 00_14347.qxp 11/20/06 3:44 PM Page v I dedicate this book to my loving wife, Sandra, for supporting me and giving me a reason to pursue excellence. D. Greg Anderson, M.D. I dedicate this book to the wonderful physicians at Johns Hopkins Medical Center, especially Ziya Gokaslan, M.D., for their care of my son Alex during our time of need. Alexander R. Vaccaro, M.D. 00_14347.qxp 11/20/06 3:44 PM Page vi 00_14347.qxp 11/20/06 3:44 PM Page vii Contents Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Acknowledgment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv I. Cervical Trauma 1. Occipitoatlantal Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 Christopher M. Bono and Edward Carreras 2. C1 Ring Fractures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Michael A. Pahl, Chadi Tannoury, and D. Greg Anderson 3. Atlantoaxial Instability. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Christopher M. Bono and William Min 4. Odontoid Fractures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Tony Y. Tannoury and Douglas G. Orndorff 5. Traumatic Spondylolisthesis ofthe Axis (Hangman’s Fracture). . 31 Matthew H. Walker, Thomas F. Day, and D. Greg Anderson 6. Flexion-Compression Injuries of the Cervical Spine . . . . . . . . . . 37 John M. Beiner 7. Cervical Distraction-Extension Injuries. . . . . . . . . . . . . . . . . . . . . . 43 John B. Thaller 8. Cervical Facet Dislocation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Brett A. Taylor 9. Cervicothoracic Fractures and Dislocations. . . . . . . . . . . . . . . . . . 55 Norman B. Chutkan 00_14347.qxp 11/20/06 3:44 PM Page viii viii Contents II. Thoracolumbar Trauma 10. Thoracic and Lumbar Vertebral Compression Fractures . . . . 61 James S. Harrop, Sumeet Vadera, and Deshdeepak Sahni 11. Thoracolumbar Burst Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . 67 James S. Harrop, Sumeet Vadera, and Deshdeepak Sahni 12. Thoracolumbar Flexion-Distraction Injuries . . . . . . . . . . . . . . 73 Qusai M. Hammouri and Jonathan N. Grauer 13. Thoracolumbar Fracture Dislocations . . . . . . . . . . . . . . . . . . . . 79 Qusai M. Hammouri and Jonathan N. Grauer 14. Sacral Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Douglas G. Orndorff and D. Greg Anderson 15. Thoracolumbar Distraction-Extension Injuries . . . . . . . . . . . . 91 Y. Raja Rampersaud III. Cervical Degenerative/Metabolic Disease 16. Cervical Disk Degeneration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Kanit Chamroontaneskul 17. Cervical Radiculopathy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Wahid M. Baqaie 18. Cervical Myelopathy: Anterior Approach . . . . . . . . . . . . . . . . . 109 Maurice L. Goins, Corey A. Pacek, and Alan S. Hilibrand 19. Cervical Myelopathy: Posterior Approach. . . . . . . . . . . . . . . . . 115 Jonathan G. Roper, Kenneth J. H. Lee, and Jeffrey C. Wang 20. Cervical Kyphosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 Todd J. Albert and Michael A. Pahl 21. Ossification of the Posterior Longitudinal Ligament. . . . . . . 129 Maurice L. Goins, Corey A. Pacek, and Alan S. Hilibrand 22. Cervical Whiplash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Aaron S. Covey and Jonathan N. Grauer 23. Cervical Diagnostic and Therapeutic Interventional Procedures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Richard Derby and Kwan Sik Seo 24. Cervical Rehabilitation and Physical Therapy Techniques . . 151 James R. Beazell IV. Thoracic Degenerative/Metabolic Disease 25. Ankylosing Spondylitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159 Kornelis A. Poelstra 26. Diffuse Idiopathic Skeletal Hyperostosis. . . . . . . . . . . . . . . . . . 165 Kornelis A. Poelstra 27. Thoracic Disk Herniation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 William Sukovich 00_14347.qxp 11/20/06 3:44 PM Page ix Contents ix V. Lumbar Degenerative/Metabolic Disease 28. Lumbar Disk Disease and Low Back Pain . . . . . . . . . . . . . . . . . 179 Jeff Scott Silber 29. Lumbar Radiculopathy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185 Jeff Scott Silber 30. Lumbar Spinal Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 Wahid M. Baqaie 31. Lumbar Degenerative Spondylolisthesis. . . . . . . . . . . . . . . . . . 199 Vincent J. Devlin and Matthew Eager 32. Degenerative Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Rocco R. Calderone and Louise E. Toutant 33. Adult Isthmic Spondylolisthesis. . . . . . . . . . . . . . . . . . . . . . . . . . 213 Jim A. Youssef 34. Failed Back Syndromes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 Adam C. Crowl 35. Lumbar Rehabilitation and Physical Therapy Techniques . . 225 James R. Beazell 36. Lumbar Injections and Procedures. . . . . . . . . . . . . . . . . . . . . . . 231 Maged Hamza 37. Cauda Equina Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237 Leo R. Spector and David H. Kim VI. Scoliosis 38. Congenital Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245 John P. Lubicky 39. Infantile Scoliosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251 Samuel R. Rosenfeld 40. Juvenile Idiopathic Scoliosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257 Peter G. Gabos 41. Adolescent Idiopathic Scoliosis. . . . . . . . . . . . . . . . . . . . . . . . . . 263 Ronald A. Lehman Jr. and Timothy R. Kuklo 42. Neuromuscular Scoliosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271 Francis H. Shen, Peter W. Thompson, and Vincent Arlet 43. Adult Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 Moe R. Lim, Joon Yung Lee, and Todd J. Albert VII. Kyphosis 44. Scheuermann’s Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289 Timothy R. Kuklo and Ronald A. Lehman Jr. 45. Posttraumatic Thoracolumbar Kyphosis. . . . . . . . . . . . . . . . . . 295 Jeff Scott Silber and Dimitry G. Kondrashov 46. Corrective Osteotomies for Kyphosis. . . . . . . . . . . . . . . . . . . . . 303 Keith H. Bridwell