Manual of Spine Surgery Uwe Vieweg (cid:129) Frank Grochulla Editors Manual of Spine Surgery Editors Dr. Uwe Vieweg Dr. Frank Grochulla Clinic for Spinal Surgery Department for Spinal Surgery Sana Hospital Rummelsberg Hospital for Orthopaedics Schwarzenbruck Trauma Surgery and Spinal Surgery Germany Euromed Clinic Fürth Germany Illustrator Atelier Erfurth Bad Dürrheim Germany ISBN 978-3-642-22681-6 ISBN 978-3-642-22682-3 (eBook) DOI 10.1007/978-3-642-22682-3 Springer Heidelberg New York Dordrecht London Library of Congress Control Number: 2012936152 © Springer-Verlag Berlin Heidelberg 2012 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adapta- tion, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi - cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) Preface This book has become necessary as a consequence of the rapid expansion of non-instrumented and instrumented spine surgery using different minimally invasive and non-fusion techniques. To do justice to this development, this book aims to present the different techniques to spinal surgeons (orthopaedics and neurosurgeons) in a clear and instructive way using detailed illus- trations. The success of any spinal operation depends on good defi nition of the indications, consideration of the contraindications, technical and organisational factors, correct preopera- tive preparation and positioning of the patient and good operating technique. The description of different open, less invasive or minimally invasive techniques with more than 600 illustra- tions will provide the spinal surgeons useful guidelines for their use. We appreciate the valu- able contributions from all the authors, and we also thank the staff of our publisher, Springer-Verlag Heidelberg, for their assistance and cooperation. Uwe Vieweg Frank Grochulla v Contents Part I General Aspects of Spinal Surgery 1 Defi nition and Trends of Modern Spinal Surgery . . . . . . . . . . . . . . . . . . . . . . . . 3 Uwe Vieweg 2 Principles of Surgical Stabilisation of the Spine . . . . . . . . . . . . . . . . . . . . . . . . . 9 Tobias Pitzen 3 Implant Materials in Spinal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Werner Schmoelz 4 Mechanical and Biomechanical Testing of Spinal Implants . . . . . . . . . . . . . . . . 23 Werner Schmoelz and Annette Kienle 5 Spinal Retractors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Luca Papavero 6 Fluoroscopy and Spinal Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Stefan Kroppenstedt 7 Surgical Microscopy in Spinal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Frank Grochulla 8 Endoscopy in Spinal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Uwe Vieweg 9 Equipment for Full-Endoscopic Spinal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . 59 Sebastian Ruetten 10 Electrosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Uwe Vieweg 11 Surgical Motor Systems in Spinal Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 Frank Grochulla and Uwe Vieweg 12 Bone Grafts and Bone-Graft Substitutes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Robert Morrison 13 On- and Offl ine Documentation of Spine Procedures: Spine Tango . . . . . . . . . 81 Christoph Röder and Thomas Zweig Part II Anterior Upper Cervical Spine 14 Overview of Surgical Techniques and Implants for the Anterior Upper Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Meic H. Schmidt 15 Odontoid Screw Fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Meic H. Schmidt vii viii Contents 16 Anterior Transarticular Screw Fixation C1/C2 . . . . . . . . . . . . . . . . . . . . . . . . . . 105 Uwe Vieweg and Meic H. Schmidt 17 Transoral Resection of the Odontoid Process . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Meic H. Schmidt and Uwe Vieweg Part III Anterior Cervical Spine C3–C8 (T1) 18 Overview of Surgical Techniques and Implants . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Tobias Pitzen 19 Anterior Cervical Discectomy and Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Frank Grochulla 20 Uncoforaminotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Kirsten Schmieder 21 Anterior Cervical Discectomy, Fusion, and Plating . . . . . . . . . . . . . . . . . . . . . . . 141 Tobias Pitzen 22 Cage Implantation in the Cervical Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Uwe Vieweg 23 Implantation of a Cervical Disc Prosthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155 Bernhard Bruns and Uwe Vieweg Part IV Posterior Cervical Spine 24 Overview of Surgical Techniques and Implants . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Stefan Schären 25 Foraminotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Frank Grochulla 26 Laminoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175 Frank Grochulla 27 Occipital Cervical Stabilization with Rod-Screw Systems . . . . . . . . . . . . . . . . . 181 Michael A. Finn and Meic H. Schmidt 28 Posterior Transarticular C1/C2 Screw Technique . . . . . . . . . . . . . . . . . . . . . . . . 187 Michael Winking 29 C1–C2 (Harms) Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 Christian Schultz 30 Rod-Screw Stabilization of the Posterior Cervical Spine . . . . . . . . . . . . . . . . . . 199 Uwe Vieweg Part V Anterior Thoracic Spine 31 Overview of Surgical Techniques and Implants . . . . . . . . . . . . . . . . . . . . . . . . . . 207 Christian Schultz 32 Anterolateral Endoscopic Stabilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211 Oliver Gonschorek 33 Vertebral Body Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 Jürgen Nothwang Contents ix Part VI Posterior Thoracic Spine 34 Overview of Surgical Techniques and Implants . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Paulo Tadeu Maia Cavali 35 Stabilization of the Thoracic Spine with Internal Fixator . . . . . . . . . . . . . . . . . 231 Robert Morrison and Uwe Vieweg 36 Transpedicular Stabilization with Freehand Technique on the Thoracic Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Paulo Tadeu Maia Cavali Part VII Anterior Lumbar Spine 37 Overview of Surgical Techniques and Implants . . . . . . . . . . . . . . . . . . . . . . . . . . 245 Karsten Wiechert and Felix Hohmann 38 Ventral Interbody Fusion with Bone or Cage . . . . . . . . . . . . . . . . . . . . . . . . . . . 251 Karsten Wiechert, Felix Hohmann, and Uwe Vieweg 39 Total Lumbar Disc Replacement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 Christoph J. Siepe Part VIII Posterior Lumbar Spine 40 Overview of Surgical Techniques and Implants . . . . . . . . . . . . . . . . . . . . . . . . . . 277 Uwe Vieweg 41 Microsurgical Intra- and Extraspinal Discectomy . . . . . . . . . . . . . . . . . . . . . . . 285 Luca Papavero 42 Microsurgical Decompression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297 Frank Grochulla 43 Endoscopic Lumbar Disc Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303 Sebastian Ruetten 44 Translaminar Screw Fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 Stefan Schären 45 Vertebroplasty and Kyphoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313 Khalid Saeed, Edward Bayley, and Bronek Boszczyk 46 Transpedicular Stabilization with Internal Fixation in the Thoracolumbar and Lumbar Spine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 319 Robert Morrison and Uwe Vieweg 47 Correction of Degenerative Scoliosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325 Uwe Vieweg and Robert Morrison 48 Correction of Spondylolisthesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331 Uwe Vieweg 49 Microsurgical Monosegmental Fusion with Internal Fixator and Interbody Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339 Uwe Vieweg and Stefan Kroppenstedt 50 Cement Augmentation of Pedicle Screw Fixation . . . . . . . . . . . . . . . . . . . . . . . . 351 Jürgen Nothwang x Contents 51 Less-Invasive Pedicle Screw Instrumentation of Lumbar Spine Fractures . . . 359 Ulrich Hahn 52 Transforaminal Lumbar Interbody Fusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Stefan Kroppenstedt and Uwe Vieweg 53 Posterior Lumbar Interbody Fusion with an Interbody Fusion Spacer or Cage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377 Uwe Vieweg and Steffen Sola 54 Transsacral Screw Fixation for High-Grade L5/S1 Spondylolisthesis Including Spondyloptosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385 Palaniappan Lakshmanan and Sashin Ahuja 55 Guided Oblique Lumbar Interbody Fusion (GO-LIF®) . . . . . . . . . . . . . . . . . . . 391 Christof Birkenmaier Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 403