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Download Advances and Technical Standards in Neurosurgery: Volume 41 by Florian Ringel MD, Jimmy Villard MD, Yu-Mi Ryang MD, PDF

By Florian Ringel MD, Jimmy Villard MD, Yu-Mi Ryang MD, Bernhard Meyer MD (auth.), Johannes Schramm (eds.)

This quantity of Advances and Technical criteria in Neurosurgery is dedicated completely to the backbone. Like different volumes within the sequence, it provides vital contemporary development within the box and gives specified descriptions of normal systems to help younger neurosurgeons. one of the advances thought of are methods to spinal navigation, together with intraoperative imaging established navigation, and ideas of spinal robotics. the price of sagittal stability as a parameter for the neurosurgeon is tested, and a singular surgical method of longitudinal pathologies in the spinal canal is gifted. advancements in surgical procedure for kyphosis also are mentioned, with a spotlight on pedicle subtraction osteotomy. The technical criteria part severely stories the newest proof concerning cervical disc arthroplasty and pedicle-based non-fusion stabilization units. The e-book concludes by means of discussing the therapy of craniovertebral junction instability because of juvenile continual arthritis.

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18] reviewed the compensatory mechanisms of sagittal unbalance described in the literature. In the spine area, the first compensatory mechanism is the reduction of the thoracic kyphosis that limits the anterior translation of the axis of gravity. This leads to a flat spine and is possible for younger patients with mobile spine and more markedly in patients under 45 years old [56, 57]. As already mentioned above, low back pain patients tend to have less distal lordosis, a more vertical sacrum and a more proximal lumbar lordosis [6, 53].

Surgical Techniques 1. Spinous process splitting and distracting technique The patients were positioned either sitting or prone for cervical and prone for thoracic and thoracolumbar procedures. A special midline posterior approach was used. The skin, fascia, nuchal (in the cervical region), and the supraspinous ligament were incised in the midline. The interspinous ligaments and muscles were 52 P. Banczerowski et al. Fig. 5 Illustration of the multilevel split and distracted spinous processes with the complementary iliac crest grafts between the facing bony parts of the spinous processes dissected longitudinally between the spinous processes without injuring the attachments of the interspinous muscles; then the ligamentum flavum was removed in the middle part to expose the midline epidural space above and below the intended levels.

Slip grade Sacro-peivic balance and morphology 37 Spinal balance Type Nutcracker (PI < 45°) Type1 Low-grade Normal pelvic incidence (PI ≥ 45° and < 60°) Type2 High pelvic incidence (PI ≥ 60°) Type3 Balanced (high SS / low PT) Type4 C7 High-grade Balanced (C7 ≤ hip axis) Type5 Unbalanced (low SS / high PT) C7 Balanced (C7 > hip axis) Type6 PI: Pelvic incidence SS: Sacral slope PT: Pelvic tilt Fig. 7 Spinal Deformity Study Group classification of lumbosacral spondylolisthesis For high-grade spondylolisthesis, the overall balance should be assessed first, using the graph provided by Hresko et al.

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