The authors present basic anatomical, biomechanical and clinical knowledge for Degenerative Diseases of the Cervical Spine: Therapeutic Management in the Subaxial Section and describe in detail the selection of access, implant and surgical technique. Numerous illustrations illustrate the decision-making process and the step of the surgical technique by step. The book also contains important points about implant safety and possible complications, as well as an outlook into the future of cervical spine surgery. You can download Degenerative Diseases of The Cervical Spine PDF free with a direct link.
Degenerative diseases of the cervical spine are aimed at spinal surgeons (neurosurgeons and orthopedists), physiotherapists, general practitioners and rehabilitation specialists worldwide.
|Book Name||Degenerative Diseases of The Cervical Spine|
|Author of Book||Alexander König, Uwe Spetzger|
The book by König and Spetzger is a modern and practical compendium for the experienced as well as for the beginner in the field of surgical treatment of degenerative diseases of the cervical spine. The chapters about anatomical and physiological basics as well as those about indications for surgery are primarily addressed to trainees. The chapters about surgical approaches, biomechanical considerations during the choice of implants and surgical techniques are of interest for advanced spine surgeons. Like in a good ‘cookbook’, each single step of surgery is illustrated by perfect intraoperative photographic images. Several microsurgical techniques are shown, and important practical hints are given for the different types of implants.
Degenerative Diseases of The Cervical Spine also describe The consecutive and clear figurative demonstration of the particular operations provides a well-defined surgical strategy to the reader. Here from the results a didactically valuable and very practical surgical textbook. Nowadays, the market of implants for cervical spine surgery is almost unmanageable and still growing. Due to their surgical experience which is referred to the reader, the authors give support for the choice of implants based on biomechanical, strategical and safety-related aspects. The book is a must-have for every spine surgeon treating patients with degenerative diseases of the cervical spine.
Topics of this Edition:
The Latest Version of Degenerative Diseases of The Cervical Spine by Alexander König, Uwe Spetzger discussed the following topics in 1st edition.
2: Anatomical Aspects
3: Biomechanical Aspects
4: Preoperative Diagnostics and Indication for Surgery
5: Conservative Treatment
6: Choice of Surgical Approach
7: Choice of Implant
8: Surgical Technique
9: Information and Consent of the Patient
10: Implant Safety and Complication Management
11: The Future of Cervical Spine Surgery
Over the past ten years, the number of operations to treat degenerative diseases of the cervical spine has increased continuously. This development is based on an increasing life expectancy as well as on the improvement of diagnostic and therapeutic possibilities. In addition, the number of implants available to replace a removed disc has increased exponentially. This development can be observed both with dynamic implants (intervertebral disc prostheses) and with non-dynamic implants (so-called cages). Due to the relatively short period of time since their market launch, numerous implants have only been evaluated on the basis of small patient populations and short follow-up times. In addition, there is a relatively small number of studies comparing the radiological and clinical comparison of fusion versus total disc replacement. When choosing a particular implant, there are different algorithms depending on the surgeon’s preference. However, most surgeons consider the patient’s age, the range of motion of the plane affected, the range of motion of adjacent planes, and the number of planes affected in their decision-making process.
There is a similar situation for cervical vertebral body replacement in cases of confluent multilevel stenoses. The interposition of an iliac crest bone graft is still the gold standard, but there are also implants made of polyetheretherketone as well as of titanium on the market. The use of a certain material differs between institutions analogue to disc replacement. Furthermore, different spine surgeons prefer different approaches and instrumentations at the cervical spine (anterior, posterior, combined) in cases of spinal instability. The aim of this book is to explain the strategies in choosing a surgical approach and an implant for disc or vertebral body replacement based on the authors´ experiences and recent biomechanical and clinical studies.
Vertebral Body, Intervertebral Disc and Uncinate Process:
The cervical vertebrae 3–7 have a shape that is typical for the cervical spine (Fig. 2.2). The cervical vertebrae 1 and 2 (atlas and axis) have morphological and functional exceptional position because of their importance for movements of the head. The condyles of the squama occipitalis together with the cranial articular surfaces of the atlas form the atlanto-occipital joint (C0/C1) which is a big range of motion for flexion/extension. Atlas and axis form the atlantoaxial joint (C1/C2) which has a high degree of rotational ability. The functional level between axis and third cervical vertebra (C2/C3) enables a large amount of lateral flexion. The subaxial cervical spine from the third to the seventh vertebra shows a wide morphological homogeneity which reflects in the similar range of motion of the levels C3/C4 to C6/C7 (Table 3.1).
A morphological special characteristic of the cervical spine is the uncinate process (Fig. 2.3) which is located at the cranial lateral aspects of the vertebral bodies. It limits rotational movements and provides integrity of the neuroforamen during lateral bending (Tubbs 2012). The upper uncinate processes a lateral orientation only, and the lower ones a dorsal orientation (Lang 1991). The intervertebral discs being deformable units fill the intervertebral spaces. Movements of vertebrae against each other base on an interaction of intervertebral discs and intervertebral joints (articulationes intervertebrales; see Sect. 2.3). The intervertebral discs ensure the elasticity of the spinal column and work as a shock absorber (Lang 1991). The outer fibrous ring (anulus fibrosus) of the intervertebral disc surrounds the inner gel-like centre (nucleus pulposus) and consists of collagenous (90 %) and elastic (10 %) fibres (Fig. 2.2; Lang (1991).
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