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The Textbook of Spinal Surgery
Third Edition Volume 1
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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
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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
Two Commerce Square2001 Market StreetPhiladelphia, PA 19103 USALWW.com
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.
Printed in China
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.
To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300.
Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST.
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To the patients who will benefi t from our evolving understanding of surgical indications, techniques, and
complications.
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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