Bridwell and DeWald's Textbook of Spinal Surgery

Contents
Contributing Authors vii
Foreword xxi
Preface xxiii
Acknowledgments xxv
Introduction A: The Evolution of Pediatric Spine Surgery
Since the Third Edition of The Textbook of Spinal Surgery xxxix
Introduction B: The Evolution of Adult Spine Surgery
Since the Third Edition of The Textbook of Spinal Surgery xliii
Volume 1
SECTION I: General Considerations
1. Evaluation and Optimization of the Adult and Pediatric Spine Patient
Preoperatively and Perioperatively to Improve Outcome ................ 1
RAJIV K. SETHI, ANDREW S. FRIEDMAN, ANNA K. WRIGHT, JEAN-CHRISTOPHE A. LEVEQUE,
JENNIFER M. BAUER, AND QUINLAN D. BUCHLAK
2. Normal Spinal Anatomy: Normal Sagittal Plane Alignment ............ 11
MARK BERNHARDT AND DANIEL CHERIAN
3. Spinal Cord and Nerve Root Monitoring .......................... 19
SHELLY M. BOLON, JOSEPH D. BRIGHT, BARRY L. RAYNOR, EARL D. THUET,
AND COLIN C. ZERTAN
4. Bone Grafting and Biologics for Spine Fusion ...................... 50
STEVEN M. PRESCIUTTI, JOHN LOUIS-UGBO, AND SCOTT D. BODEN
SECTION II: Biomechanics
5. General Considerations of Biomechanical Testing .................... 61
ANTON E. DMITRIEV
6. Clinical Biomechanics of the Cervical Spine ........................ 70
HANS-JOACHIM WILKE, FABIO GALBUSERA, AND RENÉ JONAS
7. Biomechanics of Three-Dimensional Scoliosis Correction .............. 78
ANDREW G.S. KING AND MANISH P. LAMBAT
Contents 8. Principles and Applications of Spinal Instrumentation:
A Clinical Approach .......................................... 85
KENNETH G.W. MACKINLAY, JOSEPH L. LARATTA, AND CHARLES H. CRAWFORD III
9. Treatment Considerations and Biomechanics of the Lumbosacral Spine ... 96
GEOFFREY CRONEN AND TIMOTHY R. KUKLO
SECTION III: Anatomic Approaches
10. Anterior Cervical Approaches .................................. 103
PABLO J. DIAZ-COLLADO, ALEKOS A. THEOLOGIS, AND LUKAS P. ZEBALA
11. Surgical Approach to the Posterior Cervical Spine .................. 113
PAUL A. ANDERSON AND ANDREW J. PUGELY
12. Jaw-Splitting Approaches to the Upper Cervical Spine ............... 122
JONATHAN NAKHLA, RYAN HOLLAND, DANIEL M. SCIUBBA, AND ZIYA L. GOKASLAN
13. The Modified Anterior Approach to the Cervicothoracic
Junction .................................................. 137
JASON PUI YIN CHEUNG AND KEITH DIP KEI LUK
14. Transsternal Approaches to the Spine ............................ 146
JONATHAN NAKHLA, MOUSA K. HAMAD, DANIEL M. SCIUBBA, AND ZIYA L. GOKASLAN
15. “Microscopic” Approach to the Posterior Lumbar
Spine for Decompression ..................................... 157
PATRICK S. HILL, SHEERAZ QURESHI, AND STEVEN J. MCANANY
16. Minimal Access Techniques Using Tubular Retractors for
Disc Herniations and Stenosis ................................. 164
R. NICK HERNANDEZ, CHRISTOPH WIPPLINGER, SERTAC KIRNAZ, AND ROGER HARTL
17. Open Anterior Exposure of the Thoracic, Thoracolumbar, and
Lumbar Spines ............................................. 178
HENRY HALM AND CLARA BERLIN
18. Anterior Approaches to the Distal Lumbar Spine and
Sacrum ................................................... 187
JOHN R. DIMAR II AND MIKHAIL LEW P. VER
19. Direct Lateral Approach to the Lumbar Spine ..................... 205
JOSHUA T. WEWEL AND JUAN S. URIBE
SECTION IV: The Cervical Degenerative Spine
20. Cervical: State of the Art ..................................... 211
JOHN M. RHEE 21. Evaluation of Axial Neck Pain: Who Is a Surgical Candidate and
Who Isn’t: How to Manage the Nonoperative Treatment,
How to Work Up the Pathology ................................ 213
CHASE BENNETT AND JOHN M. RHEE
22. Nonoperative Management of Cervical Radiculopathy ............... 225
GUANG-TING CONG, PHILIP SAVILLE, SHEERAZ QURESHI, AND STEVEN J. MCANANY
23. Cervical Spondylosis and Radiculopathy .......................... 233
ANDELLE L. TENG, COREY J. WALLACH, AND JEFFREY C. WANG
24. Cervical Myelopathy ......................................... 243
AMIT JAIN, K. DANIEL RIEW, AND JOHN M. RHEE
25. Anterior Decompression, Instrumentation, Fusion Techniques:
Discectomy, Foraminotomy, Disc Space Carpentry .................. 255
ANDREW B. PHAM AND JAMES D. KANG
26. Anterior Decompression, Instrumentation, Fusion Techniques:
Corpectomy, Strut Grafting ................................... 263
SHALIN S. PATEL AND JAMES D. KANG
27. Anterior Cervical Plating ..................................... 280
ALEKOS A. THEOLOGIS, PABLO J. DIAZ-COLLADO, AND LUKAS P. ZEBALA
28. Indications and Techniques for Transoral and Foramen Magnum
Decompression ............................................. 292
ARNOLD H. MENEZES AND BRIAN J. DLOUHY
29. Occipitocervical and Atlantoaxial Methods of Fusion:
Rigid Fixation and Wiring .................................... 310
HANI MALONE AND VINCENT C. TRAYNELIS
30. Subaxial Posterior Foraminotomy .............................. 322
ANDREW B. PHAM AND BOBBY TAY
31. Cervical Laminoplasty ....................................... 331
JOHN G. HELLER
32. Subaxial Posterior Decompression and Fusion Techniques ............ 338
VISHAL A. KHATRI AND STEVEN C. LUDWIG
33. Subaxial Posterior Laminoplasty and Laminectomy With
Lateral Mass Fixation ........................................ 347
CHARLES M. GORDON, IMRAN S. YOUSAF, DOUGLAS D. NOWAK,
KORNELIS A. POELSTRA, AND STEVEN C. LUDWIG
34. Subaxial Posterior Lateral Mass Fixation ......................... 361
ALFRED J. PISANO, MELVIN D. HELGESON, AND TODD J. ALBERT 35. Subaxial Cervical Pedicle Screw Fixation ......................... 369
KUNIYOSHI ABUMI, HITOSHI HABA, AND TATSUTO TAKEUCHI
36. Revision Cervical Spine Surgery ................................ 383
SOHAIB Z. HASHMI AND ALPESH A. PATEL
37. Combined Approaches (Anterior-Posterior, Posterior-Anterior-Posterior)
to the Correction of Cervical Kyphosis ........................... 390
FRANCIS C. LOVECCHIO, HAN JO KIM, AND TODD J. ALBERT
38. Cervical Pedicle Subtraction Osteotomy .......................... 403
LEE A. TAN AND K. DANIEL RIEW
39. Cervical Disc Arthroplasty .................................... 409
FRANCIS C. LOVECCHIO AND DARREN R. LEBL
40. Complications of Surgical Treatment of the Cervical Spine ............ 421
NICHOLAS STEKAS AND THEMISTOCLES S. PROTOPSALTIS
SECTION V: The Thoracic and Lumbar Degenerative Spine
41. Thoracic and Lumbar Degenerative Disorders: State of the Art. . . . . . . . . 425
M. CRAIG MCMAINS AND IVAN CHENG
42. Evaluation of Thoracic and Lumbar Axial Back Pain:
Who Is a Surgical Candidate and Who Is Not? ..................... 428
LI SUN AND SAMUEL K. CHO
43. Surgical Treatment of Lumbar Disc Herniation .................... 438
WILLIAM R. HOTCHKISS
44. Surgical Treatment of Lumbar Spinal Stenosis ..................... 445
PABLO J. DIAZ-COLLADO, GBOLAHAN O. OKUBADEJO, AND JACOB M. BUCHOWSKI
45. Revision Laminectomy: Indications and Techniques ................. 456
PETER D. ANGEVINE
46. Minimally Invasive Posterior Surgery for the Lumbar Spine ........... 466
DANIEL MICHAEL HAFEZ AND WILSON ZACHARY RAY
47. When to Consider ALIF, TLIF, and PLIF With PSF ................. 476
HONG JOO MOON AND MUNISH C. GUPTA
48. Transforaminal Lumbar Interbody Fusion/Posterior Lumbar
Interbody Fusion ........................................... 481
NEEL ANAND AND CHRISTOPHER KONG
49. Revision Lumbar Spine Surgery ................................ 490
ALEKOS A. THEOLOGIS AND MUNISH C. GUPTA 50. Thoracic Disc Herniation: Diagnosis and Management ............... 503
ADDISU MESFIN AND SHERIF M. SHERIF
51. Thoracic Stenosis ........................................... 509
TYLER KOSKI AND FADI NASR
52. Treatment of Thoracic Myelopathy .............................. 516
CATHERINE MILLER AND PRAVEEN V. MUMMANENI
53. Current State of Lumbar Total Disc Replacement: Concepts/Design
Strategy/Indications/Contraindications/Complications .............. 525
JAMES J. YUE, BRANDON LAWRENCE, AND FRED MO
54. Sacroiliac Joint Dysfunction ................................... 535
VINKO ZLOMISLIC AND STEVEN R. GARFIN
55. The Future: Disc Regeneration and Other Technologies .............. 549
ANA V. CHEE AND HOWARD S. AN
56. Complications of Lumbosacral Spine Surgery ...................... 556
JOHN R. DIMAR II AND MIKHAIL LEW P. VER
SECTION VI: Spondylolisthesis
57. Wiltse and Marchetti–Bartolozzi Classifications of Spondylolisthesis:
Guidelines for Treatment ..................................... 579
JOSEPH PERRA
58. Sagittal Alignment and the Spinal Deformity Study
Group Classification ......................................... 586
HUBERT LABELLE AND JEAN-MARC MAC-THIONG
59. Natural History of Spondylolisthesis ............................ 597
PIERRE ROUSSOULY, NISHANT NISHANT, AND KARIMAN ABELIN-GENEVOIS
60. Pars Interarticularis Repair .................................... 604
PURNENDU GUPTA AND MUNISH C. GUPTA
61. Low-Grade Spondylolisthesis in Children and Adolescents ............ 612
M. TIMOTHY HRESKO
62. Adult Degenerative Spondylolisthesis ............................ 618
MOSTAFA H. EL DAFRAWY, SACHIN GUPTA, S. MOHAMMED KARIM, AND THOMAS D. CHA
63. High-Grade Spondylolisthesis: Decision Making and Fusion Reduction .. 638
ROSS C. PUFFER AND JEREMY FOGELSON
64. High-Grade Spondylolisthesis: Partial Reduction ................... 646
HAI LE, HAROLD A. FOGEL, AND STUART HERSHMAN 65. High-Grade Spondylolisthesis: Posterior Decompression and
Spanning/Dowel Fibula ...................................... 656
BARRETT S. BOODY AND RICK C. SASSO
66. High Dysplastic Spondylolisthesis: Anatomic Reduction
Harms/Shufflebarger Technique ............................... 669
HARRY L. SHUFFLEBARGER
67. Reduction of High-Grade Spondylolisthesis: The Edwards Technique ... 677
CHARLES C. EDWARDS, SR AND CHARLES C. EDWARDS II
68. L5 Vertebrectomy for High-Grade Spondylolisthesis:
Anterior–Posterior and Posterior-Only Approaches ................. 694
JAY S. REIDLER AND KHALED M. KEBAISH
69. Complications of Spondylolysis/Spondylolisthesis Surgery ............ 708
JOHN P. LUBICKY
Volume 2
SECTION VII: Idiopathic Scoliosis
70. Natural History Including Measures of Maturity ................... 717
SUSAN E. NELSON AND JAMES O. SANDERS
71. Clinical Assessment and Parent–Patient Expectations ................ 728
SCOTT J. LUHMANN
72. Spinal Deformity Outcomes Measurement ........................ 735
JOSHUA T. BUNCH AND DOUGLAS C. BURTON
73. Radiographic Classification Scheme: Lenke Classification ............. 741
JAMES D. LIN AND LAWRENCE G. LENKE
74. Fusionless Surgery and Growing-Rod Techniques for Idiopathic
Early-Onset Scoliosis ........................................ 758
BEHROOZ A. AKBARNIA, POORIA HOSSEINI, GEORGE H. THOMPSON, AND
GREGORY M. MUNDIS, JR
75. Anterior and Posterior Scoliosis Correction Techniques
Without Fusion ............................................ 772
JAMES T. BENNETT, AMER F. SAMDANI, M. DARRYL ANTONACCI, AND RANDAL R. BETZ
76. Shilla Technique ............................................ 787
DAVID B. BUMPASS AND RICHARD E. MCCARTHY
77. Open and Thoracoscopic Anterior Thoracic Surgery ................. 795
PETER O. NEWTON AND VIDYADHAR V. UPASANI 78. Thoracoplasty ............................................. 808
DAVID H. CLEMENTS, AMER F. SAMDANI, AND RANDAL R. BETZ
79. Evolution of Instrumentation for Adolescent Idiopathic Scoliosis ....... 816
POORIA A. SALARI, GBOLAHAN O. OKUBADEJO, KEITH H. BRIDWELL,
AND MUNISH C. GUPTA
80. Posterior Spinal Deformity Correction Techniques .................. 825
DAVIN D. CORDELL, LAWRENCE G. LENKE, AND MUNISH C. GUPTA
81. Anterior Lumbar and Thoracolumbar Correction and Fusion for
Adolescent Idiopathic Scoliosis ................................. 851
UWE PLATZ AND HENRY HALM
82. Strategies in the Management of Severe and Neglected Deformities ..... 864
OHENEBA BOACHIE-ADJEI AND KWADWO POKU YANKEY
83. Complications Associated With Adolescent Idiopathic
Scoliosis Surgery ........................................... 874
MARK C. LEE, B. STEPHENS RICHARDS, AND CHARLES E. JOHNSTON
SECTION VIII: Adult Spinal Deformity
84. Adult Spinal Deformity: Introduction/State of the Art .............. 889
CHRISTOPHER L. HAMILL
85. Adult Spinal Deformity Classification ............................ 892
UWE PLATZ, FRANK J. SCHWAB, AND VIRGINIE LAFAGE
86. De Novo Scoliosis .......................................... 900
UWE PLATZ, FRANK J. SCHWAB, AND VIRGINIE LAFAGE
87. Sagittal Imbalance .......................................... 911
NICHOLAS STEKAS AND THEMISTOCLES S. PROTOPSALTIS
88. Fixed Coronal Malalignment of the Spine: Clinical Significance and
Operative Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915
BRIAN HSU AND SIGURD BERVEN
89. Spinal Deformity in the Older Patient With Kyphosis ................ 929
MARCUS D. MAZUR, THOMAS J. BUELL, JAMES H. NGUYEN, JUSTIN S. SMITH, AND
CHRISTOPHER I. SHAFFREY
90. Decision Making in Treatment of Adult Spinal Deformity ............ 937
KEITH H. BRIDWELL, JACOB M. BUCHOWSKI, MUNISH C. GUPTA,
MICHAEL P. KELLY, AND LUKAS P. ZEBALA
91. Smith-Petersen Osteotomy of the Spine .......................... 952
BRANDON B. CARLSON AND DOUGLAS C. BURTON 92. Pedicle Subtraction Procedures for Complex Spinal Deformity ......... 957
ALEKOS A. THEOLOGIS AND MUNISH C. GUPTA
93. Vertebral Column Resection for Complex Spinal Deformity:
Posterior Approach ......................................... 964
AZMI HAMZAOGLU AND MERIC ENERCAN
94. Vertebral Column Resection for Complex Spinal Deformity:
Combined Anterior and Posterior Approach ....................... 982
SIGURD BERVEN AND ROMAN TRIMBA
95. Fusion to the Sacrum and Fixation Techniques of the
Sacropelvic Junction ......................................... 989
RICHARD HOSTIN AND SHYAM KISHAN
96. Structural Grafting for Adult Spinal Deformity ................... 1009
PETER D. ANGEVINE
97. Revision Surgeries for Adult Spinal Deformity .................... 1016
NICHOLAS A. PALLOTTA AND MUNISH C. GUPTA
98. Minimally Invasive Deformity Surgery: Future Directions ........... 1023
NEEL ANAND AND CHRISTOPHER KONG
99. ACR and Minimally Invasive Surgery for Sagittal Plane Deformities .... 1029
RANDALL HLUBEK AND GREGORY M. MUNDIS, JR
SECTION IX: Dysplastic and Congenital Deformities
100. Introduction/State of the Art in the Care of Dysplastic and
Congenital Spine Deformities ................................. 1037
JOSEPH L. PETFIELD AND SUKEN A. SHAH
101. Dysplastic Scoliosis: Neurofibromatosis Spinal Pathology ............ 1041
ALVIN H. CRAWFORD, KEITH R. GABRIEL, AND ADAM SCHUMAIER
102. Spinal Deformity in Skeletal Dysplasia Conditions:
Diagnosis and Presentation .................................. 1061
KLANE K. WHITE
103. Surgical Management of Spinal Deformity in Skeletal Dysplasias ...... 1072
ERIC D. SHIRLEY AND MICHAEL C. AIN
104. The Spine in Osteogenesis Imperfecta ........................... 1083
DEREK T. NHAN AND PAUL D. SPONSELLER
105. Spinal Deformity in Familial Dysautonomia ...................... 1091
DAVID S. FELDMAN, FULYA ÜSTÜNKAN, AND DEBRA A. SALA 106. Congenital Intraspinal Anomalies: Spinal Dysraphism—Embryology,
Pathology, and Treatment ................................... 1100
AYODAMOLA OTUN, JEFFREY R. LEONARD, BRUCE A. KAUFMAN,
AND DAVID D. LIMBRICK, JR
107. Congenital Scoliosis and Kyphosis ............................. 1131
TODD J. BLUMBERG, DIDJA HILMARA, AND PATRICK J. CAHILL
108. Hemivertebra Resection ..................................... 1156
MICHAEL RUF AND JÜRGEN HARMS
109. Thoracic Insufficiency Syndrome .............................. 1170
ROBERT M. CAMPBELL, JR
110. Congenital Anomalies of the Cervical Spine in Children: Management
of Segmental Instability and Spinal Canal Encroachment ............ 1185
VINCENT J. ALENTADO, JOHN P. DORMANS, ROD J. TURNER, JR, AND ANDREW JEA
111. Complications of the Surgical Treatment of
Congenital Spinal Deformities ................................ 1203
JAYSSON T. BROOKS, LUKE C. DRAKE, AND BURT YASZAY
SECTION X: Neuromuscular Spine Deformity
112. Considerations in Neuromuscular Spine Deformity ....................1211
DEREK T. NHAN AND PAUL D. SPONSELLER
113. Preoperative Preparation for Neuromuscular Spine Surgery .......... 1215
ERIC D. SHIRLEY AND NICHOLAS D. FLETCHER
114. Surgical Techniques Unique to Neuromuscular Scoliosis. . . . . . . . . . . . . 1224
TYLER C. MCDONALD AND JAYSSON T. BROOKS
115. Pelvic Fixation in Neuromuscular Scoliosis ....................... 1237
OUSSAMA ABOUSAMRA AND PAUL D. SPONSELLER
116. Spinal Muscular Atrophy, Duchenne Muscular Dystrophy, and
Other Neuromuscular Disorders ............................... 1244
MATTHEW A. HALANSKI
117. Spinal Deformity in Patients With Cerebral Palsy and
Rett Syndrome ............................................ 1259
STUART L. MITCHELL AND PAUL D. SPONSELLER
118. Surgical Treatment of Spinal Deformity in Myelomeningocele ........ 1267
PETER G. GABOSSECTION XI: Kyphosis and Postlaminectomy Deformities
119. Introduction and Current State of the Art ....................... 1281
PETER D. ANGEVINE
120. Cervical Instability and Kyphosis (Rheumatoid, Dwarfism,
Degenerative, Others). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1283
WESLEY H. BRONSON, ANAND H. SEGAR. ERIC HARRIS, AND ALAN S. HILIBRAND
121. Surgical Treatment of Scheuermann Kyphosis .................... 1295
STEPHEN G. GEORGE AND HARRY L. SHUFFLEBARGER
122. Delayed Posttraumatic Deformity: Presentation and Management ..... 1309
OWOICHO ADOGWA AND JACOB M. BUCHOWSKI
123. Ankylosing Spondylitis/Thoracolumbar Deformities ............... 1317
YONG QIU
124. Cervicothoracic Extension Osteotomy for Chin-on-Chest Deformity ... 1349
YONG QIU
125. The Role of Osteotomies in the Cervical Spine .................... 1360
K. DANIEL RIEW, LEE A. TAN, AND PETER D. ANGEVINE
126. Complications of Surgical Treatment of Kyphotic Deformities ........ 1382
LORENA V. FLOCCARI AND DANIEL J. SUCATO
SECTION XII: Trauma
127. Classification of Cervical Spine Injury .......................... 1393
JOSEPH P. MASLAK, ANAND H. SEGAR, GREGORY D. SCHROEDER, AND ALPESH A. PATEL
128. Classification of Thoracic, Lumbar, and Sacral Fractures ............ 1401
JAMES STENSON AND CHRISTOPHER K. KEPLER
129. Surgical Management of Cervical Spine Fractures .................. 1409
BARRETT S. BOODY AND RICK C. SASSO
130. Anterior Decompression and Instrumentation Techniques for
Thoracolumbar Fractures .................................... 1420
KEITH W. MICHAEL, DALE N. SEGAL, AND JOHN M. RHEE
131. Surgical Treatment of Thoracolumbar Spine Fractures: Posterior
Decompression and Instrumentation Techniques .................. 1430
TYLER J. JENKINS AND JEFF RIHN
132. Minimal Access Techniques for Spine Trauma ..................... 1444
M. AYODELE BURAIMOH, OMER YOUSAF, AND STEVEN C. LUDWIG 133. Management of Central Cord Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . 1453
MICHAEL H. MCCARTHY AND ALPESH A. PATEL
134. Surgical Treatment of Sacral-Pelvic Fractures ..................... 1460
ASHRAF N. EL NAGA, HAITAO ZHOU, CONOR P. KLEWENO, AND CARLO BELLABARBA
135. Novel Approaches to Neural Repair and Regeneration
After Spinal Cord Injury .................................... 1481
GEOFFREY STRICSEK, GEORGE N. RYMARCZUK, ELENA OKON, BRIAN K. KWON,
AND JAMES S. HARROP
136. Outcomes Measures in Spinal Trauma .......................... 1489
S. SADIQI AND F.C. ONER
SECTION XIII: Tumor and Osteomyelitis
137. Introduction and State-of-the-Art: Tumors and Osteomyelitis ........ 1495
PETER D. ANGEVINE
138. Benign Tumors of the Spine .................................. 1496
STEFANO BORIANI AND RICCARDO CECCHINATO
139. Primary Malignant Tumors of the Spine ......................... 1509
STEFANO BORIANI
140. The Surgical Treatment of Metastatic Spine Disease ................ 1524
ILYA LAUFER, PETER S. ROSE, ORI BARZILAI, AND MARK H. BILSKY
141. Intramedullary Spinal Cord Tumors ............................ 1534
RICHARD L. PRICE, CHRISTOPHER F. DIBBLE, AND WILSON ZACHARY RAY
142. Intradural Extramedullary Spinal Tumors ....................... 1548
OWOICHO ADOGWA, ALFRED T. OGDEN, AND PAUL C. MCCORMICK
143. Spinal Vascular Malformations ................................ 1561
KENDALL A. SNYDER, LORENZO RINALDO, AND MICHELLE J. CLARKE
144. Spinal Infection/Osteomyelitis ................................ 1572
FRANCIS H. SHEN
145. Sacral Tumors ............................................ 1581
PETER S. ROSE
146. Adjuvant Therapy of Spinal Tumors ............................ 1595
JOHN BERRY-CANDELARIO, ILYA LAUFER, YOSHIYA YAMADA, AND MARK H. BILSKY
147. Complications of Surgical Treatment of Tumor and Infection ......... 1602
ALEKOS A. THEOLOGIS AND JACOB M. BUCHOWSKISECTION XIV: Complications
148. Neurologic Complications in Spine Surgery ...................... 1615
MARTIN H. PHAM, MEGHAN CERPA, EARL D. THUET, AND LAWRENCE G. LENKE
149. Perioperative Spinal Cord Deficits and Myelopathy ................ 1621
MUHAMMAD ALI AKBAR, JETAN H. BADHIWALA, AND MICHAEL G. FEHLINGS
150. Reconstruction of Complex Spinal Wounds ...................... 1627
DAVID M. BROGAN, STEVEN L. MORAN, AND MARTIN I. BOYER
151. Vascular Complications ..................................... 1640
GREGORY GEBAUER AND A. JAY KHANNA
152. Postoperative Early and Late Wound/Implant Infections ............ 1652
POORIA A. SALARI, SUMEET GARG, AND JACOB M. BUCHOWSKI
153. Dural Lacerations, CSF Fistula, Pseudomeningoceles, and
Strategies for Repair ........................................ 1662
AFSHIN SALEHI, RICHARD L. PRICE, AND NEILL M. WRIGHT
154. Pseudarthrosis in Spinal Deformity Surgery ...................... 1669
JUN S. KIM AND SAMUEL K. CHO
155. Legal Implications and Strategies .............................. 1679
RA’KERRY K. RAHMAN
156. Unresolved Postoperative Spine Pain ........................... 1699
LESLEY K. RAO
157. Medical Complications Associated With Spinal Surgery ............. 1708
REMI M. AJIBOYE AND IVAN CHENG
Index I-1