Libro de texto del Comité de Columna Vertebral de WFNS sobre la columna torácica

Chapter 1 Applied Anatomy of the Thoracic Spine 1
Cumhur Kilincer
Surface Topography and Landmarks 1
Muscles 1
The Vertebra 3
Ligaments 5
Chapter 2 Cementoplasty in Spontaneous Thoracic Spine Fractures 8
Marcos Masini, Rogerio Safatle Barros, Silen Noel Reyes Hidalgo
Indications 9
Contraindications 10
Patient Evaluation 10
Image Evaluation 10
Timing for Treatment 11
Surgical Technique 11
Complications 12
Case Report 12
Chapter 3 Intradural Extramedullary Tumors of Thoracic Spine 17
Yury Shulev, Alexander Trashin, Dmitry Pechiborsch, Gleb Grigoriev
History 17
Classification 18
Epidemiology 18
Diagnostics imaging 20
Nerve sheath tumors 21
Surgical treatment of IEMT 24
Approach selection 25
Specifics of nerve sheath tumor surgery (schwannomas and neurofibromas) 25
Specifics of meningioma surgery 27
Complications 28
Recurrences 31
Chapter 4 Lateral Extracavitary Approach to the Thoracic Spine 34
Natarajan Muthukumar
Preoperative evaluation 34
Advantages of LECA 34
Disadvantages of LECA 34
Indications 35
Contraindications 35
Surgical Techniques 35
Complications of LECA 39
Illustrative cases 39
Discussion 40
WFNS Spine Committee Textbook on Thoracic Spine xxii Chapter 5 Management of tumors of the thoracolumbar spine 42
Mehmet Zileli
Classification 42
Metastatic Tumors 42
Primary Tumors 44
Total Spondylectomy 44
Chapter 6 Spine and Spinal Cord Tumors 53
Mehmet Resid Onen, Sait Naderi
General Information 53
Diagnosis 54
Tumors 55
Spinal Cord Tumors 62
Chapter 7 Surgical Treatment of Thoracic Spinal Stenosis by
Minimally Invasive Surgery 71
Marcos Masini, João Flávio G Madureira,
Silen Noel Reyes Hidalgo
Anatomical and Pathological Aspects 72
Clinical Manifestations 72
Clinical and Imaging Diagnosis 72
Conservative Medical Treatment 73
Minimally Invasive Surgical Treatment 73
Chapter 8 Thoracic Disc Herniations 77
Mehmet Simsek, Sait Naderi
Epidemiology 77
Clinical Presentation and Diagnosis 77
Radiologic Evaluation 77
Definition of Surgical Level 78
Treatment 78
Surgical Management 78
Calcified and/or Giant TDH 80
Multilevel lesions 81
Fusion requirements 81
Chapter 9 Thoracic Spinal Canal Narrowing 83
Mehmet Zileli
Pathology 83
Clinic 84
Radiology 84
Surgery 85
Outcomes 87
Chapter 10 Thoracic Spine Biomechanics 88
Evren Yuvruk, Sait Naderi
Motion segment and Stability 88
Biomechanics Related Anatomy of the Thoracic Spine 89
Biomechanics of Thoracic Spine Pathologies 90
Contents xxiii
Chapter 11 Thoracic Spine Tumors and Minimal Access Spine Surgery 93
Ibet Marie Y Sih, Erickson F Torio, Juan Manuel L Mariano
Demographics of Spine Tumors 93
Salient Description of the Topic 93
Spine Surgery Approaches 93
Minimal Access Spine Surgery 94
Surgical Technique 95
Complications 96
Discussion 97
Chapter 12 Tuberculosis of the Thoracic Spine 100
Ram Chaddha, Swapnil M Keny, Hrushikesh Mehata
Part I: Spinal Tuberculosis—Disease Dynamics 100
Definition 100
Historical Perspective 101
Epidemiology 101
Microbiology 101
Pathophysiology of Spinal tuberculosis 102
Pathology of Spinal Tuberculosis 103
Clinical Diagnosis of Spinal Tuberculosis—Inherent Pitfalls 104
Symptoms and Signs 104
Classification of tuberculous paraplegia/tetraplegia (based on motor/sensory weakness) 104
Clinical Classification of Paraplegia in Tuberculosis 104
Laboratory Diagnosis of Tuberculosis 104
Bacteriological Methods 104
Immunology 108
Imaging 108
Treatment of Spinal Tuberculosis 112
Management in Special Situations 112
Surgery in Spinal Tuberculosis 113
Indications for Surgery in Spinal Tuberculosis 114
Prognosis 114
Part II: The Dynamics of Thoracic Spinal Tuberculosis and its Surgical Implication 114
Stabilization for Tuberculosis of the Thoracic Spine 114
Indications for Surgery in Active Thoracic Spinal Tuberculosis 115
Decision Making in Surgery for Active Tuberculosis of the Thoracic Spine 115
Decision Making for Surgery in Healed Tuberculosis of the Thoracic Spine 116
Pathology of Post-tuberculous Kyphosis 117
Single Stage Correction of Post-tuberculous Kyphosis 119
Chapter 13 Costotransversectomy 125
PS Ramani
Advantages 125
Disadvantages 125
Preoperative evaluation 125
Surgical technique 129
Complications of costotransversectomy 129
WFNS Spine Committee Textbook on Thoracic Spine xxiv Chapter 14 Anterolateral Exposure of the Dorsolumbar Spine 131
Mohamed Maziad
Indications 131
Contraindications 131
Advantages 131
Disadvantages 131
Surgical Technique 131
Modern trends 134
Discussion 134
Chapter 15 Spinal Vascular Malformations 135
Nishant Aditya, Anil P Karapurkar
Classification of spinal vascular malformations 135
Vascular supply of spinal cord 136
Clinical presentation 136
Investigations 137
Technique 138
Complications 140
Follow up 142
Chapter 16 Endoscopic Approach to Anterior Thoracic Spine 146
Sushil V Patkar
Patient selection 146
Indications 146
Advantages 147
Disadvantages 147
Contraindications 147
Applied anatomy 147
The imaging equipment 148
The portals 148
The surgical technique 148
Operating room set up 148
Wound closure and insertion of chest tube 149
Postoperative management 149
Control of pain 149
Complications 149
Chapter 17 History of Thoracic Disc Herniation 150
Ravindran Vashu, Amit Amit, Pragnesh Bhatt
Overview 150
Transthoracic Approach 152
Future 152
Chapter 18 Interventional Neuroradiology in Hypervascular Spinal Neoplasms 153
Uday S Limaye, Guruprasadh Chandrashekhar
Spinal Angiography and Embolization 154
Principles of Embolization 154
Embolization Methods 154
Embolic Agents 156
Percutaneous Vertebroplasty 157
Contents xxv
Percutaneous Ethanol Injection 159
Percutaneous Nbca Embolization 160
Hemangioma 161
Aneurysmal Bone Cyst 163
Hemangioblastoma 165
Malignant Tumors 169
Complications 170
Chapter 19 Lateral Extracavitary Approach to Thoracic Spine 175
Amol Rege
Historical background 175
Indications 175
Contraindications 175
Advantages 175
Disadvantages 175
Preoperative evaluation 175
Anesthesia and positioning 176
operative technique 176
Discussion 178
Chapter 20 Pedicle Screws and Rods for Stabilization of the Thoracic Spine 179
Devanand Dominique
Historical background 179
Indications 179
Contraindications 179
Advantages 179
Disadvantages 179
Objective 179
Radiological Evaluation 179
Surgical Technique 179
Further procedure 180
Applied anatomy of the pedicle 180
Entry point of the pedicle 180
The procedure 180
The closure 181
Postoperative management 181
Possible complications 182
Discussion 182
Chapter 21 Transaxillary Approach to the Upper Dorsal Spine 184
Vernon Velho
Advantages 184
Disadvantages 184
Indications 184
Anesthesia 184
Position 184
Operative procedure 184
The closure 185
Key points of surgical technique 187
Complications 187
WFNS Spine Committee Textbook on Thoracic Spine xxvi Chapter 22 Transclavicular and Transmanubrial Approach to the
Anterior Upper Thoracic Spine 188
Mehmet Zileli
Applied anatomy 188
Indications 189
Contraindications 189
Advantages 189
Disadvantages 189
Approaches 189
Preparative planning 192
Anesthesia and positioning of the patient 192
The closure 192
Postoperative care 192
Chapter 23 Transpedicular Approach—A Gateway to the Spine 193
Shekhar Bhojraj
Historical background 193
Indications 194
Contraindications 194
Advantages 194
Disadvantages 194
Operative Technique 194
Posterior stabilization 195
Complications 196
Discussion 196
Chapter 24 Transthoracic disc excision 199
Giulio Anichini, Keith Buchan, Pragnesh Bhatt
Overview 199
Surgical options 200
Preoperative evaluation 201
Advantages and disadvantages 202
Indications and Contraindications 202
Surgical techniques and its pitfalls 203
Chest closure 206
Trans-sternal Surgical Access to the discs below T1 and T2 207
Complications 207
Outcome and case presentation 208
Discussion 209
Chapter 25 Minimally Access VITOM Thoracotomy 211
A Younus
Introduction to minimally invasive surgery 211
Introduction to VITOM 211
Indication for Minimally Access Thoracotomy 212
Contraindication for Minimally invasive thoracotomy 213
Advantages 213
Disadvantages 213
Preoperative evaluation 213
Postoperative management 218
Complications 218
Contents xxvii
Pitfalls 218
Case Presentation 219
Discussion 219
Chapter 26 Minimally Invasive Thoracoscopic Discectomy 221
Luigi Andrew F Sabal, Jong-Mog Shin, Sang-Ho Lee, June Ho Lee
Salient description of the topic 221
Treatment options 222
Preoperative evaluation 222
Advantages and disadvantages 222
Indications and contraindications 223
Surgical Techniques and its pitfalls 223
Outcomes and Case Presentation 227
Chapter  27 Ossification of Posterior Longitudinal Ligament in Thoracic Spine 230
Se-Hoon Kim, Jung Keun Suh
Salient description of the topic 230
Treatment options 232
Preoperative evaluation 232
Indications and Contraindications of Surgical Treatment for Thoracic OPLL 232
Surgical techniques and its pitfalls 233
Complications 234
Surgical Outcomes 234
Chapter  28 Ossified ligamentum flavum in thoracic spine 237
Jae Taek Hong, Chun-Kun Park
Clinical manifestation and diagnosis 238
Treatment options 238
Surgical Outcome 240
Complications and Managements 240
Chapter 29 Percutaneous Endoscopic Thoracic Discectomy with facetoplasty 243
Ho-Yeon Lee, Sang Hoon Jang, Sang-Ho Lee
Patient selection—indication 243
Imaging diagnosis 243
Instrumentation 244
Procedures 244
Complications 247
Chapter 30 Percutaneous vertebral augmentation in thoracic spine:
extrapedicular approach 250
Kyeong-Sik Ryu, Chun-Kun Park
Surgical Technique 250
Complications and Pitfalls 253
Clinical Results 254
Discussion 255
Chapter 31 Stereotactic Radiosurgery for Metastatic Tumors of the Thoracic Spine 259
Ibet Marie Y sih, Juan Manuel L Mariano, Erickson F Torio
Salient Description of the Topic 259
Spine SRS 260
WFNS Spine Committee Textbook on Thoracic Spine xxviii St. Luke’s Medical Center Spine Radiosurgery Protocol 262
Complications 262
Spine SRS for Metastatic Tumors—Initial Experiences at St. Luke’s Medical Center, Philippines 264
Chapter 32 Thoracic Spinal Cord Tumors 267
Mazda Turel, Vedantam Rajshekhar
Clinical Presentation 267
Imaging Findings 269
Surgery for intramedullary tumors 269
Surgery for intradural extramedullary tumors 275
Outcomes and Prognosis 275
Chapter 33 Thoracic Spinal Deformity 278
Paul D Ackerman, Russ P Nockels
Salient Description of the Topic 278
Treatment Options 279
Preoperative Evaluation 279
Advantages and Disadvantages 280
Indications and Contraindications 280
Surgical Techniques and Pitfalls 282
Complications 283
Outcome and Case Presentation 283
Discussion 284
Chapter 34 Transthoracic approach for ossified posterior longitudinal
ligament of the thoracic spine 288
Yoshitaka Hirano, Hiroshi Nakagawa, Junichi Mizuno, Yasunobu Itoh
Transthoracic approach 289
Illustrative Case 291
Chapter 35 Infections of Thoracic Spine 295
Salman Sharif, Muhammad Sohail Umerani
Spinal Epidural Abscess 295
Spinal Subdural Abscess 298
Spinal Intramedullary Abscess 298
Vertebral Osteomyelitis 299
Postoperative Spine Infections 301
Tuberculous Vertebral Osteomyelitis 302
Presentation 303
Diagnosis 303
Medical Treatment 304
Surgery 306
Changing Trends 306
Chapter 36 Microsurgery for Transitional Thoracic Disc Herniation 313
Marcos Masini, Silen Noel Reyes Hidalgo
Incidence 313
Etiology 313
Physiopathology 314
Diagnosis 314
Clinical Treatment 314
Surgical Treatment (in General) 315
Contents xxix
Microsurgical Techniques 315
Our Experience 316
Chapter 37 Minimally Invasive Robotic Assisted Thoracic Spine Surgery 320
Mick Perez-Cruet, Jorge Mendoza
Indications and Contraindications 320
Technique 320
Illustrative case 321
Outcome 324
Surgical Pearls 324
Chapter 38 Percutaneous pedicle screws and rods for spinal stabilization—
Operative technique 327
PD Kulkarni, Irfan Malik
Historical aspect 327
Anatomy of the pedicles 327
Percutaneous pedicle screw systems 327
Osteoporotic fractures treated with vertebroplasty and percutaneous cement
augmented with screws and rods fixation 328
Applied Anatomy and Radiology 330
Preoperative overview 330
Operative Technique 330
Steps 330
Postoperative management 342
Complications 344
Chapter 39 Transdural Spinal Cord Herniation 346
Enrique Klériga-Grossgerge, Jesús Bustamante-Vidales,Gerardo Zambito-Brondo,
Christian Chalita-Pérez-Tagle
Etiology 346
Clinical Presentation 347
Diagnosis 347
Treatment 348
Clinical Cases Presentation 349
Chapter 40 Techniques of Percutaneous Vertebral Augmentation: Vertebroplasty,
Kyphoplasty and Vesselplasty 353
A Bambang Darwono
Indications and Contraindications 354
Description of the Device 355
Background of Scientific Testing and Clinical Outcomes 359
Operative Technique 360
Procedure 360
Postoperative Care 367
Complications and Cautions 367
Chapter 41 Minimally Invasive Spinal Surgery for Thoracic Spinal Diseases 370
Jin-Sung Kim, Chun-Kun Park
History 370
Minimally Invasive Surgical Treatments 370
WFNS Spine Committee Textbook on Thoracic Spine xxx Chapter 42 Morphometric Study of the Thoracic Vertebrae 381
Eko A Subagio, A Zamroni, M Faris, AH Bajamal
Materials and Methods 381
Results 381
Chapter 43 Early Onset Scoliosis 384
Khurjekar K, Khurjekar D, Kanikdaley V
classification of early onset scolIosis 384
Bracing in Early onset scoliosis 385
Management of Early Onset scoliosis 385
Casting Techniques for Early Onset Scoliosis 386
Chapter 44 Image-guided Thoracic Pedicle screw Placement 391
Ben Roitberg, Jonathan Hobbs
Anatomy 391
Procedure 392
Registration methods 393
Pitfall Avoidance 395
Closing Comments 396
Chapter 45 Ligamental Hypertrophy in Thoracic Spine 398
WK Mak, David TF Sun
Pathogenesis of Thoracic Ossification of Ligamentum Flavum 398
Symptoms of Thoracic Ossification of Ligamentum Flavum 398
Classification 399
Surgical management 399
Chapter 46 Posterolateral Approach to the Thoracic Spine 402
David TF Sun
Indication and Advantages 402
Surgical Techniques 403
Comparison among Three Approaches 405
Chapter 47 Vascular malformations of the spinal cord 407
Mario Zanaty, Pascal Jabbour, James Harrop
Salient description of the topic 407
Treatment options 407
Preoperative evaluation 408
Advantages and disadvantages 408
Indications and Contraindications 408
Endovascular techniques and its pitfalls 409
Complications 409
Outcome and case presentation 409
Discussion 410
Chapter 48 Surgical Management of Tuberculous Infection in the Thoracic Spine 412
Sumeet Pawar, Arjun Dhar, PS Ramani
Surgical management 416
Timing of surgery 416
Contents xxxi
Chapter 49 Minimally Invasive Anterior Approach to the Spine 420
Maziad AM
Contraindications 420
Surgical Procedure 420
Chapter 50 Anterior Approach to the chest and Thoracic Spine 423
Mohamed Maziad
Different indications for Anterior Approach 423
Thoracotomy approach 423
Thoracolumbar Junction 425
Thoracolumbar Approach 426
Complications 426
Chapter 51 Thoracic Laminectomy 429
PS Ramani
Indications 429
Contraindications 429
Advantages 429
Disadvantages 429
Surgical technique 429
Excision of spinous process 430
closure 430
Complications 430
Chapter 52 Thoracic Spine Tuberculosis, Diagnosis and Management 432
Kourosh Karimi Yarandi, Abbas Amirjamshidi, Amir Azarhomayoun
Epidemiology 432
Pathophysiology and Microbiology 432
Diagnosis 433
Classification 434
Management 436
Surgical Treatment 438
Surgical Techniques 439
Corrections of Kyphotic Deformity during Active and Healing Phases of Spinal tuberculosis 441
Relapse and Recurrence 443
Multidrug-resistant Tuberculosis 443
Atypical Forms of Spinal tuberculosis 443
Multiple Vertebral Disease 443
Prognosis and Outcome of Spinal tuberculosis 444
Chapter 53 Pattern of Spinal Tumors at a neurosurgical center in India 449
Arjun Dhar, Sumeet Pawar, Rajan Shah, Atul Goel, Nitin Dange, PS Ramani
Extradural Tumors 449
Intradural Extramedullary Tumors 451
Clinical Presentation of Tumors 452
Exposure of Tumor 452
Vascular tumors 455
Outcome 455
Discussion 456
Index 461