Index

Spinal Infections and Trauma S Rajasekaran, Anil K Jain, Ajoy P Shetty, Rishi M Kanna

SECTION ONE: SPINAL INFECTIONS
CHAPTER 1:Bacteriology of Spinal Infections
- INTRODUCTION
- PATHOGENESIS
- MICROBIAL AGENTS
  - Importance of Staph. aureus in Spinal Infections?
- TYPES OF SPINAL INFECTIONS
- DIAGNOSIS OF INFECTION
- HISTOLOGY
- ACKNOWLEDGMENTS
CHAPTER 2:Biomechanical Aspects of Spinal Infections
- INTRODUCTION
- ANATOMICAL CONCEPTS
- EFFECTS OF INFECTIOUS DISEASES ON THE ANATOMICAL STRUCTURES
- BIOMECHANICAL FEATURES IN INFECTIOUS DISEASES OF THE SPINE
- EFFECT OF BIOMECHANICAL FORCES ON VERTEBRAL ENDPLATES (VEP)
- SUMMARY
CHAPTER 3:Imaging in Spinal Infections
- INTRODUCTION
- VARIOUS MODALITIES OF IMAGING
- SPINAL OSTEOMYELITIS
- SPONDYLODISCITIS
- INTRASPINAL INFECTIONS
- CONCLUSION
- ACKNOWLEDGMENT
CHAPTER 4:Management Principles of Spinal Infections
- INTRODUCTION
- BACTERIOLOGY
- MANAGEMENT PLAN
- SUMMARY
SECTION TWO: TUBERCULOSIS OF SPINE
CHAPTER 5:Tuberculosis of the Spine: A Historical Perspective and Evolution of Treatment
- HISTORICAL PERSPECTIVE
- EVOLUTION OF TREATMENT OF SPINAL TUBERCULOSIS
- EVOLUTION OF SURGICAL TREATMENT OF SPINAL TUBERCULOSIS
- DRUG RESISTANCE, RELAPSE, OR RECURRENCE
- NEW IMAGING MODALITIES
- IMMUNODEFICIENCY AND TUBERCULOSIS
- THE CHALLENGES FOR FUTURE
CHAPTER 6:Spinal Tuberculosis—Microbiology and Pathology
- INTRODUCTION
- TYPES OF MYCOBACTERIUM ORGANISMS
  - MTB—Morphology
    - Ziehl-Neelsen (ZN) Acid-Fast Staining Procedure
    - Auramine/Rhodamine (AR) Staining
- MICROBIOLOGICAL DIAGNOSTIC METHODS FOR MTB
- PATHOLOGY OF SPINAL TUBERCULOSIS
  - Modes of Infection13
- ATYPICAL TUBERCULOSIS
- HISTOPATHOLOGY20
- CONCLUSION
- ACKNOWLEDGMENT
CHAPTER 7:Clinical Features and Physical Assessment of Tuberculosis of Spine
- INTRODUCTION
- CLINICAL PRESENTATION
- TUBERCULOUS COLD ABSCESS
- TUBERCULAR SPINAL DEFORMITY
- NEUROLOGICAL DEFICITS
- TUBERCULOSIS OF SPECIFIC REGIONS
- DIFFERENTIAL DIAGNOSIS
CHAPTER 8:Investigations for Spinal Tuberculosis
- INTRODUCTION
- BLOOD INVESTIGATIONS
- TUBERCULIN SKIN TEST
- SEROLOGICAL TESTS
- TISSUE DIAGNOSIS
- OTHER INVESTIGATIONS
- CONCLUSION
CHAPTER 9:Neurological Deficit
- INTRODUCTION
- PATHOLOGY OF NEUROLOGICAL DEFICITS
- STAGING OF NEURAL DEFICIT
  - March of Neural Deficit
- CLINICAL PRESENTATIONS
  - Intraspinal Tuberculous Granuloma
- TREATMENT
  - Paraplegia of Active Disease
- INDICATIONS OF SURGERY
- SURGICAL DECOMPRESSION (ANTERIOR OR POSTERIOR)
  - Radical Surgery versus Debridement Surgery
- SURGICAL APPROACHES TO TUBERCULAR SPINE
  - Limitations of Extrapleural (Anterolateral) Approach
  - Posterior Transpedicular Approach
- INSTRUMENTED STABILIZATION
  - Surgical Risk
  - Prognosis in Tuberculous Para/Quadriplegia
- NEUROLOGICAL COMPLICATIONS IN HEALED DISEASE
CHAPTER 10:Deformity in Spinal Tuberculosis
- INTRODUCTION
- NATURAL HISTORY OF PROGRESS OF DEFORMITY
  - Phase I—Progression in Active Phase
  - Phase II—Progression in Healed Phase
- OTHER FACTORS INFLUENCING DEFORMITY
- PATTERNS OF HEALING
- BUCKLING COLLAPSE
- SURGERY FOR PREVENTION OF DEFORMITY
- SURGERY FOR ESTABLISHED DEFORMITY
  - Closing-opening Wedge Osteotomy
- SUMMARY
CHAPTER 11:Spinal Intradural and Meningeal Tuberculosis
- INTRODUCTION
- DEFINITION
- INCIDENCE
- ETIOLOGY AND PATHOGENESIS
- CLINICAL PRESENTATION
- IMAGING STUDIES
- MANAGEMENT
- OUTCOME
- ACKNOWLEDGMENTS
CHAPTER 12:B. Management: Management Principles—An Overview
- HISTORICAL REVIEW1
- CHEMOTHERAPY
  - Monitoring the Patient on Chemotherapy
- SURGERY
- TUBERCULOSIS OF CERVICAL SPINE
- TUBERCULOSIS OF THE LUMBAR SPINE70,71
  - Pott's Paraplegia73,74
    - Decompression and Arthrodesis of Spine24
    - Late Onset Paraplegia78,79
CHAPTER 13:Drug Therapy for Spinal Tuberculosis
- RATIONALE OF CHEMOTHERAPY
- ESSENTIAL DRUGS/FIRST-LINE DRUGS
- INH
- RESERVE DRUGS/SECOND-LINE DRUGS
- DIFFERENTIAL ACTION OF ANTITUBERCULAR DRUGS IN BACTERIAL POPULATION
- SCIENTIFIC BASIS FOR INTERMITTENT THERAPY: THE “LAG PERIOD” FACTOR
- CASE DEFINITIONS
- MULTIDRUG REGIMENS FOR CHEMOTHERAPY
- MANAGEMENT OF COMMON ADVERSE EFFECTS OF CHEMOTHERAPY20
- CONCLUSION
CHAPTER 14:Multidrug-resistant Tuberculosis of the Spine
- INTRODUCTION
- DEFINITIONS
- CAUSES OF DRUG RESISTANCE
- LABORATORY DIAGNOSIS OF RESISTANCE
- MANAGEMENT PRINCIPLES
- CONCLUSION
CHAPTER 15:Upper Cervical Tuberculosis
- INTRODUCTION
- PATHOLOGY
- PRESENTATION
- IMAGING
- TREATMENT
- CONCLUSION
CHAPTER 16:Tuberculosis of the Lower Cervical Spine
- CERVICAL SPINE INFECTIONS
- PECULIARITIES OF CERVICAL SPINE TUBERCULOSIS
- CLASSIFICATION
  - Cervical Spine Tuberculosis in Skeletally Immatured Patients
  - Cervical Spine Tuberculosis in Skeletally Matured Patients
- CLINICAL FEATURES
- MANAGEMENT
  - Bracing
- THE ROLE OF SURGERY
- SUMMARY
CHAPTER 17:Thoracic and Thoracolumbar Tuberculosis
- INTRODUCTION
- ANATOMICAL PECULIARITIES
- CLINICAL PRESENTATION
- DIAGNOSIS
- DIFFERENTIAL DIAGNOSIS
- TREATMENT
- COMPLICATIONS
  - Conservative Management
  - Operative Management
- SPECIAL SITUATIONS
- AUTHORS' RECOMMENDATIONS
CHAPTER 18:Lumbosacral Tuberculosis
- INTRODUCTION
- CLINICAL PRESENTATION
  - Symptoms and Signs
    - Local
- INVESTIGATIONS
- MANAGEMENT
  - Medical Management
  - Surgical Treatment
    - Indications
    - Surgical Options
- SPECIAL CONSIDERATIONS IN LUMBOSACRAL TUBERCULOSIS
- CONCLUSION
CHAPTER 19:C. Surgical Techniques: Tuberculosis of Spine: Biopsy Techniques
- INTRODUCTION
- TECHNIQUES
  - Open Biopsy
  - Percutaneous Biopsy
- APPROACH AND TECHNIQUE
- TYPES OF NEEDLES USED
- DIFFICULT AREAS
- COMPLICATIONS
- EXAMINATION OF SPECIMEN
- AUTHORS’ PREFERRED TECHNIQUE (FOR THORACIC AND LUMBAR SPINE)
- CONCLUSION
CHAPTER 20:Cold Abscess in Spinal Tuberculosis
- INTRODUCTION
- PATHOGENESIS
- CRANIOVERTEBRAL JUNCTION
  - Radiological Features
  - Management
- MIDCERVICAL SPINE (C3-C6)
- CERVICO-DORSAL JUNCTION AND UPPER DORSAL SPINE (C7-D4)
- THORACIC SPINE
- LUMBAR AND LUMBOSACRAL SPINE
  - Psoas Abscess
    - Drainage of Psoas Abscess
  - Coccygectomy for Drainage of a Pelvic Abscess
- PROGNOSTIC SIGNS IN PLAIN RADIOGRAPH1
- PRINCIPLES OF MANAGEMENT
- TYPES OF TREATMENT
CHAPTER 21:Minimally Invasive Spine Surgery in Spinal Infections
- INTRODUCTION
- HISTORY OF MINIMALLY INVASIVE SPINE SURGERY (MISS)
- ADVANTAGES OF MISS
- THORACIC-LUMBAR SPINE
- CERVICAL SPINE
  - Minimally Invasive Anterior Procedures
  - Use of Microendoscopic System for Laminectomy, Decompression and Stabilization
CHAPTER 22:Anterior Approaches in Spinal Tuberculosis
- EVOLUTION OF THE ANTERIOR APPROACH OF THE SPINE
- SUBAXIAL CERVICAL SPINE TB
  - Anterior Approach to the Subaxial Cervical Spine
- CERVICODORSAL TB
- THORACIC TB
  - Anterior (Transthoracic) Approach to the Thoracic Spine
    - Approach to Upper Thoracic Spine T1-T4
  - Thoracoscopic Approach to the Thoracic Spine
- THORACOLUMBAR JUNCTION
  - Anterior Approach to Thoracolumbar Junction
- LUMBAR SPINE
  - Anterior Retroperitoneal Approach to L2-L5
  - Anterior Transperitoneal Approach to Lumbosacral Junction, L5-S1
CHAPTER 23:Anterior Procedures in the Management of Tuberculosis of Thoracic, Thoracolumbar and Lumbar Spine
- INTRODUCTION
- EVOLUTION OF ANTERIOR SURGERIES IN TB SPINE
- INDICATIONS FOR SURGERY IN SPINAL TB
- ANTERIOR SURGICAL OPTIONS
- CONCLUSION
CHAPTER 24:Posterior Approaches for Management of Spinal Tuberculosis
- INTRODUCTION
- POSTERIOR APPROACHES TO THE THORACIC SPINE
- POSTERIOR APPROACH TO THE LUMBAR SPINE
  - Author's Preferred Treatment
  - Results
- POSTERIOR APPROACH TO THE CERVICAL SPINE
  - Complications of Posterior/Posterolateral Approaches to the Spine
- SUMMARY
CHAPTER 25:Surgeries in Healed Tuberculosis of Spine
- INTRODUCTION
- NATURAL HEALING IN SPINAL TUBERCULOSIS
- POSTERIOR APPROACHES
  - Vertebral Column Resection (VCR) Techniques
- CONCLUSION
SECTION THREE: PYOGENIC INFECTIONS OF SPINE
CHAPTER 26:Pyogenic Vertebral Osteomyelitis
- INTRODUCTION
- EPIDEMIOLOGY
- PATHOGENESIS
- BACTERIOLOGY
- CLINICAL PRESENTATION
- DIAGNOSIS
- MANAGEMENT
  - Nonoperative Management
  - Surgical Management
    - The Goals of Surgical Intervention
    - The Role of Spinal Implants
- FACET JOINT SEPTIC ARTHRITIS
- CONCLUSION
- ACKNOWLEDGMENT
CHAPTER 27:Spinal Epidural Abscess
- INTRODUCTION
- PATHOANATOMY
- INCIDENCE
- PATHOPHYSIOLOGY AND PATHOGENESIS
- CLINICAL FEATURES
- DIAGNOSIS4,5
- MANAGEMENT OF SEA
- OUTCOME
- TUBERCULAR SPINAL EPIDURAL ABSCESS
- EPIDURAL GRANULOMA
- CONCLUSION
SECTION FOUR: MISCELLANEOUS SPINAL INFECTIONS
CHAPTER 28:Fungal Infections
- PATHOANATOMY
- CLINICAL FEATURES
- RADIOLOGICAL FEATURES
- DIAGNOSTIC TESTS
- TREATMENT
- PREVENTION OF INVASIVE ASPERGILLOSIS IN THE IMMUNOCOMPROMISED PATIENT
- EPIDEMIOLOGY
- DIAGNOSTIC TESTS
- SURGICAL TREATMENT
- MEDICAL TREATMENT
CHAPTER 29:Unusual Bacterial Infections
- INTRODUCTION
- EPIDEMIOLOGY
- ETIOLOGY
- CLINICAL FEATURES
- IMAGING
- DIAGNOSTIC STUDIES
- TREATMENT
  - Surgical
  - Medical
- PREVENTATIVE MEASURES
- INTRODUCTION
- EPIDEMIOLOGY
- ETIOLOGY
- CLINICAL MANIFESTATIONS
- IMAGING STUDIES
- DIAGNOSTIC STUDIES
- TREATMENT
- PROGNOSIS
CHAPTER 30:Parasitic Infestations
- INTRODUCTION
- EPIDEMIOLOGY
- PARASITOLOGY
- PATHOLOGY
- CLINICAL FEATURES
- LABORATORY FINDINGS
- IMAGING FEATURES
- DIFFERENTIAL DIAGNOSIS
- NATURAL HISTORY
- TREATMENT
  - Surgical
  - Medical
- INTRODUCTION
- LIFE CYCLE
- PRESENTATION
- INVESTIGATIONS
- TREATMENT
- CONCLUSION
CHAPTER 31:Spinal Infections in the Immunocompromised Patients
- INTRODUCTION
  - Global Prevalence
- HIV AND HOST INTERACTIONS
- OPPORTUNISTIC SPINAL INFECTIONS
  - Tuberculosis Spondylitis
  - Other Coinfections
- ANTIRETROVIRAL THERAPY
- MALIGNANCY AND HIV/AIDS
  - Non-Hodgkin's Lymphoma (NHL)
  - Multiple Myeloma
- CONCLUSION
CHAPTER 32:Postoperative Spondylodiscitis
- INTRODUCTION
- INCIDENCE
- ETIOPATHOLOGY
  - Host Factors
  - Intraoperative/Surgical Factors
- THE SOURCE
- CLINICAL PRESENTATION AND DIAGNOSIS
  - Acute Stage
  - Chronic Stage
- INVESTIGATIONS
  - Laboratory Investigations
- RADIOLOGY
  - X-Rays and CT scan
  - Bone Scans
- MRI
  - Biopsy
- MANAGEMENT
- PREVENTION
  - Patient, Surgeon and Environment Factors
  - Prophylactic Antibiotics
- TREATMENT
  - Acute Stage
  - Duration of Antibiotics
- SURGERY
  - Indications for Surgical Intervention
  - Surgical Approach
- INSTRUMENTATION
  - Epidural Abscess
- PROGNOSIS
- SUMMARY
CHAPTER 33:Peri-implant Spinal Infections
- INTRODUCTION
- RISK FACTORS FOR WOUND INFECTION
- ANTERIOR VERSUS POSTERIOR INSTRUMENTATION
- CLINICAL PRESENTATION
- INVESTIGATIONS
  - Laboratory Investigation
  - Imaging
- MICROBIOLOGY OF INFECTION
  - Implant Removal or Retention
  - Role of Antibiotic Prophylaxis
- CONCLUSION
SECTION FIVE: SPINAL TRAUMA
CHAPTER 34:Epidemiology of Traumatic Spinal Cord Injuries
- INCIDENCE RATE
- PREVALENCE OF SCI
- SURVIVAL TIME
- AGE
- GENDER
- MARITAL STATUS
- EDUCATIONAL LEVEL
- PRIMARY OCCUPATIONAL STATUS AT THE TIME OF INJURY
- MODE OF INJURY
- NEUROLOGICAL LEVEL AND CATEGORY OF INJURY
- TIME and PLACE OF INJURY
- ASSOCIATED INJURIES
- SUMMARY
CHAPTER 35:Prehospital Care in Spinal Injury Patients
- INTRODUCTION
- PRINCIPLES OF PREHOSPITAL CARE
  - Goals of Prehospital Management
- PREHOSPITAL CARE SYSTEM
  - Who Should Deliver Prehospital Care?
- INITIAL EVALUATION
  - Important Considerations in Spinal Injury Patients
- PROTECTION OF SPINE
  - Manual In-line Stabilization
  - Spinal Immobilization
- CERVICAL COLLARS
- TRANSFER TO TERTIARY UNITS
- CONSIDERATION IN SPECIAL CIRCUMSTANCES
- PITFALLS OF SPINAL IMMOBILIZATION
- FUTURE TRENDS
- CONCLUSION
CHAPTER 36:Initial Evaluation of Patients with Spinal Injuries
- INTRODUCTION
- GENERAL EVALUATION
- LOCAL EXAMINATION
- NEUROLOGICAL EXAMINATION
  - Sensory Examination
    - Sensory Level
    - Sensory Index Scoring
  - Motor Examination
- CLASSIFICATION AND SCORING OF THE SPINAL INJURIES
CHAPTER 37:Radiology of Spinal Trauma
- INTRODUCTION
- PLAIN RADIOGRAPH
- CERVICAL SPINE RADIOGRAPH
- THORACOLUMBAR SPINE RADIOGRAPH
- PLAIN RADIOGRAPHS FOR SACRUM
- SPINAL CORD INJURIES WITHOUT RADIOGRAPHIC ABNORMALITIES (SCIWORA)
  - Multiple Spinal Fractures
  - Missed Injuries
- COMPUTED TOMOGRAPHY IN SPINAL TRAUMA
- MAGNETIC RESONANCE IMAGING IN SPINAL TRAUMA
  - Indications of MRI in Trauma
  - Magnetic Resonance Angiography for Spinal Trauma
- CONVENTIONAL ANGIOGRAPHY FOR SPINAL TRAUMA
- RADIONUCLIDE BONE IMAGING FOR SPINAL TRAUMA
CHAPTER 38:Surgical Decision Making in Spinal Cord Injuries
- SURGICAL OR CONSERVATIVE MANAGEMENT
- THE CONTEXT OF DEVELOPING COUNTRIES
- SCI—WHEN TO OPERATE
- CONCLUSIONS
  - Conservative or Surgical treatment
  - When to Operate
SECTION SIX: SPINAL CORD INJURY
CHAPTER 39:Pathophysiology of Spinal Cord Injury
- INTRODUCTION
- EPIDEMIOLOGY
- PATHOPHYSIOLOGY OF SPINAL CORD INJURY
- SUMMARY
CHAPTER 40:Current Status of Pharmacological Agents in Acute Spinal Cord Injury
- INTRODUCTION
- PATHOPHYSIOLOGY OF SCI
  - Primary Damage
  - Secondary Damage
    - Mechanism of Secondary Damage (Fig. 1)
- MECHANISM OF ACTION OF PHARMACOLOGICAL AGENTS
CHAPTER 41:Regenerative Strategies in Spinal Cord Injury
- INTRODUCTION
- PATHOPHYSIOLOGY OF THE SCI AND OBSTACLES TO REGENERATION IN THE INJURED SPINAL CORD
- APPROACHES TO TREATMENT
  - Molecular Therapies for Axonal Regeneration
  - Cell-based Regenerative Strategies
- CHALLENGES IN DEVELOPING CELLULAR THERAPIES TO TREAT SPINAL CORD INJURY
- WHAT ARE STEM CELLS?
- OLFACTORY ENSHEATHING CELLS (OECS)
- SCHWANN CELLS
- MACROPHAGES
- BONE MARROW STROMAL STEM CELLS
- NEURAL STEM CELLS AND GLIAL PROGENITORS
- EMBRYONIC STEM CELL-DERIVED NSCS, NPCS AND OPCS
- ADULT-DERIVED NSCS
- DELIVERY METHODS
  - Delivery of Cells by Injection
  - Delivery of Cells Using Implantable Scaffolds
- CONCLUSION
SECTION SEVEN: CERVICAL SPINE TRAUMA
CHAPTER 42:Upper Cervical Spine Injuries
- ANATOMICAL CONSIDERATIONS
- ATLANTO-OCCIPITAL INJURIES
  - Occipital Condyle Fractures
  - Atlanto-occipital Dislocations
- ATLAS FRACTURES
- ATLANTOAXIAL DISLOCATIONS
  - Transverse Ligament Rupture
  - C1-C2 Rotary Subluxation
- AXIS FRACTURES
  - Odontoid Fractures
  - Hangman Fractures
CHAPTER 43:Missed Spinal Injuries
- INTRODUCTION
- EPIDEMIOLOGY
- CONSEQUENCES OF MISSED SPINAL INJURIES
- ETIOLOGY OF MISSED INJURIES
- PREVENTION
  - Clearing the C-Spine
- THORACOLUMBAR TRAUMA
  - Clearing the Pediatric Spine
  - Post-traumatic Spinal Deformity
- SUMMARY
SECTION EIGHT: THORACOLUMBAR SPINE TRAUMA
CHAPTER 44:Biomechanics and Classification of Thoracolumbar Spinal Injuries
- INTRODUCTION
- THORACOLUMBAR SPINE
- CONCEPT OF INSTABILITY AND SURGICAL INDICATION
  - Definition of Instability
    - Stable versus Unstable Burst Fractures
    - McCormack and Gaines Load-sharing Classification
  - The Thoracolumbar Injury Severity Score (TLISS) and Thoracolumbar Injury Classification and Severity System (TLICS)
- SUMMARY
CHAPTER 45:Vertebral Compression Fractures
- INTRODUCTION
- ETIOLOGY
- EPIDEMIOLOGY
- CLASSIFICATION
- BIOMECHANICS
- CLINICAL FEATURES
- DIFFERENTIAL DIAGNOSIS
- INVESTIGATIONS
- TREATMENT
CHAPTER 46:Burst Fractures of the Thoracolumbar Spine
- INTRODUCTION
- DEFINITION
- EPIDEMIOLOGY
- CLASSIFICATION
- PATHOLOGICAL ANATOMY
  - Imaging
- MANAGEMENT
- MANAGEMENT ALGORITHM ACCORDING TO THE AO CLASSIFICATION
- CONCLUSION
CHAPTER 47:Flexion-distraction Injuries and Fracture Dislocations of the Thoracic and Lumbar Spine
- INCIDENCE
- ANATOMY AND BIOMECHANICAL CONSIDERATIONS
- ASSESSMENT
- MECHANISM OF INJURY: FLEXION-DISTRACTION INJURY OF THE THORACIC AND LUMBAR SPINE
- MECHANISM OF INJURY: FRACTURE DISLOCATIONS OF THE THORACIC AND LUMBAR SPINE
  - Imaging—Fracture Dislocations of the Thoracic and Lumbar Spine
- MANAGEMENT OF FLEXION-DISTRACTION INJURIES AND FRACTURE DISLOCATIONS OF THE THORACIC AND LUMBAR SPINE
  - Long versus Short Posterior Fusion Constructs
  - Minimally Invasive Surgery (MIS)
- CONCLUSION
- ACKNOWLEDGMENT
CHAPTER 48:Fractures of the Sacrum
- INTRODUCTION
- SACRAL ANATOMY
- ETIOLOGY AND INCIDENCE
- EVALUATION OF SACRAL FRACTURES
- CLASSIFICATION
- TREATMENT
- CONCLUSION
CHAPTER 49:Pediatric Spinal Injuries
- INTRODUCTION
- EPIDEMIOLOGY
- RELATED ANATOMY
- BIOMECHANICS
- SCIWORA
- CLINICAL PRESENTATION
- IMAGING STUDIES
  - X-rays
  - Role of CT Scans and MRI
- MANAGEMENT STRATEGIES
  - Conservative Treatment
  - Surgical Treatment
- LATE COMPLICATIONS of PEDIATRIC SPINAL INJURIES
  - Spinal Deformity
  - Syringomyelia
CHAPTER 50:Gunshot Injuries to the Spine
- INTRODUCTION
- BALLISTICS OF GUNSHOT INJURIES
- ASSESSMENT
- ROLE OF STEROIDS
- INVESTIGATIONS
- ANTIBIOTIC TREATMENT
- INDICATONS FOR SURGERY
- LEAD TOXICITY
- MIGRATING BULLETS
- CASE REVIEW
- RESULTS OF TREATMENT
- CONCLUSION
CHAPTER 51:Nonoperative Management of Spinal Injuries
- INTRODUCTION
- MEDICAL MANAGEMENT OF ACUTE SPINAL CORD INJURY
- CONSERVATIVE MANAGEMENT OF UPPER CERVICAL SPINE INJURIES
- CONSERVATIVE MANAGEMENT OF LOWER CERVICAL SPINE INJURIES
  - Indications for Conservative Management in Lower Cervical Spine Injury
- CONSERVATIVE MANAGEMENT OF THORACIC SPINE INJURIES
- CONSERVATIVE MANAGEMENT OF THORACOLUMBAR FRACTURES
  - Decision Making in Conservative Management
  - Controversies in the Conservative Management of Thoracolumbar Burst Injuries
- NONOPERATIVE MANAGEMENT OF THORACOLUMBAR FRACTURES WITH NORMAL NEUROLOGY
  - Lumbar and Lumbosacral Orthosis
CHAPTER 52:Iatrogenic Spinal Cord Injury—Incidence, Prevention and Management
- IATROGENIC SPINAL CORD INJURY
  - Abstract
- INTRODUCTION
- INCIDENCE OF IATROGENIC SPINAL CORD INJURY
- ETIOPATHOGENESIS OF ISCI
- MANAGEMENT OF IATROGENIC SPINAL CORD INJURY
- SUMMARY
CHAPTER 53:SCI Rehabilitation
- ACUTE PHASE REHABILITATION
- POST-ACUTE MANAGEMENT OF CONSERVATIVELY AND SURGICALLY MANAGED PATIENTS
- MOBILITY
  - Tetraplegia
  - Mobility in Paraplegia
    - Complete Paraplegia T2 to T9
    - Complete Paraplegia T10 to L2
- NEUROGENIC BLADDER MANAGEMENT AFTER SCI
- NEUROGENIC BOWEL
  - Goals for the Management of Neurogenic Bowel
  - Type of Bowel Dysfunction
- SEXUAL REHABILITATION
- FUNCTIONAL OUTCOMES IN SCI REHABILITATION
- ACKNOWLEDGMENTS
CHAPTER 54:Complications of Spinal Cord Injury
- INTRODUCTION
  - Early Complications
  - Late Complications
- RESPIRATORY COMPLICATIONS IN SPINAL CORD INJURY
- ARDS
- CARDIOVASCULAR COMPLICATIONS AFTER SCI
- DEEP VEIN THROMBOSIS IN SPINAL CORD INJURY
- GASTROINTESTINAL (GI) COMPLICATIONS IN SPINAL CORD INJURY PATIENTS
- HEMORRHOIDS
- PRESSURE ULCER (PrU)
- HETEROTOPIC OSSIFICATION (HO)
- SPASTICITY
- GENITOURINARY TRACT COMPLICATIONS
- OSTEOPOROSIS IN SPINAL CORD INJURED PATIENT
- POST-TRAUMATIC PAIN SYNDROMES
- SYRINGOMYELIA
- MORTALITY IN SPINAL CORD INJURY
  - Mortality in Acute Phase
SECTION NINE: SPECIAL SITUATIONS
CHAPTER 55:Management of Subaxial Cervical Spine Injuries
- INTRODUCTION
- EMERGENCY IN-HOSPITAL CARE
- DEFINITIVE TREATMENT
- INDICATIONS FOR SURGERY
- SELECTION OF SURGICAL APPROACH
- COMPLICATIONS
CHAPTER 56:Osteoporosis and Spinal Trauma
- INTRODUCTION
- INCIDENCE
- CLINICAL FEATURES
- CLASSIFICATION
- PATHOLOGY
- RISK FACTORS
  - Nonmodifiable Risk Factors
  - Modifiable Risk Factors
- DIAGNOSIS
- FRACTURES IN OSTEOPOROTIC SPINE
- MANAGEMENT
- PREVENTION AND MEDICAL MANAGEMENT
- MANAGEMENT OF VERTEBRAL COMPRESSION FRACTURES
- NONOPERATIVE MANAGEMENT
- SURGICAL MANAGEMENT
- MINIMALLY INVASIVE TECHNIQUES
- OPEN SURGICAL PROCEDURES
  - Osteoporotic Compression Fracture with Spinal Stenosis
  - Osteoporotic Compression Fracture with Kyphotic Deformity, Instability and Neurological Deficit
- METHODS OF FIXATION33
- CONCLUSION
CHAPTER 57:Special Considerations for Geriatric Spinal Injuries
- INTRODUCTION
- PREDISPOSING FACTOR
- ETIOLOGY
- LEVEL OF INJURY
- TYPE OF INJURY
  - Cervical Distractive Extension Injuries8
  - Odontoid Fractures
- SYMPTOMS
- DIAGNOSIS
- COMPLICATIONS
- MORTALITY
- OUTCOMES
- CONCLUSION
CHAPTER 58:Vertebroplasty for Osteoporotic Vertebral Fractures
- INTRODUCTION
- CONSEQUENCE OF VERTEBRAL COMPRESSION FRACTURES
- INDICATIONS FOR VERTEBROPLASTY
- CONTRAINDICATIONS
- TIMING OF VERTEBROPLASTY
- PREOPERATIVE EVALUATION
- MATERIALS USED FOR AUGMENTATION
- VERTEBROPLASTY—HOW DOES IT WORK?
- DEVICES FOR PERFORMING VERTEBROPLASTY
- SURGICAL TECHNIQUE
- POSTOPERATIVE MANAGEMENT
- COMPLICATIONS
  - Techniques to Reduce Cement Leak and Improve Results
- CURRENT OPINION ON VERTEBROPLASTY
- FUTURE OF VERTEBROPLASTY
CHAPTER 59:Kyphoplasty of Symptomatic Vertebral Body Compression Fractures
- INTRODUCTION
- SURGICAL MANAGEMENT
- INDICATIONS
- DIAGNOSIS AND IMAGING
- KYPHOPLASTY
CHAPTER 60:Spinal Injuries in Ankylosing Spinal Disorders
- INTRODUCTION
- CLINICAL PRESENTATION
- INVESTIGATIONS
- GENERAL PRINCIPLES
- SPINAL FRACTURES IN ANKYLOSING SPONDYLITIS
  - Cervical Spine Fractures
  - Thoracolumbar Spine Fractures
- DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS
  - Fractures in DISH
- COMPLICATIONS
- CONCLUSION

INDEX

TOC
Index

Chapter Notes