Editor-in-Chief
PS Ramani MD MSc DSc
Senior Consultant Neurosurgeon, Lilavati Hospital and Research Centre
Mumbai, Maharashtra, India
Retired Professor and Head, Department of Neuro Spinal Surgery, University of Mumbai
Founder and Honoray President, Neuro Spinal Surgeons’ Association of India
Founder and Past President, Neurotrauma Society of India
Past Chairman, World Federation of Neurosurgical Societies – Spine Committee
Founder Member, Asian Young Neurosurgeons’ Forum
Executive Committee Member, Asia-Pacific Non Fusion Society
Past International President, Lumbar Fusion Society
Past President, Bombay Neurosciences Association
Member, WFNS Neurotrauma Executive Committee
Founder and Past Editor-in-Chief, Journal of Spinal Surgery
Editor-in-Chief, Indian Edition of American Journal – Spine
Co-editors
Marcos Masini MD
School of Medicine FAMEPLAC - UNIPLAC Department of Neurosurgery do Hospital Lago Sul and Clinica Queops Millennium,
Brasilia, DF, Brazil
Jung Keun Suh MD
Professor Department of Neurosurgery Korea University Hospital,
Seoul, Korea
Abbas Amirjamshidi MD MPH
Professor Department of Neurosurgery Sina Hospital, Tehran University of Medical Sciences
Tehran, Iran
A Bambang Darwono MD
Division of Orthopedic and Spine Gading-Pluit Hospital Boulevard Timur Raya, Kelapa Gading
Jakarta Utara 14250, Indonesia
David TF Sun MD
Associate Consultant Department of Neuro and Spinal Surgery Prince of Wales Hospital Chinese University of Hong Kong Shatin, NT,
Hong Kong, China
Forewords
Abdul Hafid Bajamal
Abd-Elhafiz Shehab-Eldien
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WFNS Spine Committee Textbook on Thoracic Spine
First Edition: 2016
9789352500079
Printed at
5Dedicated to
All my students spread around the world who during the last 44 years thronged in large numbers for my cadaver workshops, hands on models practice, lecture courses, conferences and patients teaching rounds, inspiring me to do more and more and develop operative techniques, invent instruments, teach and write more and more books and textbooks.
7Contributors
- A Bambang Darwono MD
- Division of Orthopedic and Spine
- Gading-Pluit Hospital
- Boulevard Timur Raya, Kelapa Gading
- Jakarta Utara 14250, Indonesia
- A Younus BSc MBBS (Pb) FC Ortho (SA)
- Spine Unit
- Helen Joseph Hospital
- University of Witwatersrand
- Johannesburg, South Africa
- A Zamroni MD
- Spine Division
- Department of Neurosurgery
- Dr Soetomo Hospital, Airlangga University
- Surabaya, Indonesia
- Abbas Amirjamshidi MD MPH
- Professor
- Department of Neurosurgery
- Sina Hospital, Tehran University of Medical Sciences
- Tehran, Iran
- AH Bajamal MD
- Spine Division
- Department of Neurosurgery
- Dr Soetomo Hospital, Airlangga University
- Surabaya, Indonesia
- Alexander Trashin MD PhD
- Neurosurgical Department
- City Hospital
- Uchebnyj per, Saint-Petersburg, Russia
- Amir Azarhomayoun MD
- Department of Neurosurgery
- Sina Hospital, Tehran University of Medical Sciences
- Tehran, Iran
- Amit Amit DCH MS MRCS EANS FRCS (SN)
- Stereotactic/Functional and Spinal Neurosurgeon
- Locum Consultant
- Department of Neurosurgery
- Aberdeen Royal Infirmary
- Honorary Clinical Associate
- University of Aberdeen
- Aberdeen, Scotland, UK
- Amol Rege MD
- Consultant Spinal Surgeon
- Dinanath Mangeshkar Hospital
- Pune, Maharashtra, India
- Anil P Karapurkar MD
- Honorary Consultant
- Department of Neurosurgery and
- Endovascular Neurosurgery
- Breach Candy, Saifee, Fortis Hospitals
- Mumbai, Maharashtra, India
- Formerly, Professor
- Department of Neurosurgery
- KEM Hospital and Seth GS Medical College
- Mumbai, Maharashtra, India
- Arjun Dhar MD
- Department of Neurosurgery
- Lilavati Hospital and Research Centre
- Mumbai, Maharashtra, India
- Atul Goel MD
- Professor and Head
- Department of Neurosurgery
- KEM Hospital and Seth GS Medical College
- Mumbai, Maharashtra, India
- Senior Consultant
- Department of Neurosurgery
- Lilavati Hospital and Research Centre
- Tata Memorial Hospital
- Mumbai, Maharashtra, India
- Ben Roitberg MD
- Professor
- Neurosurgery Residency Program
- University of Chicago
- Chicage, USA
- Christian Chalita-Pérez-Tagle MD
- Department of Neurosurgery
- Instituto Mexicano de Neurociencias
- Hospital Ángeles Lomas
- Av. Vialidad de la Barranca S/N
- Col. Valle de las Palmas, Consultorio 750
- 52763 Huixquilucan, Estado de México
- México
- Chun-Kun Park MD PhD
- Emeritus Professor
- Department of Neurosurgery
- The Catholic University of Korea College of Medicine
- Honorary President
- Teun Teun Spine and Joint Hospital
- Seoul, Korea
- Cumhur Kilincer MD PhD
- Trakya University Faculty of Medicine
- Department of Neurosurgery
- Edirne, Turkey
- David TF Sun MD
- Associate Consultant
- Department of Neuro and Spinal Surgery
- Prince of Wales Hospital
- Chinese University of Hong Kong
- Shatin, NT, Hong Kong, China
- Devanand Dominique MD
- Pennsylvania Neurosurgery and Neuroscience Institute
- Harrisburg, Pennsylvania, USA
- Dmitry Pechiborsch MD
- Neurosurgical Department
- City Hospital
- Uchebnyj per, Saint-Petersburg, Russia
- Eko A Subagio MD
- Spine Division
- Department of Neurosurgery
- Dr Soetomo Hospital, Airlangga University
- Surabaya, Indonesia
- Enrique Klériga-Grossgerge MD FACS FAANS
- Department of Neurosurgery
- Instituto Mexicano de Neurociencias
- Hospital Ángeles Lomas
- Av. Vialidad de la Barranca S/N
- Col. Valle de las Palmas, Consultorio 750
- 52763 Huixquilucan, Estado de México
- México
- Erickson F Torio MD
- Section of Neurosurgery
- St. Luke's Medical Centre
- Manila, Philippines
- Evren Yuvruk MD
- Department of Neurosurgery
- Umraniye Teaching and Research Hospital
- Istanbul, Turkey
- Gerardo Zambito-Brondo MD
- Department of Neurosurgery
- Instituto Mexicano de Neurociencias
- Hospital Ángeles Lomas
- Av. Vialidad de la Barranca S/N
- Col. Valle de las Palmas, Consultorio 750
- 52763 Huixquilucan, Estado de México
- México
- Giulio Anichini MD
- Department of Neurosurgery
- Aberdeen Royal Infirmary
- Aberdeen, Scotland, UK
- Gleb Grigoriev MD
- Neurosurgical Department
- City Hospital
- Uchebnyj per, Saint-Petersburg, Russia
- Guruprasadh Chandrashekhar MD
- Interventional Neuroradiologist
- Lilavati Hospital and Research Centre
- Mumbai, Maharashtra, India
- Hiroshi Nakagawa MD
- Spine Center
- Kushiro Kojinkai Memorial Hospital
- Kushiro, Hokkaido, Japan
- Ho-Yeon Lee MD
- Wuridul Hospital
- Seoul, South Korea
- Hrushikesh Mehata MS (Orth) DNB Orth ASSI Fellow
- Department of Orthopedics
- Lilavati Hospital and Research Centre
- Mumbai, Maharashtra, India
- Ibet Marie Y Sih MD FAFN
- Section of Neurosurgery
- St. Luke's Medical Centre
- Manila, Philippines
- Irfan Malik FRCS (SN)
- Department of Neurosurgery
- King's College Hospital NHS Foundation Trust
- London, UK
- Jae Taek Hong MD PhD
- Professor
- Department of Neurosurgery
- St. Vincent Hospital
- The Catholic University of Korea
- College of Medicine, Korea
- James Harrop MD
- Professor
- Department of Neurological Surgery and
- Orthopedic Surgery
- Division Director
- Spine and Peripheral Nerve Surgery
- Thomas Jefferson University Hospital
- Philadelphia, USA
- Jesús Bustamante-Vidales MD
- Department of Neurosurgery
- Instituto Mexicano de Neurociencias
- Hospital Ángeles Lomas
- Av. Vialidad de la Barranca S/N
- Col. Valle de las Palmas, Consultorio 750
- 52763 Huixquilucan, Estado de México
- México
- Jin-Sung Kim MD
- Department of Neurosurgery
- The Catholic University of Korea College of Medicine
- Honorary President
- Teun Teun Spine and Joint Hospital
- Seoul, Korea
- João Flávio G Madureira MD
- School of Medicine da FAMEPL – UNIPLAC
- Department of Neurosurgery do Hospital Lago Sul and Clínica Quéops Millennium
- Brasilia, DF, Brazil
- Jonathan Hobbs MD
- Professor
- Department of Neurosurgery
- University of Chicago
- Chicago, USA
- Jong-Mog Shin MD
- Department of Neurosurgery
- Wooridul Spine Hospital
- Seoul, Korea
- Jorge Mendoza MD
- Michigan Head and Spine Institute
- Suite, USA
- Juan Manuel L Mariano MD
- Section of Neurosurgery
- St. Luke's Medical Centre
- Manila, Philippines
- June Ho Lee MD PhD
- Department of Neurosurgery
- Wooridul Spine Hospital
- Seoul, Korea
- Jung Keun Suh MD
- Professor
- Department of Neurosurgery
- Korea University Hospital
- Seoul, Korea
- Junichi Mizuno MD
- Department of Spine and Peripheral Nerve Surgery
- Shin-Yurigaoka General Hospital
- Kawasaki, Kanagawa, Japan
- Kanikdaley V MD
- Spine Surgery Services
- Sacheti Hospital
- Pune, Maharashtra, India
- Keith Buchan MD
- Department of Cardiothoracic Surgery
- Aberdeen Royal Infirmary
- Aberdeen, Scotland, UK
- Khurjekar D MD
- Spine Surgery Services
- Sacheti Hospital
- Pune, Maharashtra, India
- Khurjekar K MD
- Chief, Spine Surgery Services
- Sacheti Hospital
- Pune, Maharashtra, India
- Kourosh Karimi Yarandi MD
- Department of Neurosurgery
- Sina Hospital, Tehran University of Medical Sciences
- Tehran, Iran
- Kyeong-Sik Ryu MD PhD
- Associate Professor
- Department of Neurosurgery
- Seoul St. Mary's Hospital
- The Catholic University of Korea College of Medicine
- Seoul, Korea
- Luigi Andrew F Sabal MD DPBO
- Orthopedic Spine Fellow
- Wooridul Spine Hospital
- Seoul, Korea
- M Faris MD
- Spine Division
- Department of Neurosurgery
- Dr Soetomo Hospital, Airlangga University
- Surabaya, Indonesia
- Marcos Masini MD
- School of Medicine FAMEPLAC – UNIPLAC
- Department of Neurosurgery do Hospital Lago Sul and Clinica Queops Millennium
- Brasilia, DF, Brazil
- Mario Zanaty MD
- Department of Neurological Surgery
- Chief, Division of Neurovascular Surgery and
- Endovascular Neurosurgery
- Thomas Jefferson University Hospital
- Philadelphia, USA
- Mazda Turel MCh
- Department of Neurological Sciences
- Christian Medical College
- Vellore, Tamil Nadu, India
- Maziad AM MD
- Spine Surgery Fellow
- Department of Orthopedic Surgery
- William Beaumont Hospital
- Oakland University
- Machigan, USA
- Mehmet Resid Onen MD
- Department of Neurosurgery
- Umraniye Training and Research Hospital
- Istanbul, Turkey
- Mehmet Simsek MD
- Department of Neurosurgery
- Umraniye Training and Research Hospital
- Istanbul, Turkey
- Mehmet Zileli MD
- Professor
- Department of Neurosurgery
- Faculty of Medicine
- Ege University
- Bornova, Izmir, Turkey
- Mick Perez-Cruet MD MS
- Neurosurgeon
- Machigan Head and Spine Institute
- Chief, Minimal Invasive Spine Surgery
- Beaumont Hospitals
- Vice-Chairman, Director and Professor
- Minimal Invasive Spine Surgery and Spine Program
- Oakland University William Beaumont School of Medicine
- Machigan, USA
- Mohamed Maziad MD PhD FRCS
- Department of Orthopedics
- Medical College, Ain Shams University
- Cairo, Egypt
- Muhammad Sohail Umerani MB MCPS FCPS (Neurosurgery)
- Registrar Neurosurgeon
- Department of Neurosciences
- King Fahad Military Medical Complex
- Dhahran, Kingdom of Saudi Arabia
- Natarajan Muthukumar MD
- Professor and Head
- Department of Neurosurgery
- Madurai Medical College
- Madurai, Tamil Nadu, India
- Nishant Aditya MD
- Honorary Consultant
- Interventional Neuroradiologist
- Saifee Hospital and Fortis Hospitals
- Mumbai, Maharashtra, India
- Nitin Dange MD
- Department of Neurosurgery
- KEM Hospital and Seth GS Medical College
- Consultant
- Lilavati Hospital and Research Centre
- Mumbai, Maharashtra, India
- Pascal Jabbour MD
- Associate Professor
- Department of Neurological Surgery
- Chief, Division of Neurovascular Surgery and
- Endovascular Neurosurgery
- Thomas Jefferson University Hospital
- Philadelphia, USA
- Paul D Ackerman MD
- Department of Neurosurgery
- Loyola University Medical Center
- Illinois, USA
- PD Kulkarni FRCS (SN)
- Department of Neurosurgery
- King's College Hospital NHS Foundation Trust
- London, UK
- Pragnesh Bhatt MD
- MS MCh FRCS FRCS (SN) EANS (Dip) PCME FHEA
- Head
- Department of Neurosurgery
- Aberdeen Royal Infirmary
- Honorary Clinical Senior Lecturer
- University of Aberdeen
- Aberdeen, Scotland, UK
- PS Ramani MD MSc DSC
- Senior Consultant Neurosurgeon
- Lilavati Hospital and Research Center
- Mumbai, Maharashtra, India
- Retired Professor and Head
- Department of Neuro Spinal Surgery, University of Mumbai
- Chairman, WFNS Spine Committee
- President, Neuro Spinal Surgeons Foundation
- Rajan Shah MD
- Consultant Neurosurgeon
- Kokilaben Hospital
- Mumbai, Maharashtra, India
- Ram Chaddha MS (Orth)
- Professor
- Department of Orthopedics
- KJ Somaiya Medical College and Hospital
- Mumbai, Maharashtra, India
- Ravindran Vashu BMedSc MD FRCS (SN)
- Senior Registrar
- Department of Neurosurgery
- Aberdeen Royal Infirmary
- Aberdeen, Scotland, UK
- Rogerio Safatle Barros MD
- Department of Neurosurgery do Hospital Lago Sul and Clinica Queops Millennium
- Brasilia, DF, Brazil
- Russ P Nockels MD
- Professor
- Department of Neurosurgery
- Loyola University Medical Center
- Illinois, USA
- Sait Naderi MD
- Department of Neurosurgery
- Umraniye Training and Research Hospital
- Istanbul, Turkey
- Salman Sharif FRCS (Eng) FRCS (SN)
- Head, Neurosurgical Unit
- Liaquat National Hospital and Medical College
- Karachi, Pakistan
- Sang-Ho Lee MD PhD
- Department of Neurosurgery
- Wooridul Spine Hospital
- Seoul, Korea
- Sang Hoon Jang MD
- Department of Neurosurgery
- Wooridul Spine Hospital
- Seoul, Korea
- Se-Hoon Kim MD PhD
- Professor
- Director of Spinal Neurosurgery
- Department of Neurosurgery
- Ansan Hospital, Korea University Medical Center
- 123 Jeokgeum-ro, Danwon-gu
- Ansan, Gyeonggi-do 425-707, Korea
- Shekhar Bhojraj MD
- Senior Consultant Spinal Surgeon
- Lilavati Hospital and Research Centre
- Mumbai, Maharashtra, India
- Silen Noel Reyes Hidalgo MD
- Department of Neurosurgery
- Central Hospital of Maracay, School of Medicine
- University of Carabobo – Aragua
- Clinica Las Delicias, Aragua, Venezuela
- Sumeet Pawar MD
- Department of Neurosurgery
- Lilavati Hospital and Research Centre
- Mumbai, Maharashtra, India
- Sushil V Patkar MD
- Neurosurgeon
- Poona Hospital, Pune
- Professor
- Department of Neurosurgery
- Bharatiya Vidyapeeth Medical College and Hospital
- Pune, Maharashtra, India
- Swapnil M Keny MS (Orth) FCPS D'Ortho
- Associate Professor
- Department of Orthopedics
- Grant Medical College
- Sir JJ Group of Hospitals
- Mumbai, Maharashtra, India
- Uday S Limaye MD
- Interventional Neuroradiologist
- Lilavati Hospital and Research Centre
- Mumbai, Maharashtra, India
- Vedantam Rajshekhar MCh
- Department of Neurological Sciences
- Christian Medical College
- Vellore, Tamil Nadu, India
- Vernon Velho MD
- Professor
- Department of Neurosurgery
- Sir JJ Group of Hospitals
- Mumbai, Maharashtra, India
- WK Mak MD
- Department of Neuro and Spinal Surgery
- Prince of Wales Hospital
- Chinese University of Hong Kong
- Shatin, NT, Hong Kong, China
- Yasunobu Itoh MD
- Spine Section
- Department of Neurosurgery
- Southern TOHOKU Research Institute for Neuroscience
- Koriyama, Fukushima, Japan
- Yoshitaka Hirano MD
- Spine Section
- Department of Neurosurgery
- Southern TOHOKU Research Institute for Neuroscience
- Koriyama, Fukushima, Japan
- Yury Shulev MD PhD
- Professor
- Neurosurgical Department
- City Hospital
- North-West State Medical University
- Uchebnyj per, Saint-Petersburg, Russia
It is a great pleasure for me to write this foreword. This is the third textbook that Prof Ramani is bringing out for WFNS Spine Committee during his tenure as President of a very active Spine Committee in the WFNS.
With advance in medicine, Neuro Spinal surgery has progressed very rapidly to a point where it is recognized as one of the most popular branches in Neurosurgery all over the world. The rapid progress has created a void and we see lack of enough neuro and spinal surgeons to cope with the demand of growing clinical material.
Fast pace and competitive spirit in day-to-day work has helped to increase alarmingly the degenerative process in the spine and we see a lot of ailments related to degenerative disorders in the spine. The new batch of Neuro Spinal surgeons are eager to learn through textbooks, e-learning, cadaver workshops, live operative workshops and lectures. This is one book on thoracic spine where postgraduate students, junior consultants and even senior practicing neurosurgeons can look upon to gain in-depth knowledge on several conditions associated with the thoracic spine.
This textbook provides a complete review of surgical management in thoracic spine and begins with a discussion of the anatomy of the thoracic spine. The description of the various surgical techniques is lucidly elaborated with several examples of patients. To me, this book exemplifies the ability of the author, Professor PS Ramani in compiling a textbook. By now, he has published several textbooks and his Textbook on Spinal Surgery in 2 volumes has become so popular that it is running into several editions.
It is my conviction that this textbook will be useful as a guide to all surgeons involved in the specialty and others who wish to learn more in Neuro spinal surgery. Professor PS Ramani is not only known for his Textbooks but indeed he is a real “Guru”, who never seems to be tired to propagate the knowledge of spine surgery by regularly traveling to various countries in greatest need and he actively organizes various symposiums and workshops both operative and cadaveric. Professor PS Ramani has proven himself as a figure who should be a role model for the generations of spinal surgeons in the future
Abdul Hafid Bajamal MD PhD
Professor of Neurosurgery
Department of Neurosurgery
Medical Faculty of Airlangga University
Dr Sutomo General Hospital
President Elect of Indonesian Neurosurgery Society
Member—WFNS Spine Committee
President of 11th ACNS
15Foreword
Advances in the field of the spinal surgery are rapidly evolving in the last decades that include the basic sciences, the available tools, the techniques, in addition to accumulated surgical skills and experience. Continuous and meticulous updates of the scientific sources are mandatory to maintain the standard of practice at the level of knowledge. Professor Ramani has a huge experience in the field. He tried in this textbook to provide the readers with an adequate cover for the basic relevant knowledge that included the history, applied anatomy, biomechanics, stability and instability issues, relevant basic investigations and current surgical standards. The care of the patient is greatly influenced by the experience of his physician. The experience of spine surgeon should never depend of a single tutor. By reading this text, the experience of all contributors is introduced to you in a practical point of view enriching you knowledge and improving the level of care of your patients. Essential topics are well covered too, that include congenital anomalies, trauma, tumors, infections, and degenerative spinal diseases. Re-stabilization issues that include both of fusion and instrumentation aspects, in addition to minimally invasive approaches have been focused on too.
Each section provides the reader with well-balanced discussions on the disease pathology, clinical features, and treatment modalities. Special attention is given for complications that represent a major impact even for the experienced spinal surgeons.
The author is very precise, thoughtful, broad-minded with a good vision. He has a wide research, clinical, surgical and teaching experience in the field. He expressed his preferred methods of performing specific operations that reflects fine points of a proven value. This has been added to the current state-of-the art advances in spine surgery into one beautifully integrated comprehensive text. The book is designed to serve as a guide for spine surgeons who strive to enhance their clinical skills and ability to provide excellent care to patients suffering from spinal diseases. The editor performs this work with the aims of making it as a valued and useful source for the practicing spinal surgeons and young spinal surgeons as an important reference book. I believe that this textbook will provide sufficient knowledge that allows each to approach the various spinal problems through the right corridor.
It is my source of happiness to get the opportunity to write the foreword of this valuable textbook. I congratulate the authors for providing it for the readers who are searching for comprehensive reference source, new information, and original concepts with adequate insight. It is perfectly fit to the needs of the personal libraries of spinal surgeons, spine sections and to institutional libraries.
Abd-Elhafiz Shehab-Eldien
Professor of Neurosurgery
Chief of Neurosurgery Center
Elsahil Teaching Hospital, Cairo, Egypt
17Preface
While writing this preface, my heart is filled with pride, accomplishment, content and sense of achievement for the faith WFNS (World Federation of Neurosurgical Societies) has in me and for the pleasure of love and confidence that innumerable luminaries round the world who cooperated with me to compile this textbook without any hassle.
It gave me an in-depth understanding of my friendship with these brilliant personalities from most corners of the world. These feelings are shared unanimously by all my colleagues who are co-editors of this textbook.
Having successfully published two textbooks earlier, one on cervical spine and one on lumbar spine, this is the third textbook in the series that is being published for WFNS by its Spine Committee with me as Editor-in-Chief.
The understanding and development of spinal biomechanics and surgery started with lumbar spine. It took several decades before the interest was focused on the cervical spine and the surgical techniques on thoracic spine were last to be developed but with the advent of MISS (Minimally Invasive Spine Surgery) and mesmerizing advance in technology the surgical techniques on thoracic spine were developed and are being practiced in leaps and bounds. Today thoracic spine forms an important contribution to the day-to-day surgical procedures of any senior spinal surgeon all over the world. It was thus felt necessary to bring out such a book encompassing all the knowledge that is available together so that it can give a comprehensive knowledge to the readers.
To approach the anterior surface of thoracic spine had remained a big challenge as it involved opening the chest and working behind the heart and its great vessels pulsating all the time and distracting the attention. Today with advance in technology the approach to the anterior surface of thoracic spine has become as easy and within the reach of younger spinal surgeons as doing a microdiscectomy in the lumbar spine.
Being a new branch the cumulative experience may not be rich but the developments have been so vast that it has attracted the attention of spinal surgeons very quickly and procedures like, endoscopic thoracic discectomy, robot-assisted thoracic discectomy, endo micro approach to the anterior thoracic spine using VITOM and 360 degrees excision and reconstruction of the spine in the thoracic region has become a reality.
Developments in thoracic spinal stabilization has helped immensely to achieve progress in deformity reconstruction surgery which has not become an established discipline in thoracic spinal surgery.
Me and my colleagues feel immensely satisfied with the outcome as the contributions have been as per our plan and outline of the book. We feel confident that it will be well received by the readers and particularly the younger generation of spinal surgeons all over the world.
19Acknowledgments
It has been a great pleasure for me to prepare this vast textbook on thoracic spine much with the prompt cooperation of leaders in the field spread round the world. I gratefully acknowledge the willing cooperation from all the contributors who have taken pains to send the chapter before the dead line that I had set. Their great enthusiasm has heightened my spirits resulting in my convincing the publisher to prepare the book for publication in our NSSA Annual Conference – Spine 2015 in Goa, India in September 2015.
I sincerely thank my friends and co-editors of the textbook for willing agreeing to be a part of this illustrious book.
The cooperation of my assistant colleague Dr Sumeet Pawar has been astounding and without whose help it would have been impossible for me to compile this book. I am indeed indebted to him.
My computer secretaries Priya and Swati were prompt and up to the mark with their work and coordination. My other staff, Dr Sudhendoo, Dr Arjun, Dr Apurva Prasad, Santosh and Ajit never let me down even in stressful circumstances. I thank them from the bottom of my heart.
The cooperation of Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Mr Tarun Duneja (Director–Publishing), Ms Sunita Katla (Publishing Manager), and Mr KK Raman (Production Manager) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, is well appreciated. I take this opportunity to sincerely thank Ms Samina Khan (Executive Assistant to Director–Publishing) from the organization who corresponded with me all the time. She was prompt and courteous. I am also thankful to Mr Rajesh Sharma (Production Coordinator), Ms Seema Dogra (Cover Designer), Mr Laxmidhar Padhiary (Proofreader) and Mr Kapil Dev Sharma (DTP Operator) for their dedicated work.20