Adult Degenerative Scoliosis–Coronal and Sagittal Deformities: Treatment and Management Alexander R Vaccaro, James S Harrop, Ahmed J Awad
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1Adult Degenerative Scoliosis Coronal and Sagittal Deformities: Treatment and Management2
3Adult Degenerative Scoliosis Coronal and Sagittal Deformities: Treatment and Management
Editors James S Harrop MD Professor of Neurological and Orthopedic Surgery Director, Division of Spine and Peripheral Nerve Disorders Director, Delaware Valley Spinal Cord Injury Center Sidney Kimmel Medical College Thomas Jefferson University Philadelphia, Pennsylvania, USA Alexander R Vaccaro MD PhD Richard H Rothman Professor and Chairman Professor of Orthopedic and Neurological Surgery Co-Director Delaware Valley Spinal Cord Injury Center Co-Chief of Spine Surgery Sidney Kimmel Medical College Thomas Jefferson University President, Rothman Institute Philadelphia, Pennsylvania, USA Associate Editor Ahmed J Awad MD Postdoctoral Fellow, Neurosurgery Faculty of Medicine and Health Sciences An-Najah National University Nablus, Palestine Foreword Edward C Benzel MD
4
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Adult Degenerative Scoliosis—Coronal and Sagittal Deformities: Treatment and Management
First Edition: 2015
9789351524960
Printed at
5Dedication
This text is dedicated to my family. Elyse, Matthew and Casey thanks for putting up with me all these years. This was possible only due to you efforts and understanding.
James S Harrop MD
I want to dedicate this book to the wonderful and supportive staff at the Rothman Institute who have been instrumental in assisting the physician staff in developing into Clinician Researchers. The ability and commitment to study ones practice, report it, and change for the better is the greatest gift we can give to our patients.
Alexander R Vaccaro MD PhD6
7Contributors 11Foreword
Adult Degenerative Scoliosis—Coronal and Sagittal Deformities: Treatment and Management is a work of monumental proportions. The field of deformity surgery is evolving and expanding rapidly. The knowledge base is equally rapidly expanding. Hence, a book that incorporates the newest of information regarding the fundamentals and technique in an incredibly organized manner, provided by the absolute top echelon of biomechanics and clinical experts in the field, is indeed monumental.
This book provides all one needs to know, and then some, regarding adult degenerative scoliosis—from the basics to the very complex. The book begins with discussions on anatomy, pathoetiology, imaging, sagittal balance, scoliosis, natural history, and biomechanics—followed by discussions on the wide variety of nuances associated with the decision making process. The book then concludes with meticulously prepared eloquent dissertations that cover all the options pertaining to surgical management.
Overall, this book is loaded with information—I mean loaded. It is well illustrated. It is as up to date as humanly possible. It is both a reference and a comprehensive primer. The editors and the authors are, as stated, at the very top of the field. If this book is not on the shelf of all providers and researchers dealing with adult degenerative scoliosis, something is wrong—very wrong.
I close by emphasizing the true value of this book. It is an honestly presented, comprehensive, and complete text. This book is elegant in its presentation. It, in addition, presents many complex concepts and techniques in a way that simplifies, so that the complex becomes easily understandable. For such, the editors and authors are to be heartily congratulated. It is simply a ‘must have’.
Edward C Benzel MD
Chairman
Department of Neurosurgery
Neurological Institute
Cleveland Clinic
Cleveland, Ohio, USA12
13Preface
There are a numerous resources in the diagnosis, evaluation and treatment of spinal deformities. Most are directed to a specific audience such as neurologic or orthopedic surgeons. This text was developed through a combined effort from the onset of orthopedic and neurologic surgeons. The text was developed to aid the general spine surgeon in understanding and approaching difficult coronal and sagittal spinal deformities secondary to degeneration. Experts in various fields based on their clinical experience and academic proficiency were specifically asked to contribute to this book.
This book will guide readers on the choice of operative therapy for various degenerative spinal conditions. Although there are numerous spinal texts, this book is one of only a few dedicated to improving the quality of life of patients with degenerative scoliosis.
The book consists of three main sections. First, an overview of lumbar degenerative scoliosis anatomy and pathoetiology, imaging and radiographic techniques, the importance of spinal balance, conservative management, and the differences between de novo lumbar degenerative scoliosis and adult idiopathic scoliosis. The second portion gives an overview of the indications for treatment and surgical planning. The third and final section discusses the available surgical techniques with commentary on the experience of experts in the field. These last two sections are presented in a unique format and include: case presentation with images and figures, surgical principles, boxed areas with key concepts, and a conclusion that summarizes potential complications and tips to optimize management. This book serves as a key reference to any spine surgeon who manages thoracolumbar spinal deformities.
James S Harrop MD
Alexander R Vaccaro MD PhD
Ahmed J Awad MD 14
Acknowledgments15
We would like to acknowledge the authors of the chapters of this book. We also acknowledge M/s Jaypee Brothers Medical Publishers (P) Ltd. New Delhi, India, especially, Ms. Sheetal Arora.16