About this book
- Describes and evaluates the various surgical modalities for low back pain, including recent ones
- Explains the reasons for success and failure of surgery
- Assesses conservative options to help the reader weigh the need for surgery
- Includes chapters on the scientific background of low back pain and on diagnostic modalities
Low back pain is a very common problem. Various treatments are available, but surgery has acquired increasing importance. In the United States, low back pain is now the principal reason for spinal surgery, and the number of procedures performed for this reason is similar to the number of total hip replacements. Consequently there is a need for careful evaluation of the possible surgical approaches to low back pain, with detailed appraisal of the factors leading to their success or failure. This book aims to meet such a need. It explains the scientific basis for surgery and considers the different diagnostic techniques that may be employed, thereby providing a better understanding of the surgical rationale, indications, and contraindications. The value of conservative options is also assessed to help the reader weigh the need for surgery. The various surgical modalities, including the most recent, are then fully described and evaluated with the aid of numerous illustrations. The book concludes with a chapter devoted to evidence-based analysis of the outcome of surgery in patients with low back pain. This book will be invaluable to orthopaedic and neurosurgeons, rheumatologists, neurologists, and all who are concerned with the effective treatment of this often debilitating condition.
Written for » Professional/practitioner
Keywords » Degenerative spine - Fusion - Surgery - Total disc replacement
Related subjects » Neurology - Orthopedics - Rheumatology - Surgery
Table of contents
Basics: Biology of intervertebral disc degeneration.- Low back pain: where does the pain come from?- Role of Cytokynes in the degenerative spine.- Psychosocial aspects of LBP.- Instability and LBP. Diagnosis: Dynamic MRI of the spine.- Assessment of end plate and diffusion in degenerative disc disease.- The role of physician extender in a low back pain practice. Conservative Treatment: Natural evolution of non specific LBP.- Prescribing Conservative treatment for LBP.- Comprehensive rehab for LBP and back schools.- The place of chiropractic care in the treatment of low back pain.- The place of IDET.- Lumbar orthosis to prevent and treat low back pain. Surgical Treatment (Fusion): Indications for lumbar spinal fusion.- Evidence for efficacy of pedicle based systems.- Low back pain is not an indication for stabilization in patients operated for lumbar spinal stenosis.- Hybrid Construct for DDD in the Lumbar Spine: The compromise between fusion and non fusion.- The Management of Spondylolysis and Spondylolisthesis.- TPDC fixation for spondylolisthesis.- Facet problems: a surgical indication?- Adjacent Level Disease: "Myth" or "Fact".- Pelvic girdle pain: Indication for surgery?- Blood loss management in major spine surgery. Surgical Treatment (Other Technologies): How Disc Replacement Fits in the Treatment Algorithm for Degenerative Disc Disease: Refining Indications for Disc Replacement.- Clinical factors that may affect outcome in lumbar total disc replacement. What is the evidence?- A Prospective Randomized Comparison of Two Lumbar Total Disc Replacements.- Limitations of total disc arthroplasty.- Is posterior dynamic stabilization an option to avoid adjacent segment decompression.- Immediate biomechanical effect of lumbar posterior dynamic stabilization.- Overview of Pedicle Screw Based Posterior Dynamic Stabilization Systems.- Semirigid Fixation System for the Lumbar Spine.- Non rigid stabilization of the spine – problems observed: screw loosening, breakage, implant failure, adajacent segment degeneration.- Interspinous devices.- NuBac Disc Arthroplasty System, rationale and clinical results.- Outcomes: Outcome assessment.- Review of the medical evidence regarding the surgical treatment of low back pain.