In this book, leading international specialists in the field join forces to discuss topics, issues and approaches that are of key importance in the optimal treatment of lumbar degenerative disk disease. The coverage is wide ranging, from current understanding of physiopathology and genetics and modern imaging techniques through to the diverse minimally invasive, non-fusion, and fusion surgical techniques. Detailed attention is drawn to the most important aspects to be considered when approaching the patient and making treatment decisions. The role of conservative management is appraised, and surgical techniques and their indications are carefully described. In the concluding section, some of the top specialists from across the world reflect on the lessons that they have learned during lifetimes in spinal surgery. Advanced Concepts in Lumbar Degenerative Disk Disease will be an instructive and fascinating source of information for all spine surgeons and other spine care providers.
- Written by leading experts in the field of lumbar spine treatment, who also reflect on the lessons learned during lifetimes in spinal surgery
- Descriptions of minimally invasive, non-fusion and fusion surgical techniques and their indications
- Coverage of a wide range of further topics, including conservative management, psychosocial issues and legal aspects
Part I: Essentials in Lumbar Degenerative Disk Disease.- We've Been Standing up for 10 Million Years.- A Historical Overview of Sciatica.- Lumbar Intervertebral Disk Injury, Herniation, and Degeneration.- Advances in Lumbar Degenerative Disk Disease Pathophysiology Comprehension.- Epidemiology of Lumbar Degenerative Disk Disease.- Genetics of Lumbar Disk Degeneration.- Part II: Imaging.- Imaging of Degenerative Disk Disease.- Discography.- Modic Changes and Symptomatic Lumbar Degenerative Disk Disease. Is There Any Correlation?- Degenerative Marrow Changes: Natural History Biomechanics in Relation to Symptoms.- Part III: General Important Aspects When Treating Symptomatic Lumbar Degenerative Disk Disease.- Psychosocial Aspects and Work-related Issues Regarding Lumbar Degenerative Disk Disease.- Legal Aspects in the Surgical Treatment of Lumbar Degenerative Disk Disease.- Cost-Effective Spinal Surgery: Reality or Oxymoron?- Outcome Measures for Spinal Surgery.- Lumbar Degenerative Disk Disease: Workup and Conservative Treatment.- Facet Joint Pain: Presentation and Treatment. Is It a Myth?- Part IV: Lumbar Disk Herniations.- Advanced Scientific Considerations for Surgery in Patients with Lumbar Disk Herniation.- Surgery for Lumbar Disk Herniations.- Lumbar Disk Revision Surgery.- Part V: Surgical Treatment of Lumbar Degenerative Disk Disease: Doubts, Decisions, and Techniques.- The Decision to Operate: Advanced Concepts.- To Fuse or Not to Fuse: That’s the Question.- Biomechanics of the Lumbar Degenerative Intervertebral Disk.- Adjacent Segment Disease: Natural History of Lumbar Degeneration or Consequence of Fusion?- How to Obtain the Best Lumbar Lordosis.- Bone Substitutes.-Techniques for the Osteoporotic Spine That Needs Fusion.- The Choice of TLIF for Lumbar Interbody Fusion.- Anterior Lumbar Interbody Fusion (ALIF).- Interbody Fusion through the Transpsoas Approach.- Oblique Lumbar Interbody Fusion.- Instrumented PLIF in Lumbar Degenerative Spine: Principles, Indications, Technical Aspects, Results, Complications, and Pitfalls.- Part VI: Minimally Invasive Techniques.- Degenerative Disk Disease: Stages of Degeneration, Low Back Pain, and Insights on Intradiscal Therapies.- Lumbar Spine Injections: An Evidence-Based Review.- Endoscopic Procedures for the Lumbar Spine: a Comprehensive View.-Minimally Invasive Lumbar Disk Herniation Surgery with Tubular Retractors: Indications and Technical Aspects.- Minimally Invasive Transforaminal Lumbar Interbody Fusion (TLIF): Indications and Techniques.- Minimally Invasive Operation for Lumbar Fusion, Canal Stenosis, Degenerative Scoliosis, and Spondylolisthesis. Is It Possible?.- Spine Injections for Persistent Lumbar and Radicular Pain after Lumbar Spine Surgery.- Cell Transplantation for Lumbar Spine Degenerative Disk Disease.- Spinal Robotics: Present Indications and Trends.- Part VII: Nonfusion Technologies.- Disk Arthoplasty: A 30-Year History.- Biomechanics of Lumbar Disk Arthroplasty.- Pedicle Screw-Based Dynamic Stabilization Devices in the Lumbar Spine: Biomechanical Concepts, Technologies, Classification, and Clinical Results.- A Word from the Inventor of Intervertebral Dynamic Fixation: on Interspinous Devices.- Interspinous Process Fixation for Motion Preservation.- Part VIII: DDD and Spine Deformity and Sagittal Balance.- Degenerative Scoliosis: Surgical Treatment.- The Importance of Sagittal Balance for the Treatment of Lumbar Degenerative Disk Disease.- Compensatory Mechanisms Contributing to the Maintenance of Sagittal Balance in Degenerative Diseases of the Lumbar Spine.- Posterior Impaction Osteotomy for Correction of Sagittal Imbalance in Iatrogenic Flat Back: Surgical Technique.- Part IX: Lessons from a Life.- Rational Evaluation and Management of the Patient with Spinal Pain.- Lessions Learned from a Life.- Lessons from 35 Years in the Trenches.- History of Lumbar Endoscopic Spinal Surgery and the Intradiscal Therapies.- The Importance of a Registry in Spinal Surgery.- Lessons from a Life: The Journey of Spinal Neurosurgery in the United States.
João Luiz M. C. Pinheiro-Franco was born in 1972. He studied medicine at the Federal University of São Paulo (EPM), Brazil, and subsequently undertook postgraduate courses in neurosurgery at the University of Strasbourg, France and the University of Tübingen, Germany. Dr. Pinheiro-Franco currently works at the Albert Einstein Hospital, São Paulo. He is a member of the Advisory Board for the European Spine Journal and is also a member of the Assistant Editorial Board for Spine. Dr. Pinheiro-Franco is a Committee Member of the Brazilian Society of Spine Neurosurgery (responsibility: international relations) and a member of the Continuing Education Committee of the Brazilian Spine Society. He is also an International Medical Correspondent of the French Red Cross and a Fellow of the World Federation of Neurosurgical Societies. From 2008 to 2012, Dr. Pinheiro-Franco was President of the Sao Paulo chapter of the Brazilian Academy of Neurosurgery. He has been a Visiting Surgeon at various centers in the United States and Europe.