... University of Bern, and Chief of Staff, Department of
Orthopaedic Surgery, Hirslanden-Salem Hospital, Bern, Switzerland. Max Aebi
is Co-Founder and Past Chairman of AO Spine, a member of the European ... 1960 and is a Swiss citizen. He studied at
the University of Saarland, Germany, and the University of Basle, Switzerland. He
then received an international training as a...
... 14
Surgery 14
BackPainandSciatica 15
AWrongMixtureofFluids 15
DiscHerniation 17
HistoricalCaseStudy 19
TheFacetSyndrome 21
SpinalStenosis 21
SpinalInfections 22
EgyptianMummiesandSirPercivalPott ... mean difficult choices in
the allocation of treatment modalities. Therefore, a basic knowledge of the state
of the art of the diagnosis and treatment of spinal di...
... “ishion” standing for hip, buttocks, sacrum, loin and also
upper limb. Since the time of Hippocrates of Cos (46 0–370
B.C.), this term has
relatedtopainsyndromeofthelowerbackandtheupperpartsofthelowerlimbs
[57].
The ... (1930).
2 Section History of Spinal Disorders
c d
Figure 2. (Cont.)
c Andreas Vesalius (15 14 15 64) . d Josias Weitbrecht’s (1702 – 1 747 ) Syndesmologia (1 742 ) p...
... of any
major advancement in the treatment of spinal dis-
orders.
In the Renaissance, the studies of Andreas Vesalius
(1514–1 564 ), the father of modern anatomy, led to
a better understanding of ... dedicated to the research and treatment of spinal cord
injuries (
Fig. 10c).
He propagated intensive rehabilitation and sports. He also wrote a profound
and epoch-making...
... the
responsibleenzymefortetrahydrobiopterin(BH4)synthesis.BH4isanessential
cofactor for catecholamine, serotonin and nitric oxide production and thus a key
modulator of peripheral neuropathic and inflammatory pain. Healthy individu-
Pathways of Spinal Pain ... integration and nociceptive transfer of noci-
144 Section Basic Science
General Concepts of Pain Treatment
Pharmac...
... work-up and initiation of treatment is mandatory.
The major goal of the clinical assessment is to differentiate:
specific spinal disorders, i.e. with a pathomorphological correlate
non-specific spinal ... consider a spinal intervention
✔
The reproducibility of the patient’s history and
examination is limited
Epidemiology
Generally, spinal pain
is common, benign,
and self...
... bilat-
eral and complex symptoms (impaired upper limb –
hand function, gait disorder, bladder and bowl dys-
function). Duration of symptoms is important for
the definition of etiology and urgency of therapy
(e.g. ... (cave: spinal shock). Pathological reflexes
indicate central (spinal and supraspinal) lesions.
Motor strength is subdivided into six grades
(M0–M5), and key mu...
... intubation
degree of mouth opening
size of the tongue
visibility of the pharynx
the state of dentition
restriction of neck movement
stability of the cervical spine
Assessment of cervical
stability is mandatory
in ... preparation and to take into account those conditions
which will add to the risk of anesthesia and surgery.
Information and Instructions
One aim of the pr...
... identification of the source
of the pain. Neurophysiologic studies and osteo-
densitometry are helpful in selected cases.
Treatment. Non-operative treatment consists of
NSAIDs, physiotherapy, spinal ... a crucial
and complex question. The treatment of a degenerative scoliosis has different
goals than the treatment of adolescent scoliosis. While in the latter the goal is...
... sagittal curvature of the
spine. Therefore, a thorough knowledge of the normal sagittal profile is required
for the understanding of this clinical entity. The sagittal profile of the spine in
humans ... degrees and 11–58 (mean 34.6) degrees [57]. Accord-
ing to Bernhart and Bridwell, the range of lumbar lordosis measured from stand-
ing radiographs between the bottom of T12 a...
... assess flexibility of the deformity. In the immature patient, the skeletal
age and the remaining spinal growth are determined from a radiograph of the
hand and wrist [24] and the pelvis (Risser ... is the result of marked structural changes in
the bones and in the soft tissues of the affected area (
Table 7, Fig. 9a).
For optimal correction of the deformity these obstacles...
... nature of the lesion [7] and is
recommended for investigating the suspected lesion in terms of:
spinal level
extent of suspected lesions
vertebral bone marrow infiltration
infiltration of the paraspinal ... to recur
and survive in a distant organ.
The hallmarks represent
a concept of carcinogenesis
The hallmarks of cancer help us to understand the complexity of such a dis-...
... and independent of, the histo-
logical grade of the primary tumor.
Non-operative Treatment
The treatment of spine tumors is determined by the:
biology
location
extent of the lesion
The wait and ... posterior part of the T7 pedicle (not shown). The soft tissue infiltration suggested a malignant
Primary Tumors of the Spine Chapter 33 971
82
Figure 8. Staging of benign...