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Rothman-Simeone THE SPINE Rothman-Simeone T H E SP I N E Sixth Edition Volume 1 Harry N. Herkowitz, MD Chairman, Orthopaedic Surgery William Beaumont Hospital Professor and Chairman, Orthopaedic Surgery Oakland University William Beaumont School of Medicine Royal Oak, Michigan Steven R. Garfin, MD Professor and Chair, Department of Orthopaedic Surgery University of California San Diego, California Frank J. Eismont, MD Leonard M. Miller Professor and Chairman Department of Orthopaedic Surgery University of Miami Miller School of Medicine Miami, Florida Gordon R. Bell, MD Director, Center for Spine Health Neurological Institute Cleveland Clinic Cleveland, Ohio Richard A. Balderston, MD Chief, Spine Service Pennsylvania Hospital Clinical Professor, Orthopaedic Surgery University of Pennsylvania School of Medicine Philadelphia, Pennsylvania 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 ROTHMAN-SIMEONE THE SPINE, SIXTH EDITION ISBN: 978-1-4160-6726-9 Copyright © 2011, 2006, 1999, 1992, 1982, 1975 by Saunders, an imprint of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. International Standard Book Number 978-1-4160-6726-9 Acquisitions Editor: Daniel Pepper Developmental Editor: Beth LoGiudice Publishing Services Manager: Patricia Tannian Team Manager: Radhika Pallamparthy Senior Project Manager: Claire Kramer Project Manager: Jayavel Radhakrishnan Designer: Louis Forgione Working together to grow libraries in developing countries Printed in the United States of America www.elsevier.com | www.bookaid.org | www.sabre.org Last digit is the print number: 9 8 7 6 5 4 3 2 1 The sixth edition of The Spine is based on the principles instilled in us, the Editorial Board, when we were fellows with Drs. Rothman and Simeone. Perhaps the most important are the joys of continually teaching, learning, questioning, and trying to understand the complexities of the spine, including diagnosis and treatment through critical analysis of natural history data and treatment outcomes. These occurred for all of us before the terms evidence-based medicine and comparative effectiveness came into common parlance and are an everyday part of what we do and how we think. As evidenced by this book, other important principles include (1) thorough knowledge of basic science as it relates to the clinical condition, (2) understanding of the natural history of spinal disorders, (3) knowledge and interpretive skills of imaging modalities and laboratory studies, (4) treatment decisions that are based on sound scientific principles, and (5) commitment to education and research to further the knowledge base of spinal disorders. As with all previous editions, this one remains dedicated to Drs. Rothman and Simeone, our teachers and friends. The Editorial Board also wishes to dedicate this edition of The Spine to those giants of spine surgery who have passed on since the last edition was published. These include Leon Wiltse, Allan Levine, and Henry Bohlman. Their contributions have significantly influenced our thought processes and clinical decisions. Their legacies will continue to influence future generations of spine surgeons, as we will always remember the richness of their friendship and their dedication to our profession. Sincerely, The Editorial Board To my wife, Jan, and my children, Seth Adam, Laura, and Rachael Helene, for their love, understanding, and support. To the residents and fellows whose enthusiasm for knowledge and “all the answers” inspires me to continue academic pursuits. To Stanko Stanisavljevic, MD, my chairman, who taught me the meaning of hard work and perseverance. To Richard Rothman, MD, PhD, my mentor and friend, for always being there for me. To Steve Garfin, Frank Eismont, Jim Weinstein, Gordon Bell, Sam Wiesel, and Ed Hanley, whose friendship and camaraderie over the past 30 years have made the journey so special. Harry N. Herkowitz, MD As time passes and techniques change, it becomes an increasing challenge to keep this book fresh and updated and to encourage friends and colleagues to write new chapters (for this and other books). It is easier for this one, however, because of the importance this book has attained in the spine world, and the dedication and fondness we have for our mentors. It is also easier for me to do because I am helped by the love and support from my family (Susan, Jessica, Cory, and now Ron) who understand the time it takes to practice medicine, do research, teach, and write. Also, to my friend and colleague Liz Stimson, who is a calm strength and cornerstone of our spine service. Steven R. Garfin, MD To my wife, Emily, and my children, Austin, Adam, April, Allison, and Andrew, whose love, encouragement, and tolerance have allowed me to avidly pursue my medical interests, and to Drs. Richard Rothman and Fred Simeone, who have been excellent role models for me to try to emulate regarding medical education and patient care. Frank J. Eismont, MD To my wife, Kathy, for her love, patience, understanding, and support. To my children, Gordie, Megan, and Michael, for making efforts such as this worthwhile. To my parents, Gordon and Ann, for their support in making this possible. Gordon R. Bell, MD To my wife, Claudia, for all the help she has given me over the past 35 years. Richard A. Balderston, MD Contributors Steven S. Agabegi, MD Peter D. Angevine, MD, MPH Assistant Professor, Department of Orthopaedic Surgery, Assistant Professor, Department of Neurological Surgery, University of Cincinnati College of Medicine; Cincinnati Columbia University College of Physicians and Surgeons, New Children’s Hospital Medical Center, Cincinnati, Ohio York, New York Pediatric Kyphosis: Scheuermann Disease and Fixed Sagittal Imbalance Congenital Deformity Postoperative Deformity of the Cervical Spine Todd J. Albert, MD Joshua D. Auerbach, MD Richard Rothman Professor and Chair, Orthopaedics, Thomas Chief of Spine Surgery, Bronx-Lebanon Hospital Center; Jefferson University and Hospitals, Philadelphia, Pennsylvania Assistant Professor of Surgery, Albert Einstein College of Surgical Management of Lumbar Spinal Stenosis Medicine, Bronx, New York Postoperative Deformity of the Cervical Spine Howard S. An, MD Richard A. Balderston, MD The Morton International Endowed Chair, Professor of Orthopaedic Surgery; Director, Division of Spine Surgery and Chief, Spine Service, Orthopaedics, Pennsylvania Hospital; Spine Fellowship Program, Rush University Medical Center, Clinical Professor, Orthopaedic Surgery, University of Chicago, Illinois Pennsylvania School of Medicine, Philadelphia, Pennsylvania Cervical Spine: Surgical Approaches Anterior Exposure to the Lumbosacral Spine: Anatomy and Techniques Dheera Ananthakrishnan, MD, MSE Lumbar Total Disc Replacement Assistant Professor, Orthopaedic and Spine Center, Emory Kresimir Banovac, MD, PhD Healthcare; Assistant Professor, Orthopaedics, Grady Healthcare Systems; Assistant Professor, Orthopaedics, Professor, Department of Rehabilitation Medicine, University Children’s Healthcare of Atlanta; Assistant Professor, of Miami; Director of Spinal Cord Division, Jackson Memorial Orthopaedics, VA Medical Center, Atlanta, Georgia Medical Center, Miami, Florida Ankylosing Spondylitis Spinal Cord Injury Rehabilitation D. Greg Anderson, MD Qi-Bin Bao, PhD Associate Professor, Thomas Jefferson University; Spinal Chief Technology Officer, Pioneer Surgical Technology, Surgeon, Department of Orthopaedic Surgery, Thomas Marquette, Michigan Jefferson University, Rothman Institute, Philadelphia, Lumbar Nucleus Replacement Pennsylvania Joel A. Bauman, MD Posterior Minimally Invasive Lumbar Fusion Techniques Resident, Neurosurgery, University of Pennsylvania, Megan E. Anderson, MD Philadelphia, Pennsylvania Department of Orthopaedic Surgery, Beth Israel Deaconess Congenital Anomalies of the Spinal Cord Medical Center, Boston, Massachusetts Asheesh Bedi, MD Tumors of the Spine Assistant Professor, Department of Orthopaedic Surgery, Paul A. Anderson, MD University of Michigan Hospitals, Ann Arbor, Michigan Professor, Department of Orthopedic Surgery and Congenital Anomalies of the Cervical Spine Rehabilitation, University of Wisconsin, Madison, Wisconsin Gordon R. Bell, MD Injuries of the Lower Cervical Spine Director, Center for Spine Health, Neurological Institute, Gunnar B. J. Andersson, MD, PhD Cleveland Clinic, Cleveland, Ohio Ronald L. DeWald Professor and Chairman Emeritus, Spine Imaging Department of Orthopedic Surgery, Rush University Medical Degenerative Spondylolisthesis Center, Chicago, Illinois Lumbar Disc Disease Annular Repair vii viii Contributors Carlo Bellabarba, MD Keith H. Bridwell, MD Director, Orthopaedic Spine Service, Department of Asa C. and Dorothy W. Jones Professor of Orthopaedic Orthopaedics and Sports Medicine, Harborview Medical Surgery, Washington University in St. Louis; Chief, Adult/ Center; Associate Professor, Department of Orthopaedics and Pediatric Spinal Surgery, Orthopaedic Surgery, Barnes Sports Medicine, University of Washington School of Hospital, St. Louis, Missouri Medicine, Seattle, Washington Fixed Sagittal Imbalance Sacral Fractures Stephen H. M. Brown, PhD David M. Benglis, Jr., MD Assistant Professor, Department of Health and Nutritional Resident Physician, Department of Neurosurgery, University Sciences, University of Guelph, Guelph, Ontario, Canada of Miami, Miami, Florida Anatomy and Mechanics of the Abdominal Muscles Syringomyelia Robert Byers, MD Joseph R. Berger, MD Mt. Tam Spine Center, Larkspur, California Ruth L. Works Professor and Chairman, Neurology, University Surgical Management of Lumbar Spinal Stenosis of Kentucky, Lexington, Kentucky Peter G. Campbell, MD Medical Myelopathies Neurosurgical Resident, Thomas Jefferson University Hospital, Sigurd Berven, MD Philadelphia, Pennsylvania Associate Professor in Residence, Department of Orthopaedic Spinal Dural Injuries Surgery, University of California San Francisco, San Francisco, Eugene Carragee, MD California Professor and Vice-Chairman, Orthopaedic Surgery, Stanford Adult Scoliosis University School of Medicine; Chief, Division of Spinal Nitin N. Bhatia, MD Surgery, Stanford University Medical Center, Stanford, Chief, Spine Surgery, University of California Irvine Medical California Center; Associate Professor, Orthopaedic Surgery, University Discography of California, Irvine, California Jens R. Chapman, MD Postoperative Spinal Infections Professor and Acting Chair; Director, Spine Service; Ashok Biyani, MD Hansjöerg Wyss Endowed Chair, Department of Associate Professor, Department of Orthopedic Surgery, Orthopaedics and Sports Medicine; Joint Professor of University of Toledo, Toledo, Ohio Neurological Surgery, University of Washington, Seattle, Lumbar Disc Disease Washington Scott D. Boden, MD Sacral Fractures Professor of Orthopaedics and Director, Emory Orthopaedics Kingsley R. Chin, MD and Spine Center, Orthopaedic Surgery, Emory University; Orthopaedic Spine Surgeon; Founder, The Institute for Staff Physician, Department of Orthopaedic Surgery, Atlanta Minimally Invasive Spine Surgery, West Palm Beach, Florida VA Medical Center, Atlanta, Georgia Late Decompression for Patients with Spinal Cord Injury Genetic Applications: An Overview Elisha K. Clouse, RN, BSN, CCRP †Henry H. Bohlman, MD Director of Clinical Research, Tristate Orthopaedic Treatment Professor of Orthopaedic Surgery, The Spine Institute, Center; Student, University of Cincinnati, School of Nursing, University Hospitals of Cleveland, Case Western Reserve Cincinnati, Ohio Medical School, Cleveland, Ohio Vascular Complications in Spinal Surgery Late Decompression of Patients with Spinal Cord Injury Howard M. Cohen, MD Christopher M. Bono, MD Adjunct Assistant Professor, Graduate School of Nursing, Assistant Professor of Orthopaedic Surgery, Harvard Medical University of Texas at Arlington, Arlington, Texas; Associate School; Chief, Orthopaedic Spine Service, Brigham and Medical Director, Productive Rehabilitation Institute of Dallas Women’s Hospital, Boston, Massachusetts for Ergonomics (P.R.I.D.E.), Dallas, Texas Development of the Spine Functional Restoration Applied Anatomy of the Spine Lumbar Disc Herniations Edward C. Covington, MD David G. Borenstein, MD Director, Neurological Center for Pain, Cleveland Clinic Foundation, Cleveland, Ohio Clinical Professor of Medicine, The George Washington Psychologic Strategies for Chronic Pain University Medical Center, Washington, DC Arthritic Disorders †Deceased. Contributors ix Alvin H. Crawford, MD, FACS Jason C. Eck, DO Professor of Pediatric Orthopaedic Surgery, University of Assistant Professor of Orthopedics and Physical Cincinnati Medical Center, University of Cincinnati College of Rehabilitation, University of Massachusetts Medical School, Medicine, Cincinnati, Ohio Worcester, Massachusetts Pediatric Kyphosis: Scheuermann Disease and Thoracic Disc Disease Congenital Deformity Robert Eilert, MD Terrence T. Crowder, MD Emeritus Professor of Orthopaedic Surgery and Pediatrics, Associate, Sonoran Spine Center, Mesa, Arizona University of Colorado, Denver, Colorado Cervical Radiculopathy: Anterior Surgical Approach The Immature Spine and Athletic Injuries Bryan W. Cunningham, MSc Frank J. Eismont, MD Director Spinal Research, Orthopaedic Surgery, St. Joseph Leonard M. Miller Professor and Chairman, Department of Medical Center, Baltimore, Maryland Orthopaedic Surgery, University of Miami, Miller School of Failed Disc Replacement Medicine, Miami, Florida Thoracic Disc Disease Bradford L. Currier, MD Injuries of the Upper Cervical Spine Professor of Orthopaedics; Director of Spine Fellowship Infections of the Spine Program, Mayo Clinic, Rochester, Minnesota Sanford E. Emery, MD, MBA Infections of the Spine Professor and Chairman, Department of Orthopaedics, West Scott D. Daffner, MD Virginia University, Morgantown, West Virginia Assistant Professor, Department of Orthopaedics, West Surgical Management of Rheumatoid Arthritis Virginia University School of Medicine, Morgantown, West Steven T. Ericksen, MD Virginia Surgical Management of Rheumatoid Arthritis Resident Physician, Orthopedic Surgery, University of Toledo, Toledo, Ohio Michael Dahl, PhD Lumbar Disc Disease Research Scientist, Disc Dynamics, Inc., Eden Prairie, Reginald S. Fayssoux, MD Minnesota Lumbar Nucleus Replacement Fellow in Orthopaedic Spine Surgery; Clinical Instructor, Department of Orthopaedic Surgery, Emory University Spine Clayton L. Dean, MD Center, Atlanta, Georgia The Maryland Spine Center, Baltimore, Maryland Complications of Spinal Surgery Nonoperative Management of Cervical Disc and Catherine J. Fedorka, MD Degenerative Disorders Orthopaedic Surgery Resident, Drexel University College of Michael J. DeLeo III, MD Medicine/Hahnemann University Hospital, Philadelphia, Department of Radiology, University of Massachusetts Pennsylvania Medical School, Worcester, Massachusetts Cervical, Thoracic, and Lumbar Spinal Trauma Vascular Anatomy of the Spine, Imaging, and Endovascular of the Immature Spine Treatment of Spinal Vascular Diseases Richard G. Fessler, MD Scott L. Delp, PhD Professor, Department of Neurosurgery, Northwestern James H. Clark Professor of Bioengineering, Mechanical University Feinberg School of Medicine, Chicago, Illinois Engineering, and Orthopaedic Surgery; Co-Director, Stanford Rationale of Minimally Invasive Spine Surgery Center for Biomedical Computing, Stanford University, Palo Jeffrey D. Fischgrund, MD Alto, California Architectural Design and Function of Human Back Muscles Fellowship Director, William Beaumont Hospital, Royal Oak, Michigan Richard Derby, MD Cervical Radiculopathy: Anterior Surgical Approach Medical Director, Spinal Diagnostics and Treatment Center, Kevin Foley, MD Daly City, California Targeting Pain Generators Department of Neurosurgery, University of Tennessee Health Science Center, Semmes-Murphey Clinic, Memphis, Tennessee Clinton J. Devin, MD Minimally Invasive Posterior Approaches to the Spine Assistant Professor, Orthopaedic Surgery, Vanderbilt Winston Fong, MD University, Nashville, Tennessee Cervical, Thoracic, and Lumbar Spinal Trauma Spine Surgeon, Department of Orthopaedic Surgery, McBride of the Immature Spine Clinic, Oklahoma City, Oklahoma Bone Substitutes: Basic Science and Clinical Applications W. Dalton Dietrich III, PhD The Miami Project to Cure Paralysis, The Miller School of Medicine, University of Miami, Miami, Florida Basic Science of Spinal Cord Injury
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