Seminars in Spine Surgery RSS feed: Current Issue. Seminars in Spine Surgery is a continuing source of current, clinical information for practicing surgeons. Under the direction of a specially selected guest editor, each issue addresses a single topic in the management and care of patients. Topics covered in each issue include basic anatomy, pathophysiology, clinical presentation, management options and follow-up of the condition under consideration. The journal also features "Spinescope," a special section providing summaries of articles from other journals that are of relevance to the understanding of ongoing research related to the treatment of spinal disorders.http://www.semspinesurg.com/?rss=yesElsevier Inc.en © 2010 Published by Elsevier Inc. All rights reserved. Seminars in Spine Surgery1040-7383222June 2010 © 2010 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.semspinesurg.com/article/PIIS104073831000033X/abstract?rss=yesMasthead10.1053/S1040-7383(10)00033-XSeminars in Spine Surgery 22, 2 (2010)2010-06-01Seminars in Spine Surgery2010-06-01222S1040-7383(10)X0003-XIFCIFChttp://www.semspinesurg.com/article/PIIS1040738310000341/abstract?rss=yesContributors10.1053/S1040-7383(10)00034-1Seminars in Spine Surgery 22, 2 (2010)2010-06-01Seminars in Spine Surgery2010-06-01222S1040-7383(10)X0003-Xiihttp://www.semspinesurg.com/article/PIIS1040738310000353/abstract?rss=yesForthcoming/Previous Issues10.1053/S1040-7383(10)00035-3Seminars in Spine Surgery 22, 2 (2010)2010-06-01Seminars in Spine Surgery2010-06-01222S1040-7383(10)X0003-Xiiiiiihttp://www.semspinesurg.com/article/PIIS1040738310000365/abstract?rss=yesTable of Contents10.1053/S1040-7383(10)00036-5Seminars in Spine Surgery 22, 2 (2010)2010-06-01Seminars in Spine Surgery2010-06-01222S1040-7383(10)X0003-Xvvhttp://www.semspinesurg.com/article/PIIS1040738309001038/abstract?rss=yesAs guest editors, we are excited to present the second half of the issue on Thoracolumbar Spine Injuries. In this edition we start by covering the use of cement augmentation for the management of osteoporotic senile fractures. Recently, as we gain experience with these techniques, indications have expanded to include the management of traumatic lesions, which previously was thought to be a relative contraindication.IntroductionFrancis H. Shen, Adam L. Shimer10.1053/j.semss.2009.12.006Seminars in Spine Surgery 22, 2 (2010)2010-03-29Seminars in Spine Surgery2010-03-29222S1040-7383(10)X0003-X5757http://www.semspinesurg.com/article/PIIS1040738309001002/abstract?rss=yesApproximately 2 million people sustain an osteoporotic fracture in the United States each year; 25% of those are vertebral compression fractures. Most fractures can be treated nonoperatively, using a combination of bracing, physical therapy, and pain medications. Surgical treatment may be considered for patients with severe pain or who have failed nonoperative options. Surgical treatment options include vertebroplasty and kyphoplasty, which involve the injection of bone cement (polymethylmethacrylate) to augment vertebral bone strength; kyphoplasty adds the inflation of a balloon tamp to help reduce the fracture and create a space for the cement. The risk of cement extravasation is relatively high, especially during vertebroplasty; however, the incidence of symptomatic leaks is relatively low. Overall, both procedures offer low complication rates, excellent pain relief, and improved function after vertebral compression fractures.Management of Osteoporotic Fractures of the Thoracolumbar SpineGregory P. Gebauer, A. Jay Khanna10.1053/j.semss.2009.12.003Seminars in Spine Surgery 22, 2 (2010)2010-04-08Seminars in Spine Surgery2010-04-08222S1040-7383(10)X0003-X5866http://www.semspinesurg.com/article/PIIS1040738309001026/abstract?rss=yesThe combination of percutaneus vertebral augmentation with posterior instrumentation may be an attractive treatment option for certain high energy burst fractures. Biomaterials such as calcium phosphate cement are biocompatible, share similar biomechanical properties to bone, and are gradually replaced by host bone tissue. Early biomechanical and clinical results indicate that the anterior column may be restored without the need of a traditional anterior surgical approach. Further clinical studies are needed to confirm that this less invasive approach improves patient outcome.Balloon-Assisted Fracture Reduction in High-Energy Burst FracturesDalip Pelinkovic, Ranjith Kamal Udayakumar, Frank M. Phillips10.1053/j.semss.2009.12.005Seminars in Spine Surgery 22, 2 (2010)2010-06-01Seminars in Spine Surgery2010-06-01222S1040-7383(10)X0003-X6772http://www.semspinesurg.com/article/PIIS1040738309001014/abstract?rss=yesGunshot wounds to the spine are a common cause of spinal cord injury. The thoracolumbar area is the second most commonly injured region of the spine by gunshot wounds and is the focus of this article. In this article, the authors discuss the fundamentals of ballistics and tissue injury, involved in both low- and high-velocity gunshot wounds to the thoracolumbar spine. A discussion of the diagnostic and therapeutic tools involved in the management of these injuries is undertaken. Furthermore, the approach to the patient with a thoracolumbar gunshot wound is presented. Management must start with maintenance of airway, breathing, and circulation, and proceed with physical examination, laboratory, diagnostic imaging, and medical and surgical interventions. Tetanus prophylaxis and antibiotic administration for 7-14 days are imperative. Surgical debridement and surgical stabilization are rarely necessary in low-velocity, low-energy civilian gunshot wounds. Indications for surgery include wartime gunshot wounds, progression of neurologic deficit, persistent cerebrospinal fluid fistula, cauda equina syndrome with mass effect from bullet or bone fragments, and intracanalicular bullets between T12 and L4.Gunshot Injuries to the Thoracolumbar SpineRobert F. Heary, Antonios Mammis10.1053/j.semss.2009.12.004Seminars in Spine Surgery 22, 2 (2010)2010-03-29Seminars in Spine Surgery2010-03-29222S1040-7383(10)X0003-X7377http://www.semspinesurg.com/article/PIIS1040738309000999/abstract?rss=yesMinimally invasive surgical techniques hold promise as a valuable tool for the treatment of patients with thoracolumbar fractures. Percutaneous pedicle–based fixation provides secure fracture stabilization and theoretically may minimize associated morbidity while allowing for early mobilization. This holds particular benefit in the management of critically ill patients who may not tolerate conventional open procedures. Furthermore, in select cases the ability to stabilize spinal fractures without fusion may reduce the risk of fusion disease by allowing for late implant removal after fracture healing and subsequent motion preservation. Although early results are promising, prospective trials are necessary for understanding long-term results.Percutaneous and Minimally Invasive Techniques for the Management of Thoracolumbar Spine InjuriesJoseph Elkhalil, Tony Tannoury10.1053/j.semss.2009.12.002Seminars in Spine Surgery 22, 2 (2010)2010-04-08Seminars in Spine Surgery2010-04-08222S1040-7383(10)X0003-X7883http://www.semspinesurg.com/article/PIIS104073830900104X/abstract?rss=yesBecause of its complex anatomy, the thoracolumbar spine remains one of the most common sites for spinal column injuries and pathologies. Current surgical management to address thoracolumbar lesions remains challenging as traditional surgical procedures—anterior, posterior, and either combined or staged anterior-posterior approaches—are frequently associated with complications and morbidity. By remaining extrapleural and/or extraperitoneal, the extracavitary approach avoids many of these potential complications by using a single incision to provide direct access to anterior, middle, and posterior column, while offering direct visualization of the common dural sac and neural elements. Recent improvements in surgical technique combined with advancements in spinal instrumentation have reduced complication rates with this approach to levels comparable to the more traditional surgical approaches.Extracavitary Approach to the Thoracolumbar SpineFrancis H. Shen, Justin Haller10.1053/j.semss.2009.12.007Seminars in Spine Surgery 22, 2 (2010)2010-04-05Seminars in Spine Surgery2010-04-05222S1040-7383(10)X0003-X8491http://www.semspinesurg.com/article/PIIS1040738309000987/abstract?rss=yesSpinal trauma is relatively common, and each year approximately 10,000 to 17,000 people in the United States will sustain a spinal cord injury, and approximately 150,000 to 160,000 will fracture their spinal column. Posttraumatic spinal deformity is a common potential complication of spinal injury and poses as the greatest challenge in spinal surgery. Successful treatment of posttraumatic spinal deformity is dependent on careful patient selection and appropriate surgical intervention. Surgery should be considered in the presence of significant or increasing deformity, increasing back and/or leg pain, “breakdown” at levels above or below the deformity, pseudarthrosis or malunion, and increasing neurological deficit. The goals of surgery should be to decompress the neural elements if neurological claudication or neurological deficit is present and to recreate normal sagittal contours and sagittal and coronal balance and to optimize the chances for successful fusion. These goals can be achieved through an all-anterior, all-posterior, or a combined anterior and/or posterior approach, assuming that close attention is paid to using the appropriate bone-grafting techniques, selecting technically sound segmental instrumentation, and providing appropriate biomechanical environment for maintenance of correction and successful fusion.Management of Posttraumatic Kyphosis After Thoracolumbar InjuriesJacob M. Buchowski, Keith H. Bridwell, Lawrence G. Lenke10.1053/j.semss.2009.12.001Seminars in Spine Surgery 22, 2 (2010)2010-04-05Seminars in Spine Surgery2010-04-05222S1040-7383(10)X0003-X92102http://www.semspinesurg.com/article/PIIS1040738310000298/abstract?rss=yesRecently, a clinical predictive rule has been developed and validated that identifies patients with low back pain who are likely to respond rapidly and dramatically to thrust manipulation. Cleland et al performed a randomized clinical trial to examine the generalizability of 3 different manual therapy techniques in a patient population with low back pain.SpinescopeScott D. Boden10.1053/j.semss.2010.03.010Seminars in Spine Surgery 22, 2 (2010)2010-06-01Seminars in Spine Surgery2010-06-01222S1040-7383(10)X0003-X103108