Revision spine surgery requires a unique skill set different from performing a primary operation. Understanding when a simple revision is sufficient, when a more complex approach is needed, or when a non-surgical option should be considered is critical to good patient care and outcomes. In this first book to focus exclusively on the complex topic of revision spine surgery, world-renowned Dr. Alex Vaccaro and leading neuro and orthopaedic spine surgeons, navigate physicians through the initial evaluative process and the potential pitfalls and complications encountered in revision surgery.
GENERAL. The approach to revision procedures. How to dissect the plane between the scar of a laminectomy defect in the posterior cervical spine. How to dissect the plane between the scar of a laminectomy defect in the posterior thoracic and lumbar spine. Local muscle flaps in the setting of revision spine surgery: Indications, operative planning, principles, and postoperative management. Revision and reimplantation of a spinal cord stimulator device. ANTERIOR CERVICAL. Revision ACDF at the same level. Revision ACDF: Adjacent level. Converting a total disc replacement to an ACDF. Treatment of adjacent segment disease after total disc replacement (TDR). POSTERIOR CERVICAL. Revision suboccipital decompression for complex Chiari malformation. How to revise a failed occipital cervical fusion. How to revise a failed C1–C2. fusion. Treatment of postlaminectomy kyphosis. Revision of failed posterior cervical fusions. Complications necessitating surgical intervention following cervical laminoplasty. THORACIC/THORACOLUMBAR SPINE. Revision surgery for proximal junctional kyphosis following thoracolumbar fusion. Pedicle subtraction osteotomy (PSO) nonunion revision. Treatment of a nonunion of a thoracolumbar deformity, not at the site of a three-column osteotomy. How to safely remove a pedicle screw abutting the aorta. LUMBAR SPINE. Revision of an anterior lumbar interbody fusion (ALIF) nonunion. How to revise nonunion of a lateral interbody fusion (LLIF) through a lateral approach. How to surgically manage a recurrent lumbar herniated nucleus pulposus (HNP). How to perform revision lumbar decompression. How to perform revision lumbar decompression at the index level through a minimally invasive (MIS) approach. How to revise a transforaminal lumbar interbody fusion (TLIF) nonunion with recurrent stenosis at the index level (open). How to revise a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) nonunion with recurrent stenosis at the index level through an MIS approach. How to revise a posterior lateral decompression and fusion at the index level. How to revise a posterior lumbar fusion that has developed adjacent-level stenosis with or without instability. Flat back deformity revision surgery. Revision high-grade spondylolisthesis surgery. Management of a ventrally displaced graft following ALIF, TLIF or DLIF. SPECIAL CASES. Treatment of symptomatic cervical and lumbar pseudomeningocoeles. Treatment of a persistent cervical dural tear. Treatment of a ventral thoracic dural defect. Treatment of a persistent lumbar dural tear. Treatment of a chronic postoperative cervical and lumbar spine infection.