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Now is its revised and extended 3rd variation, together with 9 new chapters, this step by step, state of the art procedural handbook covers over 50 targeted surgical techniques for accidents and prerequisites of the backbone. Generously illustrated, a number of surgical techniques to the cervical, thoracic and lumbar backbone are truly enumerated and defined, together with anterior, lateral, and posterior techniques and the global circulate towards using tubular retractors for a large number of ways. Written and edited by way of leaders within the box of backbone surgical procedure, this up-to-date version could be a useful source for orthopedic surgeons, neurosurgeons and activities medication practitioners alike.
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Additional resources for Surgical Approaches to the Spine (3rd edition)
Example text
Position the patient supine on the operating table. Turn the head to the right. 2. Usually, the incision goes from the midline to the medial sternocleidomastoid muscle (SCM). After the transverse skin incision (Fig. 1), at the appropriate level, dissect through subcutaneous tissue to the platysma muscle. Open the platysma muscle in the line of its fibers when possible. Elevate the platysma muscle with Adson pick-ups and open carefully. Beware of damage to veins and the sternocleidomastoid muscle [1, 2].
Use the blunt-tipped Cloward vertically if needed to expose the desired disc [5]. (Fig. 7). Closure: After hemostasis has been achieved, the deep wound closes with removal of retractors. Close the platysma muscle very carefully to prevent superficial scarring of subcutaneous and skin layers. Use subcuticular skin closure and always use a closed suction wound drainage system. G. G. G. Watkins, III 40 Remember: 1. Plan skin incision for proper spine level. 2. Open platysma muscle along the line of its fibers and close carefully for cosmesis.
3 The key to the dissection at this point is to identify the medial border of the sternocleidomastoid muscle. With lateral retraction of the sternocleidomastoid, the interval between this muscle and the medial strap muscles is delineated Sternocleidomastoid Muscle Trapezius Muscle Anterior Scalene Sternothyroid Muscle Stemohyoid Muscle Ornohyoid Muscle 42 Fig. 4 After retracting the sternocleidomastoid muscle laterally and the strap musculature medially, the arteriovenous structures of the middle cervical fascial layer must be identified.
