Autor(es): KRAEMER
Editorial: THIEME
Fecha de publicación: enero 2009
Nº de edición: 3
Nº de páginas: 384
Medidas: 20x27x2 cms



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The definitive guide to intervertebral disk diseases

The new edition of this book provides the current information on the diagnostic techniques and therapeutic approaches that will help clinicians optimize care for patients with intervertebral disk disease. The book covers the full range of problems frequently encountered in the clinical setting, including traumatic injuries, non-degenerative disk diseases, and the numerous clinical syndromes of the cervical, thoracic, and lumbar spine. For each syndrome, the book provides the definition and prevalence, anatomy, biomechanics, pathological anatomy and pathophysiology, clinical presentation, and the conservative and surgical treatment options.

Features of the third edition:

- New information on the biomechanics of the spine, pain management, recent advances in spinal injection techniques, and microsurgical treatment of lumbar disk herniation
- More than 560 high-quality illustrations and images, including MRIs, demonstrating key concepts
- In-depth coverage of essential background information for management, rehabilitation, and preventive treatment
- Comprehensive online references to aid further research

With its accessible presentation and comprehensive scope, this book is a valuable reference for all practicing physicians, specialists in spine surgery, orthopaedists, neurosurgeons, and residents in these specialties.

Table of Contents

1 Introduction

2 History and Terminology
Pre-Christian Times
AD 1–1700
From 1900 Onward
Anatomy and Pathology
Clinical Syndromes

3 Epidemiology
Lifetime Prevalence
Point and Annual Prevalence
Localization and Frequency
International Figures

4 General Anatomy, Physiology, and Biomechanics
Development of the Intervertebral Disk
Fine Structure and Biochemistry
The Disk as an Osmotic System
Changes of Intervertebral Disk Height
Traction and the Intervertebral Disk
Vibration and the Intervertebral Disk
Mechanical Functions of the Intervertebral Disks
The Disk and the Intervertebral Joints
Therapeutic Approaches

5 Nondegenerative Disk Diseases
Developmental Disturbances
Notochord Remnants
Developmental Disturbances of the Vertebral Bodies and Intervertebral Disks in Childhood
Congenital Anomalies
Inflammatory and Infectious Disorders
Bacterial Infection of the Intervertebral Disk
Rheumatic Inflammation of the Intervertebral Disk
Involvement of the Intervertebral Disks in Systemic Illness
Possible Reactions
Ochronosis (Alkaptonuria)
Loss of Bone Density in the Vertebral Bodies
Disk Calcification and Ossification

6 Discosis
Biochemical Changes of Aging
Biomechanical Basis of Disk Tissue Displacement
Effects on the Osmotic System
Instability of the Motion Segment
Pathogenesis of Instability
Clinical Significance
Surgical Indications
Prognosis and Course of Discogenic Degenerative Instability
Prediscotic Deformities

7 Traumatology
Etiologies and Types of Spinal Injury, and the Role of Pre-existing Degenerative Changes
Sprains of the Motion Segment
Isolated Traumatic Disk Rupture
Vertebral Body Fracture with Injury of the Intervertebral Disk

8 Pain: Its Pathogenesis and the Evolution of Chronic Pain
Local and Radiating Pain
Nerve Supply of the Spine
The Foramino-articular Region
Discogenic Pain
Spinal Deformities without Pain
Pain Arising from the Posterior Longitudinal Ligament
Radicular Pain
Intervertebral Joint Pain (Facet Syndrome, Pseudoradicular Syndrome)
Muscle Pain
Combined Types of Pain
Nociception and the Transition from Acute to Chronic Pain
Physiology of Nociception in the Spine
Evolution of Chronic Pain
Pharmacological Pain Therapy

9 Cervical Syndrome
Definition and Prevalence
Special Anatomy and Physiology of the Cervical Motion Segments
Uncinate Processes
Horizontal Fissures
Vertebral Artery and Cervical Sympathetic Chain
Cervical Nerve Roots and Nerve Root Sleeves
Special Pathoanatomy and Pathophysiology
Clinical Features of Cervical Syndromes
Overview of Symptoms and Their Classification
Patients’ Description of Symptoms
Clinical Findings
Radiological Studies
CT and MRI
Neurophysiological Testing: EMG
General Differential Diagnosis
Classification of Cervical Syndromes
Local Cervical Syndrome
Acute Torticollis (Wry Neck)
Cervicobrachial Syndrome
Brachialgia Due to Soft Disk Protrusion
Brachialgia Due to Uncinate Process Exostosis
Segmental Syndromes
Cervicocephalic Syndrome
Cervicomedullary Syndrome
Post-traumatic Cervical Syndrome
Treatment of Cervical Syndromes
Overview of Treatment Methods
Conservative Treatment
Operative Treatment
Special Patient Exercises, Rehabilitation, and Back School
Treatment Planning

10 Thoracic Syndrome
Definition and Prevalence
Special Anatomy, Biomechanics, and Pathoanatomy of the Thoracic Motion Segments
Clinical Features of Thoracic Disk Prolapse
Intercostal Neuralgia
Differential Diagnosis

11 Lumbar syndrome
Definition and Prevalence
Special Anatomy of the Lumbar Motion Segments
Lumbar Disks
Intervertebral Foramina
Ventral Epidural Space
Ligamentum Flavum
Venous System
Numerical Variations and Transitional Vertebrae
Topographical Relationships Between the Spinal Nerve Roots and Disks in the Lumbar Spinal Canal
Radiological/Surgical Subdivisions of the Lumbar Motion Segments
Special Biomechanics of the Lumbar Spine (H. J. Wilke)
Mechanical Stress on the Lumbar Disks
Methods of Measuring Stress on the Lumbar Motion Segments
Special Pathological Anatomy and Pathophysiology
Protrusions and Prolapses
Disk Slackening and Instability
Bony Deformation
Clinical Features of Lumbar Syndromes
Findings of Clinical Examination
Neurophysiologic Testing—EMG
Plain Radiographs
Lumbar Myelography
Diagnostic Study of the CSF
Clinical Syndromes
Classification of Lumbar Syndromes
Local Lumbar Syndrome, Low Back Pain
Lumbago, Discogenic Back Pain
Low Back Pain of Arthroligamentous Origin
Facet Syndrome
Imaging Studies in Patients with Low Back Pain
Differential Diagnosis of Low Back Pain
Red Flags in Low Back Pain
Discogenic Hip and Thigh Extension Stiffness
Lumbar Root Syndromes
Red Flags in Lumbar Root Syndromes
Treatment of Lumbar Syndromes
Classification of Treatment Methods
Conservative Treatment
Minimally Invasive Therapy of Lumbar Syndromes
Surgical Treatment
Post-discotomy Syndrome
Fusion Procedures
Intervertebral Disk Prostheses
Treatment Planning—Integrated Care

12 Natural Course and Prognosis of Intervertebral Disk Diseases
Pathoanatomical Changes of the Intervertebral Disk
Disk Disease over the Course of Life
The Spontaneous Course of Acute Intervertebral Disk Disease
L5/S1 Case Illustration: Prolapse with Infradiscal Extension and Spontaneous Resorption
L4/5 Case Illustration: Spontaneous Resorption of an Infradiscal L4/5 Disk Prolapse

13 The Spine and the Mind
Psychosomatic Processes
Mind–Body Interactions as Described in the Literature
The Spine as a Projective Field for Mental Disturbances (Psychosomatic Changes)
The Effect of Disk Disease on the Mind (Somatopsychic Changes)
Deliberate Simulation or Exaggeration of Disk Disease
Psychotherapy and Relaxation Techniques

14 Back School
The Biomechanical Principles Of Back School
Sitting Forward
Sitting Back
Dynamic Sitting

15 Exercise in a Pain-Free Range of Motion
Exercise and Nociception
Which Exercises are Suitable?
Exercise Points
Stepwise Program
Running with Simultaneous Activation of the Arms
Running with a Reduced Load
Dynamic Work at Home, in the Garden, and at Work

16 Sports
Introduction and Literature
Sports and the Cervical Spine
Sports and the Lumbar Spine
Sporting Activities that are Good and Bad for the Intervertebral Disks

17 Medicolegal Assessment
Frequency of Medicolegal Assessment of Disk-Related Diseases
Disk Herniations and Accidents
Pre-existing Damage
The Accident
Damage to the Intervertebral Disks After the Loss or Permanent Injury of a Limb
Cervical Spine
Lumbar Spine
Medicolegal Assessment
Whiplash: Acceleration Injury of the Cervical Spine
Degree of Severity
Course and Prognosis
Symptoms That Become Chronic
Medicolegal Assessment
Assessment of Loss of Earning Capacity in Lumbar Intervertebral Disk Disease
Definition and Classification of Loss of Earning Capacity
Levels of Loss of Earning Capacity
Problems in Medicolegal Assessment
Course and Prognosis




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