Szpalski: Surgery for Low Back Pain

Low back pain is one of the most common conditions encountered in clinical practice; however, its definition itself is subject to debate and precise knowledge about it is conflicting. It can be attributed to a great number of different origins although, often, the true cause of nociception cannot be precisely defined. Furthermore, psychosocial variables have an important influence on the reporting back pain symptoms. Nevertheless, low back pain and the pathologies believed to be its cause are the main indication for spine surgery in most area of the world while true evidence about indications remains elusive and there is much discussion about the very different techniques used.
The goal of Surgery for Low Back Pain by Marek Szpalski, Robert Gunzburg, Björn L. Rydevik, Jean-Charles Le Huec, et al book is to shed some light on this complex subject. The indispensable bases of biology and biomechanics of spinal structures are covered as well as the important psychosocial determinants associated with back complaints. Diagnosis is now enhanced by new magnetic resonance techniques described thoroughly.Conservative treatment is still the base of low back pain handling, and natural history of the condition as well as the main conservative therapeutic options are described in detail. Medications, rehabilitation, back schools, manipulative therapies, and orthoses are the subject of fully documented chapters.
Surgical techniques abound for the treatment of lumbar spine disorders and this book tries to clarify their indications and results. For many years fusion was the most used technique and became the “de facto” gold standard. The role of pelvic girdle pain and facet syndrome is subject to debate and the possible surgical treatment is discussed in those conditions. Chapters will cover different technique as well as the possible drawbacks like blood loss and adjacent level degeneration. The latter has led to the development of “nonfusion” technologies like artificial disks, semirigid fixation techniques, or interspinous implants. Indications, counter indications, techniques, and complications of those different techniques are presented and lead to discussion about what evidence we have for their effectiveness.
Outcome assessment is paramount to finding evidence for treatments of low back pain. The principles of outcome assessment in back pain as well as the review of actual available evidence ends the book.
This book is intended for clinicians as well as researchers in many fields of spinal disorders. It is of use to orthopedic and neurosurgeons, rheumatologists, neurologists, physiatrists, physical therapists, as well as psychologists and social security and insurance specialists.

Contents
Part I Basics

• 1.1 The Biology of Intervertebral Disc Degeneration
• 1.2 Low Back Pain: Where Does the Pain Come From?
• 1.3 The Role of Cytokines in the Degenerative Spine
• 1.4 Psychosocial Aspects of Low Back Pain
• 1.5 Instability and Low Back Pain

Part II Diagnosis

• 2.1 Dynamic MRI of the Spine
• 2.2 Assessment of Status of End Plate and Diffusion in Degenerative Disc Disease
• 2.3 The Role of Physician Extenders in a Low Back Pain Practice

Part III Conservative Treatment

• 3.1 Natural Evolution of Nonspecific Low-Back Pain
• 3.2 Prescribing Conservative Treatment for Low Back Pain
• 3.3 Comprehensive Rehabilitation for Low back Pain and Back Schools
• 3.4 The Place of Chiropractic Care in the Treatment of Low Back Pain
• 3.5 Efficacy of IDET and PIRFT for the Treatment of Discogenic Low Back Pain
• 3.6 Lumbar Orthoses to Prevent and Treat Low-Back Pain

Part IV Surgical Treatment: Fusion

• 4.1 Indication for Lumbar Spinal Fusion
• 4.2 Evidence for Efficacy of Pedicle-Based Systems
• 4.3 Low Back Pain Is Not an Indication for Stabilisation in Patients Operated for Lumbar Spinal Stenosis
• 4.4 Hybrid Construct for DDD in the Lumbar Spine: The Compromise Between Fusion and Nonfusion
• 4.5 The Management of Spondylolysis and Spondylolisthesis
• 4.6 Transpedicular-Transdiscal-Transcorporal (TPDC)-Fixation
• 4.7 Facet Problems: A Surgical Indication?
• 4.8 Adjacent Level Disease: “Myth” or “Fact”
• 4.9 Pelvic Girdle Pain: Indication for Surgery?
• 4.10 Blood Loss Management in Major Spine Surgery

Part V Surgical Treatment: Other Technologies

• 5.1 How Disc Replacement Fits in the Treatment Algorithm for Degenerative Disc Disease: Refining Indications for Disc Replacement
• 5.2 Clinical Factors that May Affect Outcome in Lumbar Total Disc Replacement. What Is the Evidence?
• 5.3 A Prospective Randomized Comparison of Two Lumbar Total Disk Replacements
• 5.4 Limitations of Lumbar Disk Arthroplasty
• 5.5 Is Posterior Dynamic Stabilization an Option to Avoid Adjacent Segment Decompensation?
• 5.6 Immediate Biomechanical Effects of Lumbar Posterior Dynamic Stabilisation
• 5.7 Overview of Pedicle Screw-Based Posterior Dynamic Stabilization Systems
• 5.8 Semirigid Fixation System for the Lumbar Spine
• 5.9 Nonrigid Stabilization of the Spine – Problems Observed: Screw Loosening/Breakage/Implant Failure/Adjacent Segment Degeneration
• 5.10 Interspinous Implants: State of the Art and Research of Evidence
• 5.11 NuBac Disc Arthroplasty System: Rationale and Clinical Results

Part VI Outcomes

• 6.1 Outcome Assessment for Cost-Utility Evaluations: SF-6D vs. EQ-5D
• 6.2 Review of the Medical Evidence Regarding the Surgical Treatment of Low Back Pain

Index  

Book Details

• Hardcover: 285 pages
• Publisher: Springer; 1st edition (June 7, 2010)
• Language: English
• ISBN-10: 3642045464
• ISBN-13: 978-3642045462
• Product Dimensions: 10.5 x 8 x 0.8 inches 

List Price: $139.00