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Imaging of Novel Spine Operations : What the Surgeon Wants to Know 2012

Interventional Spine

Chris, Buckle
Mojtahedi, Saeid, MD, Non ASSR Member
Roitberg, Ben, MD, Non ASSR Member

Poster

Purpose

The purpose of this exhibit is to review the indications and techniques for three surgical approaches - cervical laminoplasty, new posterior spinal instrumentation, and pedicle screw fixation and to demonstrate how imaging can help the spine surgeon optimize patient outcome.

Methods & Materials

An interactive pictorial review of three novel surgical approaches to the spine. Viewers will undergo a pre and post knowledge assessment for CME.

Results

1.Laminoplasty - Indications and contraindications - Surgical technique - Role of imaging - Pre operative evaluation of spinal stenosis - Post operative - Expected findings - How to measure canal size - Complications to watch for and how they are managed 2.Pedicle screw fixation - Indications and contraindications - Surgical technique - Role of imaging - Best technique (MRI vs CT) - Optimizing image quality to reduce hardware artifact MRI CT - Pre operative evaluation : anatomic considerations - Post operative - Evaluation of complications (screw position, loosening, fracture) and how they are managed 3.Novel Posterior Approaches (ex. X-Stops for spinal stenosis) - Indications and contraindications - Surgical technique - Role of imaging Normal post operative appearance (position and expected post surgical changes)

Conclusion

Imaging is a powerful tool that can help the spine surgeon both before and after surgery. It is important for the spine radiologist to be aware of the surgical principles that underlie new spine intervention techniques, to understand how imaging criteria help determine the surgical approach and to familiarize themselves with expected and unexpected post operative appearances.

References/Financial Disclosures

1.Cervical laminoplasty for multilevel cervical myelopathy. Sayana MK, Jamil H, Poynton A.Adv Orthop. 2011;2011:241729. Epub 2011 Oct 2. 2. Complications of pedicle screw fixation in scoliosis surgery: a systematic review.Hicks JM, Singla A, Shen FH, Arlet V.Spine (Phila Pa 1976). 2010 May 15;35(11):E465-70. Review.