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Imaging in Spine Surgery


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Table of Contents

SECTION 1: NORMAL ANATOMY AND TECHNIQUES Normal Anatomy Overview Craniovertebral Junction Cervical Spine Thoracic Spine Lumbar Spine Measurement Techniques Normal Postoperative Change: Disc Space Normal Postoperative Change: Epidural Space Metal Artifact SECTION 2: DEVICES AND INSTRUMENTATION Devices and Instrumentation Overview Plates and Screws Cages Subaxial Posterior Instrumentation Transpedicular Screw Fixation Cervical Artificial Disc Lumbar Artificial Disc Interspinous Spacing Devices Scoliosis and Devices Instrumentation Pumps and Catheters SECTION 3: CONGENITAL AND GENETIC DISORDERS BONY VARIATIONS C2-C3 Fusion C1 Assimilation Ponticulus Posticus Ossiculum Terminale Paracondylar Process Condylus Tertius Posterior Arch Rachischisis Split Atlas DIAGNOSES Odontoid Hypoplasia/Aplasia C1 Dysmorphism/Hypoplastic Arch Chiari 1 Complex Chiari Chiari 2 Chiari 3 Myelomeningocele Lipomyelomeningocele Lipoma Dorsal Dermal Sinus Simple Coccygeal Dimple Dermoid Cysts Epidermoid Cysts Tethered Spinal Cord Segmental Spinal Dysgenesis Caudal Regression Syndrome Terminal Myelocystocele Anterior Sacral Meningocele Occult Intrasacral Meningocele Sacrococcygeal Teratoma Klippel-Feil Spectrum Failure of Vertebral Formation Vertebral Segmentation Failure Diastematomyelia Neurenteric Cyst Os Odontoideum Lateral Meningocele GENETIC Neurofibromatosis Type 1 Neurofibromatosis Type 2 Down Syndrome Mucopolysaccharidoses Achondroplasia Osteogenesis Imperfecta Spondyloepiphyseal Dysplasia SECTION 4: DISORDERS OF ALIGNMENT Introduction to Scoliosis Scoliosis Kyphosis Degenerative Scoliosis Scoliosis Instrumentation Spondylolisthesis Instability SECTION 5: TRAUMA VERTEBRAL COLUMN, DISCS Fracture Classification Atlantooccipital Dislocation Ligamentous Injury Occipital Condyle Fracture Jefferson C1 Fracture Atlantoaxial Rotatory Fixation Odontoid C2 Fracture Burst C2 Fracture Hangman's C2 Fracture Apophyseal Ring Fracture Cervical Hyperflexion Injury Cervical Hyperextension Injury Cervical Burst Fracture Traumatic Disc Herniation Thoracic and Lumbar Burst Fracture Fracture Dislocation Chance Fracture Anterior Compression Fracture Sacral Insufficiency Fracture CORD, DURA, AND VESSELS Posttraumatic Syrinx Presyrinx Edema Spinal Cord Contusion-Hematoma Idiopathic Spinal Cord Herniation Traumatic Epidural Hematoma Traumatic Subdural Hematoma SECTION 6: DEGENERATIVE DISEASES AND ARTHRITIDES DEGENERATIVE DISEASE Nomenclature of Degenerative Disc Disease Degenerative Disc Disease Degenerative Endplate Changes Disc Bulge Anular Fissure, Intervertebral Disc Cervical Intervertebral Disc Herniation Thoracic Intervertebral Disc Herniation Lumbar Intervertebral Disc Herniation Intervertebral Disc Extrusion, Foraminal Cervical Facet Arthropathy Lumbar Facet Arthropathy Facet Joint Synovial Cyst Baastrup Disease Bertolotti Syndrome Schmorl Node Scheuermann Disease Acquired Lumbar Central Stenosis Congenital Spinal Stenosis Cervical Spondylosis DISH OPLL Ossification Ligamentum Flavum Periodontoid Pseudotumor Spondylolysis INFLAMMATORY, CRYSTALLINE, AND MISCELLANEOUS ARTHRITIDES Adult Rheumatoid Arthritis Juvenile Idiopathic Arthritis Neurogenic (Charcot) Arthropathy Hemodialysis Spondyloarthropathy Ankylosing Spondylitis CPPD Gout SECTION 7: INFECTION AND INFLAMMATORY DISORDERS INFECTION Pathways of Spread Pyogenic Osteomyelitis Tuberculous Osteomyelitis Fungal and Miscellaneous Osteomyelitis Osteomyelitis, C1-C2 Septic Facet Joint Arthritis Paraspinal Abscess Epidural Abscess Abscess, Spinal Cord INFLAMMATORY AND AUTOIMMUNE Acute Transverse Myelopathy Multiple Sclerosis Neuromyelitis Optica ADEM Sarcoidosis Grisel Syndrome IgG4-Related Disease/Hypertrophic Pachymeningitis SECTION 8: NEOPLASMS, CYSTS, AND OTHER MASSES EXTRADURAL NEOPLASMS Spread of Neoplasms Blastic Osseous Metastases Lytic Osseous Metastases Hemangioma Osteoid Osteoma Osteoblastoma Aneurysmal Bone Cyst Giant Cell Tumor Osteochondroma Chondrosarcoma Osteosarcoma Chordoma Ewing Sarcoma Lymphoma Leukemia Plasmacytoma Multiple Myeloma Neuroblastic Tumor INTRADURAL EXTRAMEDULLARY Schwannoma Meningioma Solitary Fibrous Tumor/Hemangiopericytoma Neurofibroma Malignant Nerve Sheath Tumors Metastases, CSF Disseminated Paraganglioma INTRAMEDULLARY Astrocytoma Cellular Ependymoma Myxopapillary Ependymoma Hemangioblastoma Spinal Cord Metastases Primary Melanocytic Neoplasms/Melanocytoma NONNEOPLASTIC CYSTS AND TUMOR MIMICS CYSTS CSF Flow Artifact Meningeal Cyst Perineural Root Sleeve Cyst Syringomyelia TUMOR MIMICS Fibrous Dysplasia Kummell Disease Hirayama Disease Paget Disease Bone Infarction Extramedullary Hematopoiesis Tumoral Calcinosis SECTION 9: VASCULAR DISORDERS Vascular Anatomy Approach to Vascular Conditions Type 1 Vascular Malformation (Dural Arteriovenous Fistula) Type 2 Arteriovenous Malformation Type 3 Arteriovenous Malformation Type 4 Vascular Malformation (Arteriovenous Fistula) Posterior Fossa Dural Fistula With Intraspinal Drainage Cavernous Malformation Spinal Artery Aneurysm Spinal Cord Infarction Subarachnoid Hemorrhage Spontaneous Epidural Hematoma Subdural Hematoma Bow Hunter Syndrome Vertebral Dissection Carotid Dissection Fibromuscular Dysplasia SECTION 10: COMPLICATIONS Complications Overview Myelography Complications Vertebroplasty Complications Failed Back Surgery Syndrome Epidural Abscess, Postop Disc Space Infection Meningitis CSF Leakage Syndrome Pseudomeningocele Direct Cord Trauma Vascular Injury Epidural Hematoma, Spine Instrumentation Failure Bone Graft Complications rhBMP-2 Complications Heterotopic Bone Formation Recurrent Disc Herniation Peridural Fibrosis Arachnoiditis/Adhesions Arachnoiditis Ossificans Accelerated Degeneration Postsurgical Deformity Radiation Myelopathy SECTION 11: REMOTE COMPLICATIONS Remote Complications Overview Donor Site Complications Deep Venous Thrombosis Pulmonary Embolism Aspiration Pneumonia Acute Myocardial Infarction Cerebral Infarction Cerebellar Hemorrhage Intracranial Hypotension Extraaxial Hematoma, Brain Retroperitoneal Hemorrhage Retroperitoneal Lymphocele Ophthalmic Complications Esophageal Perforation Acute Pancreatitis Pseudomembranous Colitis (Clostridium difficile) Rhabdomyolysis Bowel Perforation Ureteral Trauma SECTION 12: DIFFERENTIAL DIAGNOSIS Basilar Invagination Basilar Impression Cranial Settling Platybasia Intrinsic Skull Base Lesion Foramen Magnum Mass SECTION 13: PERIPHERAL NERVE AND PLEXUS Normal Plexus and Nerve Anatomy Superior Sulcus Tumor Thoracic Outlet Syndrome Muscle Denervation Brachial Plexus Traction Injury Idiopathic Brachial Plexus Neuritis Traumatic Neuroma Radiation Plexopathy Peripheral Nerve Sheath Tumor Peripheral Neurolymphomatosis Hypertrophic Neuropathy Femoral Neuropathy Ulnar Neuropathy Suprascapular Neuropathy Median Neuropathy Common Peroneal Neuropathy Tibial Neuropathy SECTION 14: IMAGE-GUIDED PROCEDURES CERVICAL SPINE Medial Branch Block, Cervical Spine Facet Joint Injection, Cervical Spine Selective Nerve Root Block, Cervical Spine Epidural Steroid Injection, Cervical Spine THORACIC SPINE Medial Branch Block, Thoracic Spine Facet Joint Injection, Thoracic Spine Selective Nerve Root Block, Thoracic Spine Epidural Steroid Injection, Thoracic Spine LUMBAR SPINE Medial Branch Block, Lumbar Spine Facet Joint Injection, Lumbar Spine Selective Nerve Root Block, Lumbar Spine Epidural Steroid Injection, Lumbar Spine VERTEBRAL BODY Vertebroplasty Kyphoplasty Sacroplasty Vertebral Biopsy INTERVERTEBRAL DISC Percutaneous Discectomy Intradiscal Electrothermal Therapy Nucleoplasty Disc Aspiration/Biopsy PELVIS Pelvis Anatomy Sacroiliac Joint Injection Sacral Nerve Root Block Piriformis Steroid Injection

About the Author

Jeffrey S. Ross, MD is Professor of Radiology at the Mayo Clinic College of Medicine in Phoenix, AZ. He's a Consultant in the Neuroradiology Division of the Department of Radiology at the Mayo Clinic in Arizona

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