By Henry Vernon Crock A.O., M.D., M.S., F.R.C.S., F.R.A.C.S. (auth.)
"... i'd suggest this ebook for an in-depth research of the lumbar backbone and its degenerative states ... tremendous useful for the resident early in trainings as she or he makes an attempt to correlate the advanced anatomy of the lumbosacral quarter with linked pathological states ...” magazine of Neurosurgery
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Additional info for A Short Practice of Spinal Surgery
Note the use of the curved pointed end of the Watson -Cheyne dissector being used to free the soft tissues anterior to the medial edge of the S 1 facet. b Note the disposition of the sucker and pattie and the use of a 45 degree forward angled fine cup pituitary punch to excise the apical portion of the facet of S 1. This manoeuvre can be carried out as depicted in tHis drawing from the left side of the laminal interspace or from below and on the right, the tip of the instrument passing beneath the interspinous ligament from the right to the left side of the spinal canal posterior to the dural sac.
41 a, b). The use of myelography in the diagnosis of these problems is recommended and typical changes, with gross local deformity, can be seen in a number of the miscellaneous causes referred to in this text (Figs. 42 a, b). However, it is very important to recall that the myelogram may be reported as normal in many of these cases especially if root oedema has not been identified. The surgeon must then fall back on his clinical assessment of the patient, aided by plain X-ray findings, while deciding whether or not to recommend surgical treatment in a particular case.
These veins are shown refilled after the operative procedure which is designed to relieve symptoms in this condition (Figs. 25). The deep seated buttock and thigh pain in these patients which comes on after standing or sitting is a form of nerve root claudication due to this venous obstruction. 25. A drawing depicting the view from within the spinal canal after foraminal and nerve root canal decompressions. The ligamentum flavum has been totally excised. A stippled green and black outline indicates the extent of bony excision of the superior facet of S 1 and of the bony ridge on the anterior aspect of the lamina of L5 at the level of the upper attachment of the ligamentum flavum.