Ortho Oracle - orthopaedic operative atlas

Section 10, Chapter 7: Transcutaneous Electrical Nerve Stimulation (TENS) for Low Back Pain

Peter Gladwell, Shea Palmer, and Fiona Cramp WHAT IS TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS)? Transcutaneous electrical nerve stimulation is a portable, inexpensive and low risk form of electrostimulation, typically delivered via self-adhesive pads or carbon rubber pads with conducting gel that are attached over the area of pain. TENS has been defined as “the delivery … Read more

Section 10, Chapter 8: What Psychological Interventions Are Available for People with Spinal Pain, and What Is the Current Evidence on Them?

Tamar Pincus and Chris Main WHY ARE PSYCHOLOGICAL INTERVENTIONS RELEVANT TO PEOPLE WITH SPINAL PAIN? As technology and communication of scientific findings improve, so grows the consensus that the experience of pain needs to be understood and treated within the conceptual framework of the biopsychosocial model. This approach is supported by a plethora of studies … Read more

Section 11, Chapter 5: Lateral Approaches to the Lumbar Spine

Nicolas Plais, MD and Federico P. Girardi, MD INTRODUCTION/CONCEPTS In 2003,1 Bertagnoli et al. described the transpsoas approach to access the retroperitoneal lumbar spine. In 2006,2 Ozgur et al. described a minimally invasive technique for anterior lumbar interbody fusion with less morbidity than the classic retroperitoneal approach. Today, lateral lumbar interbody fusion (LLIF) is a … Read more

Section 11, Chapter 9: Pedicle Screw Fixation and Design

Helton Defino, Fabio Galbusera, Hans-Joachim Wilke HISTORICAL DEVELOPMENT Pedicle screw fixation represents a landmark in the field of spinal surgery. In view of the biomechanical advantages of pedicular fixation systems, which provide more tridimensional stability to the vertebral segment with a small area of instrumentation, even in the absence of posterior vertebral elements, and improves … Read more

Section 11, Chapter 14: Navigation in Spine Surgery

Rajasekaran, S. Dilip Chand Raja, and Ajoy Prasad Shetty INTRODUCTION Pedicle screws with its capability to achieve three-column fixations and higher fusion rates have revolutionized the use of instrumentation in spine surgery. They provide good biomechanical anchorage by achieving three-column fixations and, therefore,permits the surgeon to avoid long segment fixations.Theyare now used in a wide … Read more

Section 12, Chapter 2: Psychosocial Factors and Effects on Low Back Management

Xavier F. Jimenez and Sara Davin INTRODUCTION Pain is an experience that is perceived by the brain and is indisputably modifiable by psychological components, including but not limited to emotions and beliefs. Actual physical tissue or nerve damage is neither necessary nor sufficient for the perception of pain. Anger, depression, anxiety, fear and other psychological … Read more