By Henry Vernon Crock A.O., M.D., M.S., F.R.C.S., F.R.A.C.S. (auth.)
"... i might suggest this e-book for an in-depth research of the lumbar backbone and its degenerative states ... tremendous valuable for the resident early in trainings as she or he makes an attempt to correlate the advanced anatomy of the lumbosacral zone with linked pathological states ...” magazine of Neurosurgery
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Additional resources for A Short Practice of Spinal Surgery
A A diagrammatic representation of the findings of S 1 nerve root canal stenosis at the L5/S 1 level in isolated disc resorption. 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.
It is often sufficiently severe to disturb sleep at night. The patient with limb pain due to internal disc disruption always finds difficulty in describing it as the limb pain differs remarkably from that described by patients with impingement neuralgia due to disc prolapse. Usually these limb pains are widespread and described as being deep inside it, having an intolerable aching character. When these patients first present for treatment, one may be unimpressed with their description of symptoms and struck by the complete absence of abnormal physical signs in many of them.
When low back pain is the dominant symptom, primary anterior interbody fusion at the affected level may be indicated (Fig. 29). The cause of the back pain in these cases is not related to nerve root canal and foraminal stenosis. It emanates from either the vertebral bodies, or the arthritic subluxed facet joints which are stressed by degrees of rotatory vertebral body instability, particularly with disc resorption at L4/L5 or L3/L4. 29. A lateral tomogram showing interbody fusion following anterior disc excision and autogenous bone grafting in a female aged 37 years with isolated disc resorption at the lumbosacral junction 30 Nerve Root Canal Stenosis ii) Technique of Lumbar Nerve Root Canal and Foraminal Decompressions at LS/S 1 Level The surgical approach to the LS/S1 interspace is described on pp.
A Short Practice of Spinal Surgery by Henry Vernon Crock A.O., M.D., M.S., F.R.C.S., F.R.A.C.S. (auth.)