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Pitfalls Related to Inadequate or Incomplete Surgical Technique and Errors of Level

  • Luca DenaroEmail author
  • Rocco Papalia
  • Nicola Maffulli
  • Vincenzo Denaro

Insidious pitfalls of cervical spine surgery include the incomplete or inadequate surgical technique. Inadequate decompression is one of the most common reasons for failed spinal surgery [11]. Both traditional and the more recent minimally invasive techniques may be not suffi-cient to obtain adequate decompression of the myelora-dicular structures [9]. In particular, increased rates of incomplete decompression have been demonstrated with minimally invasive procedures [12, 14].

Understanding the common sites where neural impingement occurs in the cervical spine, correlating patient's symptoms to these changes recognized on imaging studies help provide a preoperative template for thorough decompression [11]. A thorough preoperative assessment of the patient, evaluation of the sagittal alignment of the cervical spine, of any static and dynamic causes of compression, instability (if present), identification of the location of the compression, and diagnosis of the compressive lesion help the surgeon to minimize technical errors [11]. The most important concept regarding inadequate decompression is to avoid it with careful preoperative planning of the index procedure [11]. Before considering surgical intervention, the surgeon should have a complete understanding of the indications for surgery and should have conducted a thorough physical examination and evaluation of radiologic and electro-physiological studies.

Keywords

Cervical Spine Surgery Basilar Invagination North American Spine Society Functional Overload Preoperative Template 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  • Luca Denaro
    • 1
    Email author
  • Rocco Papalia
    • 2
  • Nicola Maffulli
    • 3
  • Vincenzo Denaro
    • 2
  1. 1.Department of NeuroscienceUniversity of PaduaPaduaItaly
  2. 2.Department of Orthopaedic and Trauma SurgeryCampus Bio-Medico UniversityRomeItaly
  3. 3.Barts and The London School of Medicine and DentistryMile End HospitalLondonEngland

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