Pathology And Surgery Around The Vertebral Artery

This is the first comprehensive book about surgery on and around the vertebral artery all along its cervical and intracranial course. This vessel has been considered for long as out of surgical reach leaving many different pathologies not or incompletely treated. The surgical exposure and control of the vertebral artery not only permit to treat lesions of the vertebral artery wall or developed in contact to it but also to improve the access to the intervertebral foramen (tumors, osteophytes), to the anterior aspect of the spinal cord (tumors, spondylotic spurs), to the foramen magnum and to the jugular foramen. This book written by leading experts includes all aspects of vertebral artery surgery from anatomy to imaging, surgical techniques and pathologies; it is illustrated by many figures especially operative views and schematic drawings so that the beginner as well as the experienced surgeon find useful information. One of the editors of this book (B. GEORGE) was recently awarded the Olivecrona award for his work on the surgery of the vertebral artery.

Our common interest in surgery of the vertebral artery was born in 1976, when as residents in the same hospital, we attended an attempt by two senior surgeons to treat an aneurysm of the vertebral artery at the C 3 level. Long discussions had preceded this unsuccessful trial, to decide if surgery was indicated and to choose the surgical route. Finally a direct lateral approach was performed, but access was difficult and correct treatment was impossible, resulting in only partial reduction of the aneurysmal pouch. Following this experience, we decided to seek a regular and well defined approach for exposition of the vertebral artery. Review of the literature indicated some surgical attempts, but the descriptions did not give the impression of safety and reproducibility. No landmark on the described surgical route appeared sufficiently reliable. Henry's anatomical work (1917) gave the only accurate description on vertebral artery anatomy, and it became the basis for our work. When the same patient was referred again one year later, after a new stroke in the vertebro-basilar system, we had behind us repetitive experience on cadavers of an original approach to the distal vertebral artery.

Vascular surgery is a discipline that has grown by trial and error—and at its core is the process by which surgeons must decide when and how to mend vessels. With this invaluable resource, readers will benefit from the author’s years of surgical experience, thorough understanding of vascular anatomy and pathology, and keen surgical judgment. More than a procedural guide, the text represents a guide to decision-making—highlighting individual anatomy, patient screening, selection of procedure, surgical technique, avoidance of pitfalls, and management of potential complications.

Management of carotid and vertebral artery disease has undergone tremendous strides since the introduction of thin section CT angiography and neurointerventions. These minimally invasive techniques continue to evolve allowing great advantages for patients. In this book we will focus on both endovascular (minimally invasive) and open arterial reconstructions as both types of procedures are still very much part of routine practice in managing extracranial carotid and vertebral artery disease. This text is designed to be a comprehensive and state-of-the art approach in managing straight forward to complex arterial reconstructions. Sections will focus on carotid/vertebral anatomy, physiology, diagnostic modalities. Subsequent chapters will focus on specific disease processes and their management with best medical therapy neurointerventions (carotid artery stenting) and open reconstructions like carotid endarterectomy and arterial reconstructions for vertebral artery disease. In addition, management of extracranial carotid artery aneurysms, carotid body tumors and carotid trauma will be covered in detail. Modern techniques in rehabilitation practice for stroke patients will also be addressed. The authors will be recognized experts in their field, whether an acknowledged academic leader or a well respected community based surgeon. Each chapter dealing with clinical pathology will address patient selection, preoperative considerations, technical steps for operation and emphasis on avoiding complications. Management of common complications related to each procedure will be outlined in a step-wise fashion. Pertinent case illustrations will be described in short at the end of the chapter. Figures and illustrations will help the reader in grasping the technique of a particular procedure.

Vascular Neurology, Vascular Neurosurgery and Interventional Neuroradiology are independent fields with dedicated Training Programs. Neuroimaging, and in particular what we call "Neurovascular Imaging" is a unifying factor which can be considered the intersection of these three medical specialties. With this book we aim to cover thoroughly the imaging techniques, potentialities, and present and future applications as applied to all the vascular diseases of the central nervous system from the imaging point of view. This book will comprise eight main sections: (1) The Basics, (2) Arteries of the Head and Neck (3) The basics of Intracranial Arteries (4) Diseases of the vessels (5) Stroke Imaging (6) Veins Imaging (7) Spine Imaging (8) Pediatrics.

A comprehensive review of vascular disease in the vertebrobasilar circulation by one of the world's leading authorities, fully updated throughout.

Unique in the field, Comparative Management of Spine Pathology presents commonly encountered spinal cases with side-by-side, case-by-case comparisons that clearly show how various experts would handle the same case. This second volume in the Neurosurgery: Case Management Comparison Series offers multiple opinions from international experts in both neurosurgery and orthopaedics, each of whom explains their preferred approach and management style for the same case. This format allows for quick and helpful comparisons of different ways to approach a lesion, advantages and disadvantages of each approach, and what each expert is looking for in how they would manage a particular case. Offers 4 expert opinions on each case in a templated format designed to help you quickly make side-by-side comparisons—an ideal learning tool for both trainee and practicing neurosurgeons and orthopaedic surgeons for board review and case preparation. Helps you easily grasp different approaches to spine management with different expert approaches to the same case and summaries from the editors on the advantages and disadvantages to each approach. Features a wide variety of management decisions, from preoperative studies to surgical approach, surgical adjuncts, and postoperative care, from experts in the field who specialize in different aspects of spine surgery. Presents 70 cases in the areas of degenerative spine, traumatic spine, spinal deformity, spinal oncology, and miscellaneous topics such as epidural abscess, osteomyelitis, and post-instrumentation infection.

The latest management strategies for complex lesions of the craniovertebral junction Written by masters in the field, The Craniovertebral Junction: Diagnosis, Pathology, Surgical Techniques provides in-depth coverage of up-to-date management principles for this delicate anatomic region. After a brief introduction to anatomy, biomedical considerations, and embryology, the multidisciplinary team of authors, led by Professor Goel, discusses in detail the most innovative fixation and stabilization techniques for atlantoaxial dislocation, as well as congenital,infective, and acquired anomalies in the craniovertebral junction region. Each concise chapter focuses on a single pathology to guide readers through the nuances of these intricate and demanding surgical procedures. Features: Discusses in detail Professor Goel's groundbreaking treatment methods - now accepted as standards in the field Covers state-of-the-art protocols and techniques, including alternative treatment protocols for irreducible and rotatory atlantoaxial dislocation and more Introduces a novel concept of craniovertebral realignment Over 1,000 high-quality drawings, radiographs, and full-color photographs demonstrate surgery and anatomy and enhance the text Contains a full section Casebook featuring 22 well-illustrated cases displaying a wealth of pathology Text is rounded out by practical advice on how to manage trauma, degenerative disorders, infections, and tumors This fully illustrated manual fills the current gap in craniovertebral junction literature with the clear, accessible information every neurosurgeon, orthopedic surgeon, and spine surgeon needs.