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Ramey WL, Altafulla J, Yilmaz E, Ishak B, Jack A, Litvack ZN, Oskouian RJ, Tubbs RS, Chapman JR. The ABC's of Spinal Decompression: Pearls and Technical Notes. World Neurosurg 2019; 129:e146-e151. [PMID: 31102772 DOI: 10.1016/j.wneu.2019.05.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The foundation of spine surgery centers on the proper identification, decompression, and stabilization of bony and neural elements. We describe easily reproducible and reliable methods for optimal decompression and release of neural structures to alleviate symptoms and improve patients' quality of life. METHODS Multiple spinal decompression techniques were described in procedures for which the goal of surgery was decompression alone or decompression and fusion. Eight fundamental techniques were described: inverted U-cut, J-cut, T-cut, L-cut, Z-cut, I-track cuts, C-cut, and O-cut. RESULTS These foundational cuts may be combined, as needed, to develop an individually tailored approach to the patient's pathology. CONCLUSIONS After properly identifying the anatomic structures, each of these techniques provides a consistent, reproducible, and efficient means to decompress the spine under various circumstances. These techniques provide surgical trainees with a framework for approaching surgical decompression.
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Affiliation(s)
- Wyatt L Ramey
- Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Juan Altafulla
- Department of Neuroanatomy, Seattle Science Foundation, Seattle, Washington, USA; Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Emre Yilmaz
- Department of Neuroanatomy, Seattle Science Foundation, Seattle, Washington, USA; Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Basem Ishak
- Department of Neuroanatomy, Seattle Science Foundation, Seattle, Washington, USA; Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Andrew Jack
- Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Zachary N Litvack
- Department of Neuroanatomy, Seattle Science Foundation, Seattle, Washington, USA; Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - Rod J Oskouian
- Department of Neuroanatomy, Seattle Science Foundation, Seattle, Washington, USA; Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA
| | - R Shane Tubbs
- Department of Neuroanatomy, Seattle Science Foundation, Seattle, Washington, USA; Department of Anatomical Sciences, St. George's University, St. George's, Grenada, West Indies
| | - Jens R Chapman
- Department of Neurosurgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington, USA.
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