Evidence-based diagnosis and treatment of cervical spine disorders

Neck pain from cervical spine disorders is the second-leading cause of musculoskeletal disorders. Neck pain can exist alone or with the presence of upper extremity symptoms. This review of evidence-based guidelines assists the provider in identifying and treating various cervical disorders.

Artificial disc replacement--evolutionary treatment for degenerative disc disease

Back pain is a common problem that affects the majority of people at some point in their lives. Most back pain is not serious, but back pain caused by injury and aging can result in chronic pain that can last months, years, or indefinitely. Arthrodesis (ie, spinal, fusion) has been the treatment of choice for symptomatic degenerative disc disease that has not responded to conservative treatment modalities. Artificial disc replacement is a more recent option that preserves spinal motion but also recreates the natural function of the disc. The history of artificial disc replacement surgery, preoperative preparation, the surgical procedure, and postoperative recovery are discussed.

Osteogenic sarcoma of the sacral spine: an interdisciplinary team challenge

A child with osteogenic sarcoma of the sacral spine has complex nursing and interdisciplinary team needs. The course of one patient is discussed, both from the patient and family's perspective and that of her inter-disciplinary care team. The need for a coordinated, holistic approach to care that involves advance planning, continual reassessment of goals, and clear communication among the team members and consulting services is clearly demonstrated.

Thoracoscopic spine surgery: current indications and techniques

The first report of thoracoscopic surgery was in 1910, after Jacobaeus used thoracoscopy to lyse tuberculous lung adhesions. However, it was not until the end of the century that Lewis (1991) recognized the value of thoracoscopic surgery, and Mack (1993) reported the application of video-assisted thoracic surgery (VATS) for spine surgery. VATS is still in its infancy and the application of this technology for spine surgery continues to rapidly expand. The current indications for thoracoscopic spine surgery include tissue biopsies, thoracic paravertebral abscess drainage and debridement, thoracic disc herniation excisions, anterior spinal release and/or fusion for spinal deformity, stabilization and fusion of thoracic and thoracolumbar fractures, corpectomy for vertebral tumors, and the placement of anterior spinal instrumentation with fusion. This article reviews these current indications for VATS--the technique and subsequent nursing implications.

Epidural abscesses of the spine: case comparisons

Epidural abscesses of the spine generally arise from staphylococcal infections that by hematologic spread or direct invasion affect the integrity of the vertebral column or meningeal coverings of the spinal cord. A case comparison approach highlights goal-oriented nursing interventions which assist the patient in the adaptation to and recovery from this unique central nervous system infection.