Decompression in athletes, 420 for C5-C6 disc herniation, 167

Decompression (Continued) before cervical osteotomy, 485 classification of problems after procedure, 240t complications of, 345 computed tomography following, 95, 96f in degenerative spondylolisthesis, 363, 364f indications for, 152 interlaminar, 345

before lumbar osteotomy, 486-487 for lumbar spinal stenosis, 343-344, 344f, 345 pain-free interval following procedure, 238 procedures for, 165-170 revision surgery after prior, 239 for sacral fractures, 401 for spinal cord injury, 376 for spondylolisthesis, 266, 266f of stenosis from burst fracture, 392 transoral, 167 Deep vein thrombosis, 233 Degenerative cascade, 314 Degenerative disc disease, lumbar, 337-341 clinical presentation, 337 subtypes of, 338

treatment options, 338, 339t, 340-341 Degenerative spinal disorders cervical, 316-324

pathophysiology and pathoanatomy of, 311-315 scoliosis, 347-353

spondylolisthesis, 361-364, 362f, 364f Degree of slip, 263, 263f Demineralized bone matrix, 506 Denis classification of sacral fractures, 400, 400f of thoracic and lumbar fractures, 388 Denosumab, for osteoporosis, 453 Dens-basion interval, 369 Dependence, 114 Derangement syndrome, 107-108 DEXA. See Dual energy x-ray absorptiometry Diabetes mellitus, surgical risks and, 163 Diaphragm, innervation of, 19 Diastematomyelia, 292-293, 430 Diffuse idiopathic skeletal hyperostosis (DISH) ankylosing spondylitis compared, 481, 482f cervical spine injuries and, 384 Disability

American with Disabilities Act (ADA), 62 cost of, 60-61 defined, 59-60, 109

evaluation compared to impairment evaluation, 60

Social Security Disability (SSD), 60 workers' compensation, 60 Disability syndrome, 330 Disc arthroplasty cervical, 491 lumbar total, 491-494 Disc degeneration changes in disc biochemistry, 313 facet degeneration and, 313 genetics of, 314-315 Discectomy anterior, 166-167, 166f, 318-319, 319t artificial disc replacement, 167

Discectomy (Continued) for cervical disc herniation anterior, 318-319, 319t posterior, 317, 318f thoracic, 327 Disc herniation in athletes, 420 cervical anterior discectomy and fusion, 318-319, 319t disorder evaluation, 36

posterior foraminotomy and discectomy, 317, 318f surgery indications, 153 traumatic, 411 treatment options, 317 lumbar, 332-336 discectomy, 335-336, 335f localizing, 334, 334f spine evaluation, 44 surgical approaches, 336, 336f surgical indications, 335 surgery indications, 153 surgical indications, 335 thoracic, 325-328 disorder evaluation, 41 surgical approaches, 325-326, 327f treatment approach, 326-327 varieties of, 333f Discitis childhood, 254

magnetic resonance imaging (MRI), 89f vertebral osteomyelitis compared, 254 Discogenic pain, 120, 124, 126

low back pain, 337-341 Discography, 66 complications of, 126 lumbar, 125f, 337

for presurgical patient evaluation, 238 provocative controversy surrounding, 126 described, 124-125 diagnosis based on, 126 types of, 125f

Disc space infection, magnetic resonance imaging (MRI) of, 89

DISH. See Diffuse idiopathic skeletal hyperostosis Disseminated intravascular coagulation (DIC), 229 Dorsal column tracts, 14, 14f assessment in spinal cord injury, 49 Down syndrome, cervical instability in, 259 Dual energy x-ray absorptiometry (DEXA), 66 bone mineral density determination, 452 limitations of, 452-453 of osteoporotic compression fracture, 457 Duchenne muscular dystrophy, scoliosis associated with, 288 Dural tears, 235

Dynamic stabilization, 210, 210f Dysfunctional syndrome, 107-108 Dysphagia, after cervical surgery, 182

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