Table Of ContentRevision Spine Surgery
Pearls and Pitfalls
Revision Spine Surgery
Pearls and Pitfalls
Edited by
Gregory D. Schroeder, MD
Assistant Professor of Orthopaedic Surgery at Thomas Jefferson University,
Spine Surgeon at The Rothman Institute,
Philadelphia, Pennsylvania
Ali A. Baaj, MD
Associate Professor of Neurological Surgery
Co-Director, Spinal Deformity and Scoliosis Program, Weill Cornell Medical
College, New York-Presbyterian Hospital, New York City, New York
Alexander R. Vaccaro, MD, PhD, MBA
Richard H. Rothman Professor and Chairman,
Department of Orthopaedic Surgery, Professor of Neurosurgery,
Co-Director, Delaware Valley Spinal Cord Injury Center,
Co-Chief of Spine Surgery,
Sidney Kimmel Medical Center at Thomas Jefferson University,
President, Rothman Institute, Philadelphia, Pennsylvania
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Library of Congress Cataloging-in-Publication Data
Names: Vaccaro, Alexander R., editor. | Baaj, Ali A., editor. | Schroeder, Gregory D., editor.
Title: Revision spine surgery : pearls and pitfalls / edited by Alexander R. Vaccaro, Ali Baaj, Gregory D. Schroeder.
Other titles: Revision spine surgery (Vaccaro)
Description: Boca Raton : CRC Press, 2019. | Includes index.
Identifiers: LCCN 2019010037| ISBN 9781498773829 (hardback : alk. paper) | ISBN 9780429188848 (e-book)
Subjects: | MESH: Spine--surgery | Reoperation--methods | Spinal Diseases--surgery
Classification: LCC RD768 | NLM WE 725 | DDC 617.4/82--dc23
LC record available at https://lccn.loc.gov/2019010037
Visit the Taylor & Francis Web site at
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This book is dedicated to my wife Katie, and our three sons, Leo, Henry and Grant. Your support is an
incredible gift that I am blessed to have.
Gregory D. Schroeder
This book is dedicated to my beautiful daughter, Hannah, who has filled our hearts with endless joy.
Ali A. Baaj
This book is dedicated to my nephew Luke Vaccaro. There is a wise saying that the meaning of life is to find
your gift and the purpose of life is to give that gift away. Luke your gift is your courage, tenacity, resiliency
and love for family. Your parents are proud of you and you will always be a role model for your younger
brother Drew.
Alexander R. Vaccaro
Contents
Video list xi
Contributors xiii
GENERAL 1
1 The approach to revision procedures 3
Joseph A. Weiner and Wellington K. Hsu
2 How to dissect the plane between the scar of a laminectomy defect in the posterior
cervical spine 13
Ken Ishii
3 How to dissect the plane between the scar of a laminectomy defect in the posterior
thoracic and lumbar spine 19
Nickul S. Jain and Raymond J. Hah
4 Local muscle flaps in the setting of revision spine surgery: Indications, operative planning,
principles, and postoperative management 27
Briar L. Dent, Jaime L. Bernstein, and Jason A. Spector
5 Revision and reimplantation of a spinal cord stimulator device 35
Fadi Al-Saiegh, John M. DePasse, Francis J. Sirch IV,
Gregory D. Schroeder, and Chengyuan Wu
PARt 1 ANtERIOR CERVICAL 39
6 Revision ACDF at the same level 41
Fadi Al-Saiegh, George M. Ghobrial, and James S. Harrop
7 Revision ACDF: Adjacent level 47
Courtney Pendleton, Matthew S. Galetta, and Jack Jallo
8 Converting a total disc replacement to an ACDF 51
Joseph D. Smucker and Rick C. Sasso
9 Treatment of adjacent segment disease after total disc replacement (TDR) 59
Bruce V. Darden II
vii
viii Contents
PARt 2 POStERIOR CERVICAL 65
10 Revision suboccipital decompression for complex Chiari malformation 67
Jacob L. Goldberg, Ibrahim Hussain, Ali A. Baaj, and
Jeffrey P. Greenfield
11 How to revise a failed occipital cervical fusion 77
Joshua T. Wewel, Mazda K. Turel, Joseph E. Molenda, and
Vincent C. Traynelis
12 How to revise a failed C1–C2 fusion 83
Nizar Moayeri and Michael G. Fehlings
13 Treatment of postlaminectomy kyphosis 89
Christopher T. Martin and John M. Rhee
14 Revision of failed posterior cervical fusions 101
Trevor Mordhorst, Vadim Goz, and William Ryan Spiker
15 Complications necessitating surgical intervention following cervical laminoplasty 109
Michael J. Moses, Amos Z. Dai, and Themistocles S. Protopsaltis
PARt 3 tHORACIC/tHORACOLUMBAR SPINE 115
16 Revision surgery for proximal junctional kyphosis following thoracolumbar fusion 117
Sundeep S. Saini, Daniel Cataldo, Christopher R. Cook, Hamadi Murphy,
Paul W. Millhouse, and Kris Radcliff
17 Pedicle subtraction osteotomy (PSO) nonunion revision 127
Jason W. Savage
18 Treatment of a nonunion of a thoracolumbar deformity, not at the site of a three-column
osteotomy 133
Randall B. Graham, Tyler R. Koski, and Patrick A. Sugrue
19 How to safely remove a pedicle screw abutting the aorta 145
Kevin Savage, Paul W. Millhouse, Hamadi Murphy, Gregory D. Schroeder,
and Alexander R. Vaccaro
PARt 4 LUMBAR SPINE 149
20 Revision of an anterior lumbar interbody fusion (ALIF) nonunion 151
Edward Delsole, Rishi Sharma, and Gregory D. Schroeder
21 How to revise nonunion of a lateral lambar interbody fusion (LLIF) through a lateral approach 155
Heeren S. Makanji, Jacqueline Koomson, Dhruv K.C. Goyal, and
Gregory D. Schroeder
22 How to surgically manage a recurrent lumbar herniated nucleus pulposus (HNP) 161
Taylor Paziuk, Matthew S. Galetta, and Jeffrey A. Rihn
23 How to perform revision lumbar decompression 167
Jacob Hoffman, Ryan Murphy, Mark L. Prasarn, and
Shah-Nawaz M. Dodwad
24 How to perform revision lumbar decompression at the index level through a minimally
invasive (MIS) approach 173
Aaron Hillis, Christoph Wipplinger, Sertac Kirnaz, Franziska A. Schmidt, and
Roger Härtl
Contents ix
25 How to revise a transforaminal lumbar interbody fusion (TLIF) nonunion with recurrent
stenosis at the index level (open) 183
Jesse E. Bible and Gregory Pace
26 How to revise a minimally invasive transforaminal lumbar interbody fusion (MIS TLIF)
nonunion with recurrent stenosis at the index level through an MIS approach 191
Fady Y. Hijji, Ankur S. Narain, Gregory D. Lopez, Krishna T. Kudaravalli,
Kelly H. Yom, and Kern Singh
27 How to revise a posterior lateral decompression and fusion at the index level 199
Fadi Sweiss, Cristian Gragnaniello, Anthony J. Caputy, and Michael Rosner
28 How to revise a posterior lumbar fusion that has developed adjacent-level stenosis with
or without instability 205
Patrick Curry and Mark F. Kurd
29 Flat back deformity revision surgery 211
Jefferson Wilson, Matthew S. Galetta, and Srinivas Prasad
30 Revision high-grade spondylolisthesis surgery 217
Peter D. Angevine
31 Management of a ventrally displaced graft following ALIF, TLIF or DLIF 223
Dhruv K.C. Goyal, Heeren S. Makanji, Gregory D. Schroeder, and
Brian W. Su
PARt 5 SPECIAL CASES 229
32 Treatment of symptomatic cervical and lumbar pseudomeningocoeles 231
Joshua E. Heller and George Rymarczuk
33 Treatment of a persistent cervical dural tear 241
Jessica L. Block and D. Greg Anderson
34 Treatment of a ventral thoracic dural defect 245
Ibrahim Hussain, Peter F. Morgenstern, and Ali A. Baaj
35 Treatment of a persistent lumbar dural tear 251
Joseph S. Butler, Matthew S. Galetta, and Barrett I. Woods
36 Treatment of a chronic postoperative cervical and lumbar spine infection 255
Kamil Okroj and Christopher Kepler
Index 261
