Percutaneous lumbar discectomy is a new surgical method for treating lumbar disc diseases. The goal of the procedure is decompression of the spinal nerve root by percutaneous removal of the nucleus pulposus under local anesthesia. Probably 20 % of all patients requiring lumbar disc surgery can be successfully treated by this method. During the past two years, percutaneous discectomy has spread rapidly, and it is now performed in most clinical departments engaged in spinal surgery. The first International Symposium on Percutaneous Lumbar Discectomy, held in Berlin in August 1988, covered all current procedures known as "percutaneous discectomy" and the entire range of percutaneous techniques, both clinical and experimental. Its publication is important because of the recency of this new surgical procedure, the outstanding experience of the speakers - including the Japanese, American, and European "pioneers" of the technique - and last but not least the gaps in the knowledge of physicians concerning this topic. This procedure opens up new perspectives in the surgical treatment of degenerative diseases of the lumbar spine.

Joint replacement is a logical step in the treatment of severe joint pathologies with irreversible lesions resisting conservative therapy. At the spinal level, arthrodesis became, very early, the gold standard of treatment for severe intervertebral disc pathologies. The next logical step was to envision functional replacement, and this step was taken as early as 1956, when the first intervertebral implant was described. However, it took many more years and a great variety of proposed implant designs before clinical applications could be attempted.

Don t miss it The second, completely revised and expanded edition of the successful surgical manual on minimally invasive spine surgery includes 51 chapters (including more than 20 new chapters) covering all current minimally invasive techniques in spine surgery. A complete survey of all microsurgical and endoscopic techniques with a special focus on semi-invasive injection techniques for diagnostic and therapeutic purposes in low back pain is given. The clear chapter structure with terminology, history, surgical principles, advantages/disadvantages, indications, access principles, complications, and results facilitates navigation through the manual. Topics include the principles of microsurgical and endoscopic treatment, spinal navigation and computer-assisted surgery, minimally invasive reconstruction, fusion, dynamic stabilization in fractures, degenerative disc disease, spinal stenosis, low back pain and deformities. The didactic presentation of surgical steps makes the reader familiar with all types of new minimally invasive techniques in clinical use or still in ongoing clinical trials such as minimally invasive spine arthroplasty."

In this book, leading international specialists in the field join forces to discuss topics, issues and approaches that are of key importance in the optimal treatment of lumbar degenerative disk disease. The coverage is wide ranging, from current understanding of physiopathology and genetics and modern imaging techniques through to the diverse minimally invasive, non-fusion, and fusion surgical techniques. Detailed attention is drawn to the most important aspects to be considered when approaching the patient and making treatment decisions. The role of conservative management is appraised, and surgical techniques and their indications are carefully described. In the concluding section, some of the top specialists from across the world reflect on the lessons that they have learned during lifetimes in spinal surgery. Advanced Concepts in Lumbar Degenerative Disk Disease will be an instructive and fascinating source of information for all spine surgeons and other spine care providers.

The Spine: Medical and Surgical Conditions is a complete, two volume, evidence based study edited by an internationally recognised team of spine surgeons based in the USA, China, Canada, Germany, Japan, Brazil, Egypt and India. The two volumes are divided into 137 chapters, across fourteen sections. The first section covers general topics in spinal medicine, including anatomy, biomechanics, physical and neurological examination, interventional diagnostics and therapeutics, and anaesthesia. This is followed by sections on the development of the spine, metabolic disorders, and bone grafting. Subsequent sections focus on surgery for particular parts of the spine, including cervical, lumbar and thoracic, as well as sections on spinal cord injuries and motor preservation. Later sections in the book provide information on the spine in paediatrics, adult deformity, tumours, vascular malformations and infections, complications of spinal surgery, and a final section on minimally invasive techniques. Enhanced by 1500 full colour images, The Spine: Medical and Surgical Conditions is also made available online, complete with text, images and video, with each physical copy. Key Points Comprehensive, two volume guide to spinal medicine Covers anatomy, biomechanics, examination, diagnostics, therapeutics, anaesthesia, surgery and complications Enhanced by 1500 full colour images Includes access to online version with complete text, images and video

Low back pain is a very common problem that is increasingly being treated surgically. This book aims to evaluate carefully the possible surgical approaches to low back pain, with detailed appraisal of the factors leading to their success or failure. It begins by explaining the scientific basis for surgery and considering the different diagnostic techniques that may be employed, thereby elucidating the surgical rationale, indications, and contraindications. The value of conservative options is also assessed to help the reader weigh the need for surgery. The various surgical modalities, including the most recent, are then fully described and evaluated with the aid of numerous illustrations. The book concludes with a chapter devoted to evidence-based analysis of the outcome of surgery in patients with low back pain. This book will be invaluable to orthopaedic and neurosurgeons, rheumatologists, neurologists, and all who are concerned with the effective treatment of this often debilitating condition.

Had we ever guessed the historical importance of this day, had we expected the impressive and touching episode of German history that took place on November 9, 1989, had we dared to hope that a dream three decades old would come true on precisely that day, we would have held our symposium in the immediate vicinity of the Branden burg Gate! While it is difficult to describe the atmosphere on that evening, when the news suddenly spread that "the wall had opened", it is almost impossible to describe the feeling of fraternity and sense of belonging that overcame everyone, a feeling that had been repressed (but never suppressed) for three decades! Berlin M. BROCK H. M. MAYER K. WEIGEL Contents Introductory Remarks M. BROCK, H. M. MAYER and K. WEIGEL. . . . . . . . . . . . . . . . . . . 1 . . . . Functional Anatomy of the Lumbar Spine R. LOUIS (With 4 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . . . . . . . . Implant Materials H. STALLFORTH, W. WINKLER-GNIEWEK and M. UNGETHUM (With 4 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 . . . . . . . . . . . Performance of Alloplastic Materials and Design of an Artificial Disc H. J. SCHMITZ, B. KADEN, R. T. FRITZ, U. GROSS and G. FUHRMANN (With 9 Figures) . . . . . . . . . . . . . . . . . . . . . 23 . . . . . . Intradiscal Implants in 1989: Concepts and Possibilities J . A. N. SHEPPERD (With 4 Figures) . . . . . . . . . . . . . . . . . . . . . 35 . . . . . . . Intradiscal Polymerization: Preliminary Results of Chemical and Biomechanical Studies A. GARCIA, B. LAVIGNOLLE, P. MORLIER, D. DUCASSOU and C. BAQUEY (With 2 Figures) . . . . . . . . . . . . . . . . . . . . . . . 39 . . . . . . . Intervertebral Implants for Fixation and Disc Replacement J. A. N. SHEPPERD (With 6 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Lumbar Interbody Threaded Prostheses C. D. RAY (With 5 Figures) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .