Rehabilitative Surgery

 

Description:

This book represents the first interdisciplinary text on the emerging field of rehabilitative surgery, in which state of the art procedures from multiple surgical specialties are combined. It proposes a completely new framework for understanding, coordinating, and providing treatment for paralyzed or severely neurologically impaired patients and explains the potentially critical impact of surgery in creating a new baseline of functional status, thereby improving the patient’s daily life. Every major aspect of reconstructive surgical treatment is considered, including anesthesia, orthopedic surgery, plastic surgery, neurosurgery, general surgery, vascular surgery, and otolaryngology. The most up-to-date and evidence-based surgeries are clearly described and evaluated, with coverage of treatment of pressure sores, placement of feeding tubes, and upper extremity interventions to improve function and hygiene. Cutting-edge protocols are presented for the surgical treatment of severe nerve injuries, spinal cord injuries, and stroke or cerebrovascular accidents, and a first description and evaluation of phrenic nerve repair to assist weaning of paralyzed patients from ventilators is provided. Both surgical and nonsurgical readers will find this book to be an ideal guide and reference.

 

 

Table of Contents:

 

Part I: Introduction

1: Introduction to Rehabilitative Surgery

2: Introduction to Surgical Principles

Surgical Metabolism and Nutrition in the Surgical Patient

Inflammation and Injury

Wound Healing

Surgical Technique

Antiseptic Technique

Sutures

Types

Techniques

Complications

Drains

Surgical Complications

Infections

Hernias

Fistulas

Marjolin’s Ulcer

References

Part II: Anesthesia

3: Anesthetic Considerations in Rehabilitative Surgery

Introduction

Autonomic Dysreflexia

Preoperative Evaluation

Cardiovascular System

Respiratory System

Genitourinary System

Musculoskeletal System

Thermal Regulation

Psychological Issues

Intraoperative Considerations

Intraoperative Monitoring

Anesthetic Considerations

General Anesthesia

Induction

Maintenance

Emergence

Spinal and Epidural Versus Regional Anesthesia

Treatment of Autonomic Hyperreflexia

Special Cases: Peripheral Nerve Reconstruction

Postoperative Considerations

Postanesthesia Care

Long-Term Care

Acute Pain Management

Summary

References

4: Deep Venous Thrombosis in the Operative Rehabilitation Patient

References

Part III: Pain Management

5: Evaluation and Management of Chronic Pain

Introduction

What Is Pain?

Diagnostic Workup

Treatment Strategies

Medication Management

Physical Medicine Modalities

Psychological Approaches

Cognitive and Behavioral Approaches

Interventional Pain Management

Epidural Steroid Injections

Epidural Infusions of Local Anesthetics

Sympathetic Ganglion Blocks

Vertebroplasty and Kyphoplasty

Minimally Invasive Lumbar Decompression

Neuromodulation

Spinal Cord Stimulation

Novel Targets and Frequencies

Intrathecal Drug Therapy

Summary

References

Part IV: Nervous System and Spine

6: Neurosurgical Overview

Cerebrovascular Disease

Stroke Overview

Cerebral Ischemia or Cerebral Infarction

Hemorrhagic Stroke

Pathophysiology of Ischemic Stroke

Presenting Symptoms of Ischemic Stroke

Evaluation and Management of Ischemic Stroke

Pathophysiology, Evaluation, and Management of Spontaneous Intracerebral Hemorrhagic Stroke

Cerebrovascular Lesions Causing Intracranial Hemorrhage

Aneurysmal Subarachnoid Hemorrhage (SAH)

Arteriovenous Malformations (AVM)

Cavernous Malformation (Cavernoma)

Brain Tumors

Introduction

Advances in Operative Technique and Treatment Options

Intracranial Tumor Types and Treatment Considerations

Postoperative Management of Brain Tumor Patients

Adult Cranial Neurosurgery: Developmental Disorders and Hydrocephalus

Neurosurgical Infections

Introduction

Cerebral Abscess

Subdural Empyema

Parasitic Infections

Viral Encephalitis

Fungal Infection

Spinal Epidural Abscess

Shunt Infection

Postoperative Infection

Traumatic Brain Injury (TBI)

TBI Overview

Concussion

Contusion

Traumatic Subarachnoid Hemorrhage

Epidural Hematoma

Subdural Hematoma

Multicompartment Trauma

Late Complications/Delayed Deterioration

References

7: Neurologic Injury and Spasticity

Introduction to the Motor System

Lower Versus Upper Motor Neuron Injury

Spasticity

Clinical Features

Treatment

Physical Therapy

Oral Medications

Chemodenervation

Intrathecal Baclofen

Surgical Treatment

References

8: Electrodiagnostic Testing for Nerve Injuries and Repairs

Introduction

Part I: Preoperative Electrodiagnostic Testing

Part II Intraoperative Electromyography

Nerve Action Potentials

Stimulus-Triggered EMG

References

9: Spine Trauma

Introduction

Anatomy

Spine Trauma Overview

Epidemiology

Initial Care

Physical Examination

Neurologic Injury

Radiographic Evaluation

Plain Films

Cervical Spine

Thoracic and Lumbar Spine

Computed Tomography

MRI

Cervical Spine

Thoracic and Lumbar Spine

C-Spine Clearance

Cervical Spine Injuries

Outcomes

Postoperative Care

Thoracic and Lumbar Spine Injuries

Classification

Outcomes

Postoperative Care

References

Part V: Airway, Thorax and Abdomen

10: Phrenic Nerve Reconstruction for Diaphragmatic Paralysis and Ventilator Dependency

Introduction

Neuromuscular Anatomy and Physiology of the Respiratory System

Central Pathways

The Muscles of Respiration

The Phrenic Nerve

The Diaphragm

Diaphragmatic Paralysis

Incidence and Etiology

Signs and Symptoms

Evaluation

Neuromuscular Pathology

Treatment Options for Diaphragmatic Paralysis

Positive Airway Pressure Supplementation (CPAP/BiPAP)

Plication of the Diaphragm

Phrenic Nerve Reconstruction

Background

Surgical Treatment

Outcomes

Treatment Algorithm

Ventilator Dependency

Demographics

Consequences of Positive Pressure Ventilation on the Diaphragm

Treatment Options

References

11: Physical Therapy Following Phrenic Nerve Graft Surgery: Implications Far Beyond Breathing

Introduction

Physical Therapy (PT) Preoperative Assessment

Respiration

Endurance

Postural Alignment

Postural Stability

Pain

Continence

Summary

Physical Therapy Rehabilitation

PT Reassessment

PT Rehabilitation Treatment

Summary

References

12: Recovery of Diaphragm Function Through Functional Electrical Stimulation: Diaphragm Pacing

Introduction

Surgical Intervention with Diaphragm Pacing

Results of Diaphragm Pacing

References

13: Acute and Long-Term Surgical Management of the Spinal Cord Injury Patient

Introduction

Damage Control Surgery

Enterocutaneous and Enteroatmospheric Fistulas

Ileostomy and Colostomy

Nutrition

Wound Complications

Surgical Drains

Compartment Syndrome

Tracheostomy

Acute Abdomen in Spinal Cord Injury Patients

Summary

References

14: Surgical Reconstruction of Pressure Ulcers

Introduction

Terminology

Epidemiology

Economic Burden

Pathophysiology

Anatomic Distribution

Basic Science

Pressure

Friction

Shear

Moisture

Malnutrition

Neurological Injury

Prevention

Skin Care

Incontinence

Spasticity

Pressure Relief

Nutrition

Diagnosis and Evaluation

Classification

Patient Evaluation

Osteomyelitis

Surgical Management of Pressure Ulcers

Reconstructive Concepts

Reconstruction by Anatomic Region

Sacrum

Midline Defects

Ischium

Trochanter

Prophylactic Bone Resection

Postoperative Management

Outcomes and Complications

References

15: Acute Burn Management and Rehabilitation

The Acute Burn

Epidemiology

The Burn Wound and Triage

Care of the Acute Burn

Inhalational Injury

Infection

Burn Surgery

Escharotomy and Fasciotomy

Excision and Grafting

Principles of Burn Surgery

Burn Reconstructive Ladder

Direct Closure

Adjacent Tissue Transfer

Skin Grafts

Cultured Epidermal Autografts (CEA)

Tissue Expansion

Flaps

Reconstruction by Anatomical Site

Scalp

Face

Breast

Upper Extremity

Perineum

Lower Extremity

Long-Term Complications

References

Part VI: Reanimation of the Paralyzed Extremity

16: A Global Approach to Upper Extremity Paralysis: The Role of Surgery in Limb Reanimation

General Philosophy of Reanimation

Animation, Spastic and Flaccid Paralysis of the Upper Extremity

Spastic Paralysis

Flaccid Paralysis

Treatment Options

The Garage Door Analogy

The Systematic Study of Spare Parts

Surgical Planning Exam and Evaluation

Assessment of Function

Assessment of Pain

Assessment of Donors

Nerves

Muscles

Creation of New Donors and Donor “Disease”

Electromyography and Imaging

Introduction to Surgical Planning

Surgical Timing

The Surgical Planning Process

Targeted Muscle Reinnervation

Preoperative Evaluation

Transfers for Muscle Reinnervation

Transhumeral Level

Shoulder Disarticulation Level

Postoperative Care

Future Directions

References

17: Amputation Versus Limb Salvage of the Lower Extremity

Introduction

Salvage Versus Amputation

The Pathologic Process

Vascular Etiologies

Traumatic Etiologies

Orthopedic Care

Plastic Surgery Care

Psychosocial Aspects

Overall Outcomes

Litigation and Outcomes

Financial Considerations

Summary

References

18: Surgical Rehabilitation of the Tetraplegic Upper Extremity

Introduction

Epidemiology

Etiology

Upper Extremity Functional Surgery

Current Utilization of Upper Extremity Surgery

Clinical Picture: Symptoms and Physical Findings

Therapeutic Options

Nonoperative Treatment

Surgical Treatment

Indications for Surgery

Time Management

Goals of Surgery

Surgical Techniques

Reconstruction of Elbow Extension

Reconstruction of Forearm Pronation

Reconstruction of Wrist Extension

Positioning and Stabilization of the Thumb

Reconstruction of Grip Function

Reconstruction of Intrinsics

Reconstruction of Hand Opening (Extensor Phase)

ECU Tenodesis for Wrist Alignment

Additional Procedures to Reduce Spasticity

Combined Procedures: Active Flexor and Passive Extensor Phase with Intrinsic Reconstruction (Alph

Nerve Transfers

Postoperative Protocol

Immediate Activation of Transferred Tendons

Complications

Clinical Results

Tendon Transfers

Neuroprosthetic Devices (Functional Electrical Stimulation (FES))

Nerve Transfers

References

19: Lower Extremity

Approach to the Lower Extremity of Patients

Anatomy

Compartments of the Leg

Innervation

Compression Syndromes

Pudendal Neuralgia

Piriformis Syndrome

Femoral and Obturator Nerve Compression

Peroneal Nerve Compression

Tarsal Tunnel Syndrome

Lower Extremity Neuropathy

Diagnosis

Medical Therapy

Surgical Therapy

Basic Science

Coverage of the Diabetic Foot Wound

Clinical Evaluation and Surgical Planning

Reconstructive Options

References

20: Inguinal Pathology

Introduction

Athletic Pubalgia

Pathophysiology

Clinical Presentation and Physical Examination

Diagnostic Imaging

Surgical and Postoperative Management

Inguinal Neuralgia

Pathophysiology

Clinical Presentation

Diagnosis

Management

Summary

References

21: Hand Transplantation and Rehabilitation

Introduction

Unique Aspects

Upper Extremity Allotransplantation

Donor and Recipient Selection

Donor Limb Procurement

Recipient Surgery

Maintenance Immunosuppression

Rehabilitation

Functional Assessment

Rejection Assessment

Outcomes

Cortical Plasticity and Neurointegration

Summary

References

22: Targeted Reinnervation Strategies to Restore Upper Limb Function

Introduction

Targeted Muscle Reinnervation: Basic Concepts

Integration with Bioprostheses

Surgical Considerations

Targeted Sensory Reinnervation

Clinical Applications

Future Directions

References

Part VII: Orthopedic Surgery

23: Orthopedic Considerations in Rehabilitative Surgery

Principles of Acute Orthopedic Injury Treatment

Common Orthopedic Complications and Treatments

Acute Blood Loss and Vascular Injury

Venous Thromboembolic Disease

Fat Embolism Syndrome (FES)

Neurologic Injury

Acute Infection and Chronic Osteomyelitis

Acute and Chronic Soft Tissue and Wound Complications

Nonunion or Fixation Failure

Deformity/Malunion

Arthritis and Avascular Necrosis

Heterotopic Ossification

Contracture and Arthrofibrosis

Instability*

References

24: Upper Extremity Neuromuscular Disorders

Upper Extremity Basic Orthopedic Principles

Shoulder Reanimation: Tendon and Nerve Transfers

Scapulothoracic and Glenohumeral Fusions

Elbow Reanimation: Tendon and Nerve Transfers

Elbow Fusion

Wrist Reanimation: Tendon and Nerve Transfers

Wrist Fusion

Digital Reanimation: Tendon and Free Muscle Transfer

Digital Fusion

Cerebral Palsy Involving the Upper Extremities

Heterotopic Ossification: Traumatic Brain and Neurological Injury

References

Part VIII: Urologic Surgery

25: Surgical Considerations in Neurogenic Bladder

Introduction

Anatomy and Physiology of the Upper and Lower Urinary Tracts

Upper Urinary Tract

Lower Urinary Tract

Neuroanatomy of the Lower Urinary Tract

Voiding Centers

Suprapontine (Higher) Centers

Pontine Micturition Center

Sacral Micturition Centers

Impact of the Location of Spinal Cord Injury on Voiding

Suprapontine Lesions (Higher Centers)

Suprasacral Spinal Cord Lesions

Sacral Lesions

Preoperative Urologic Evaluation

Types of Bladder Management and Surgical Considerations

Intermittent Catheterization

Indwelling Catheterization (Urethral and Suprapubic Catheterization)

Reflex Voiding

Crede/Valsalva Voiding

Common Urological Problems Following SCI

Urinary Tract Infections

When and How to Treat UTI in SCI

Autonomic Dysreflexia

Prevention of Autonomic Dysreflexia

Treatment of Autonomic Dysreflexia (AD)

Pharmacological Treatment for Acute Autonomic Dysreflexia (AD)

Post-autonomic Dysreflexia Management

Bladder Stones

Summary

References

Part IX: Vascular Considerations, Including Lymphedema

26: Vascular Considerations in Rehabilitative Surgery

Introduction

Peripheral Arterial Disease

Epidemiology

History and Physical Exam

Noninvasive Testing

Treatment

Venous Disease and Deep Vein Thrombosis

Risk Factors

History and Physical Exam

Testing for DVT

Treatment

Lymphedema

Epidemiology and Etiologies

Pathophysiology

Treatment

References

Part X: Future Directions

27: Spinal Cord and Peripheral Nerve Regeneration Current Research and Future Possibilities

Introduction

Spinal Cord Regeneration

Early Studies of Spinal Cord Regeneration

Go or Nogo?

Glial Scar

Proteoglycans

One, Some, or All of the Above?

None of the Above

All By Itself

Peripheral Nerve Effects on Spinal Cord Regeneration

The Importance of Rehabilitation

Peripheral Nerve Regeneration

Autologous Repairs and Timing

Nerve Guidance Conduits and Neurotrophic Devices

Into the Future

NED: The End or the Beginning?

Nervous System 2.0

NS2.0 Possibilities

Class I Possibilities (Within 30 Years)

Class II Possibilities (30 Years to Centuries)

Class III Possibilities (No Substantial Achievements Yet)

Concluding Thought

References

Erratum to: Rehabilitative Surgery: A Comprehensive Text for an Emerging Field

Index

 

An aparitie	2017
Autor	Elkwood
Dimensiuni	17.78 x 2.39 x 25.4 cm
Editura	Springer
Format	Hardcover
ISBN	9783319414041
Limba	Engleza
Nr pag	417