David Kieser

By David Kieser, Scheherezade Soltani, Michael Wyatt, Khoon Lim and Sandra Kieser

Spinal epidural haematomas (SEH) occur from extra-dural bleeding, most commonly after trauma, epidural anaesthesia or operative intervention. However, these also occur in arterio-vascular malformations or spontaneously without an obvious inciting event. Spontaneous spinal epidural haematomas (SSEH) are rare, with a quoted incidence of 0.1 cases per 100,000 population annually. However, these haematomas carry a significant risk of spinal cord or nerve root compression potentially resulting in permanent neurological dysfunction or death. This chapter reviews the presentation, diagnosis and treatment of SSEH in adults, pregnancy and children in order to provide clinicians with an understanding of their typical presentation, required investigations and treatment algorithms.

Part of the book: Vascular Malformations of the Central Nervous System

By David Christopher Kieser and Niels Hammer

Structural failure of the spine adjacent to the level of a previous spinal fusion is commonly observed. It may be defined by the radiologic degree of adjacent deformity, often termed junctional level kyphosis, proximal junctional kyphosis or junctional level failure, or the symptomatic failure of the spine above the level of an operation, termed adjacent segment disease (ASD). ASD can be further specified according to its anatomical location of failure, which provides insight into the specific pathological cause of failure and the optimal subsequent management. This chapter describes the anatomical and pathological classification of ASD in order to help clinicians understand the cause of failure and thereby reduce its rate and offer a treatment algorithm if it occurs.

Part of the book: Spinal Deformities in Adolescents, Adults and Older Adults

By David Christopher Kieser and Michael Charles Wyatt

The prevalence of adult spinal deformity (ASD) is increasing worldwide, driven by changing patient demographics, as well as an increased capacity to diagnose and treat this condition. ASD carries the worst healthcare burden of all chronic conditions including arthritis, chronic lung disease, congestive heart failure, diabetes and ischaemic heart disease. Recent advances in diagnostic and treatment modalities have resulted in an increase in surgical intervention for this condition. To be successful, however, a comprehensive understanding of the functional deficits caused by ASD must be recognised by those clinicians managing such patients. This chapter provides an overview of the functional deficits caused by ASD and its treatment.

Part of the book: Spinal Deformities in Adolescents, Adults and Older Adults