Cervical surgery Flashcards
1
Q
Cervical spine disc
A
- more cescent shaped
- nucleus becomes more fibrotic and can break into fragments
- more vulerable to rotation stresses than L/S
2
Q
Degeneration in the C/S indications and reasons for surgery
A
- degenerative cascade is the same
- degenerative disc and joint disease
- primary indications = pain and progressive muscle weakness
- lower C/S vertebrae are less flexiable in flexion meaning that they reach end range quicker
3
Q
common types of cervical surgeries
A
- discectomy
- discectomy with instrucmented fusion
- disc arthroplasty
4
Q
Discectomy
A
- removal of portion of the disc
- usually anterior approach
5
Q
Anterior cervical fusion
A
- placed anteriorly over bodies with a bone graft
- must move trachea, esophagus, and deep neck flexors
- adjacent sites increase degenerative processes
6
Q
Cervical cage fusion
A
- acts as a spacer
- take out the disc
- bone graft causes a physiologic fusion
7
Q
Cervical stand alone cage
A
- if fusion doesnt take = puts pressure on hardware and can accelerate degeneration of other segments
- bone graft inside cage designed to stand alone
- will be immobilized
8
Q
bryan cervical disc prothesis
A
- early generation arthroplasty type
- polyurithan disc filled with saline for shock absorption
- area for bone to grow into
- allows some motion to decrease the acceleration of degeneration above and below
- bony healing and will likely be immobilized
9
Q
Medtronics cervical disc prothesis
A
- some areas for bony growth
- allows for early mobility = 1 bony healing
- convexity and concavity
10
Q
Zimmer mobi-c cervical disc prothesis
A
- cobalt crome
- keels going into body
- porous for bony growth
- plastic disc
- allows disc tomove provides more physiological like motion
- lining similar to THA
11
Q
Simplify cervical disc arthroplasty
A
- ceramic disc = glass
- provides more normal movement
- metal on plastic can cause debride in which body will attack prothesis
12
Q
Anterior microforamenotomy
A
- newer procedures
- tries to keep things as normal as possibel
- take out only what is needed
13
Q
Surgical considerations
discectomy
A
- potential disc space collapse = take out too much
- not enough taken out = doesnt solve problem
14
Q
A
15
Q
Surgical considerations
discectomy with fusion
complications
A
- donor site morbidity: bone graft = separate incision
- autograft vs alllograft
- nonunion risks of this = smoking, DM,
- Infection = risk with obesity
- adjacent site degeneration
