Chapter 13 - Diagnostics and Non-surgical treatment of spinal disorders

Question 1

Cox-2 inhibitors have been linked to what with long term use?

Answer 1

increased risk of vascular and cardiac events

Question 2

Cox-2 inhibitors have what benefit over Cox-1 inhibitors

Answer 2

Fewer GI, GU, or platelet function adverse effects

Question 3

Primary indication for epidural steroid injection?

Answer 3

Radicular pain or claudication symptoms not relieved with non-operative management

Question 4

Efficacy of epidural steroid injections?

Answer 4

Are efficacious in avoiding surgery for herniated discs, but are not very efficacious in avoiding surgery for spinal stenosis

Translaminar injections &laquo_space;transforaminal injections which have shown positive results for up to 3 years

Question 5

Innervation of the facet joint

Answer 5

medial branch of the dorsal ramus after it exits the neuroforamen above and at the level of the facet

Question 6

EMG findings of myelopathy

Answer 6

presence of fasiculations and a polyradicular picture

Question 7

define Somatosensory evoked potentials

Answer 7

cortical or subcortical responses to the repetitive stimulation of a mixed peripheral nerve

Question 8

What suggests a significant change in SSEPs?

Answer 8

a >50% change in AMPLITUDE of the signal is more concerning than changes in latency

SSEPs are NOT real time. they are averaged over time to extract background noise

Question 9

Define motor evoked potentials

Answer 9

stimuli to the motor cortex stiulates the corticospinal tract axons to synapse with motor neurons which innervate muscles

Question 10

What finding suggests a significant change in motor evoked potentials?

Answer 10

a >75% reduction in amplitude

Question 11

Innervation of the anuus fibrosis

Answer 11

sinuvertebral nerve