Degenerative Disc Module Updated Flashcards
Contains collagen fibers and proteoglycans
Nucleus pulposus
What is the role of the annulus?
To contain the nucleus
True or false: intervertebral discs are avascular
True
Three major functions of disc
Spacer
Distribute Load
Accommodate movement
Phases of degenerative cascade
Dysfunction
Instability
Stabilization
Can result in general laxity in annulus
Bulging disc
Nucleus begins to protrude through a year in annulus in one area
Herniated disc
The type of herniation in which a portion of disc that has protruded through the annulus remains attached to remain material
Extruded disc herniation
Protruding portion of disc detached from remainder of disc
Sequestration disc herniation
Herniation towards midline putting pressure on spinal cord or cauda equina
Central herniation
May experience localized numbness, weakness, and tingling
Far lateral herniation
Generally affects spinal nerve
Far lateral herniation
When a herniation affect both spinal cord and spinal nerve
Paracentral herniation
Condition that develops when the ligaments and posterior elements hypertrophy, enlarge, and the vertebral foramen narrows
Spinal stenosis
Numbness and tingling
Paresthesia
What is spondylolysis
When the pars fractures completely
What are radicular symptoms
Numbness, tingling, weakness, and/or paresthesia
Radicular symptoms typically correspond to what?
A dermatome
What do myelopathic symptoms typically indicate?
Impingement of spinal cord
What are myelopathic symptoms?
Gait disturbances, bowel and bladder dysfunction, and or/generalized weakness
What are some conservative treatment options available to patients prior to considering spinal surgery?
Rest, weight management, anti-inflammatory drugs, chiropractic care, physical therapy, pain management
Success rate for treating severe lumbar radiculopathy with conservative therapy
50%
Removal of bone or soft tissue putting pressure on neural elements
Decompression
Physically removing the pieces of tissue that are exerting pressure onto a neural element
Direct decompression
Increasing the amount of room for the neural structures by increasing or restoring the height of the disc space
Indirect decompression
A procedure in which sections of the lamina and the facet are removed
Foraminotomy
Removal of part of the lamina to relieve compression on a neural element or to gain access to other anatomical structures
Laminotomy
A procedure that involves the removal of the herniated portion of a disc, performed through a small incision, usually with the assistance of a microscope to enhance visualization
Microdiscectomy
A procedure in which the lamina is removed
Laminectomy
A procedure that involves reshaping the lamina to increase the volume of the vertebral foramen and decompress the spinal cord without removing the protective function of the lamina
Laminoplasty
Removal of the disc
Discectomy
Inducing the body to grow a bridge of bone from one vertebra to another
Fusion
Five basic steps of discectomy and fusion
Removal of disc Placement of spacer in disc space Graft Augmentation Stabilization Fusion
