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Providence > Imaging > Flashcards

Imaging Flashcards

1
Q

What does AP view show?

A

Possible deviations of the spine (scoliosis), helps to identify which level to treat

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2
Q

What does the lateral view show?

A

Show spine curvature (lordosis). Helps to identify the level to treat, shows bone spurs, and disc height

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3
Q

What does oblique view show?

A

Foraminal areas, stenosis to arthrosis

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4
Q

Dynamic films?

A

Instability of segment, identifying a fused level, height changes in posterior disc

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5
Q

CT Scan

A 
Computer processed xrays
Tomographic images (slices) allows user to see inside
Views are:
Axial
Sagittal
Coronal
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6
Q

MRI

A 
Good for examining soft tissues.  Herniated, bulging discs.  Fresh fractures, tumors, hematoma, nerve damage.
Views are:
Axial
Sagittal
Coronal
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7
Q

Modic Changes, type 1

A

Represents bone marrow oedema and inflammation.

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8
Q

Modic changes, type II

A

Represents normal red haemopoietic bone marrow conversion into yellow fatty marrow as a result of marrow ischaemia.

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9
Q

Modic changes, type III

A

Represents subchondral bony sclerosis

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10
Q

What are the cervical procedure options?

A 
ACDF
CDA/TDR
Foraminotomy
Hemi laminectomy or bilateral
Laminectomy + Lateral mass screw system
Laminoplasty
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11
Q

What three materials are used in cages?

A

Titanium
PEEK
Carbon Fiber

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12
Q

What are the advantages of an ACDF?

A 
Gold Standard Approach
Fusion considered best option
Good recovery
Good stability
Good results
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13
Q

What are the disadvantages of an ACDF?

A 
Oversizing can create neck pain
Pseudo
Disphonia
Disphagia
Facet pain
Adjacent level syndrome due to stiffness
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14
Q

What are the advantages of CDA/TDR?

A

Same approach as cage
Preserves movement
Preserves normal range of motion
Reduces risk of adjacent level syndrome

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15
Q

What are the disadvantages of CDA/TDR?

A

Not always easy to insert
Must be perfectly centered otherwise you create another axis of rotation
Many artificial discs become fused after 5 years
Subsidence
Facet pain

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16
Q

What are the posterior surgical options for C3-C7 degenerative disease?

A

Laminectomy
Laminectomy + Lateral Mass Screws
Laminoplasty
Foraminotomy

17
Q

What are the advantages of a laminectomy?

A

Direct decompression of spinal cord
Useful in cases of myelopathy due to posterior compression
Surgeon has the option to use mass screw system or not

18
Q

What are the disadvantages of a Laminectomy?

A 
Can be complicated
Not ideal for older patients
Not as useful for single level foraminal-anterior compression
No big opening of the foramen
Nerve root manipulation
Risk of thermal injury
19
Q

What is a Laminoplasty?

A

Small section of bone (lamina) is cut into to relieve the compression.
One side cut completely, the other side cut partially, enabling it to swing open in a manner similar to a door.
Creates room decreases compression
Uses titanium spacers or bone graft with plates.

20
Q

What are the advantages of a Laminoplasty?

A

Big central canal and spinal cord decompression
Useful in case of myelopathy due to posterior compression
Useful in multilevel myelopathy

21
Q

What are disadvantages of a Laminoplasty?

A 
Not easy
Long surgery
Not ideal for older patients
Not as useful for single level foraminal-anterior compression
No big opening of the foramen
Risky
22
Q

What are the advantages of a foraminotomy?

A

Good posterior mini access decompression

Fast recovery

23
Q

What are the disadvantages of a foraminotomy?

A 
Difficult procedure
Difficult to remove all bone spurs
Selected cases
Decompression may be insufficient
Nerve root manipulation
24
Q

What are five common pathologies of the cervical spine?

A 
Degenerative disc disease
Disc herniation
Stenosis - central / foraminal
Myelopathy
Facet Syndrome
25
Q

What are the risk factors for cervical disc herniations?

A 
Aging
Trauma
Lifestyle - no exercise, poor diet, smoking
Poor posture
Genetic
26
Q

What is Myelopathy?

A

Spinal canal is narrowed by surrounding tissue and creates compression on spinal cord.
Process is chronic and symptoms develop slowly

27
Q

What are the symptoms of myelopathy?

A 
Difficulty walking
Loss of bladder control
Loss of fine motor skills
Weakness
Numbness
Tingling
Pain
Paralysis

Providence (7 decks)

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