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PHTY3260 > L10: Pathologies and surgical management of cervical spine disorders > Flashcards

L10: Pathologies and surgical management of cervical spine disorders Flashcards

1
Q

What are the 3 causes of neck pain (alone)?

A
  1. musculoligamentous
  2. discogenic pain
  3. facet osteoarthritis
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2
Q

What are the 3 treatments of neck pain (alone)?

A
  1. surgery ineffective
  2. best treated nonoperatively
  3. can consider facet injections
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3
Q

What is the bone scan VS SPECT VS SPECT-CT?

A
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4
Q

What is the cervical facet joint injection?

A

Put a needle down on the region of interests, which is where the small nerve roots come that supply the facet joints.

interrupting the pain pathways and the needle has a radio frequency current and you zap the nerve.

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5
Q

What are the 2 causes (groups) of radiculopathy?

A
  1. disc protrusion
  2. facet & uncovertebral OA with osteophytes
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6
Q

What are 4 presentations of radiculopathy?

A
  1. pain
    1. neck
    2. trapezius/medial scapula
    3. arm
  2. parasthesia
  3. weakness
  4. reflex loss

C5-6: trapezius pain

C6-7: levator scapula & rhomboid pain

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7
Q

Where does C5, C6, C7 get compressed? (What is the most common?)

A

C6 gets compressed at C5-6 level (most common) –> numbness of thumb, biceps weakness & reflexes

C7 gets compressed at C6-7 level (2nd most common) –> middle finger, triceps weakness & reflexes

C5 gets compressed at C4-5 level (rare)

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8
Q

What does a compressed exiting nerve root by disc herniation VS osteophytes (occur at the side, not the back)?

A
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9
Q

What are the 2 types of treatment of radiculopathy?

A
  1. non-operative
  2. operative
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10
Q

What are 2 non-operative treatments for radiculopathy?

A
  1. time
  2. nerve root block
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11
Q

What are 2 operative treatments for radiculopathy?

A
  1. can be treated ANTERIORLY with discectomy and fusion
  2. can be treated POSTERIORLY with foraminotomy
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12
Q

______ (Do not/do) exercise with disc herniation = will aggravate pain/get worse

A

Do not

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13
Q

What is the aim of spinal fusion?

A

Take nerve pressure but sacrifice movement at that level

  • Doesn’t move much anyways
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14
Q

What does a disc replacement look like?

A
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15
Q

What does a disc replacement look like in a spinal x-ray?

A
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16
Q

What are the 3 causes of cervical myelopathy?

A
  1. DEGENERATION
  2. ISCHAEMIA
  3. PREDISPOSITION
17
Q

What is degeneration in cervical myelopathy?

A

Unable to extend neck (narrower/compressed spinal canal) –> arm pain

18
Q

What is predisposition in cervical myelopathy?

A
19
Q

What is ischaemia in cervical myelopathy?

A

compression of anterior spinal artery important in early stages

20
Q
A
21
Q

What are the 7 symptoms of cervical myelopathy?

A
  1. Clumsy weak numb hands
  2. Leg stiffness or weakness
  3. Neck stiffness
  4. Pain in shoulders or arms
  5. Unsteady gait
  6. Urinary hesitancy
  7. L’Hermitte’s sign

vague slow delay

22
Q

What is OPLO?

A

Ossification of the posterior longitudinal ligament

23
Q

What are the 7 signs of cervical myelopathy?

A
  1. Wasting of hand intrinsics
  2. Hyperreflexia
  3. Hoffmann’s sign
  4. Variable sensory loss
  5. Inverted radial reflex
  6. L’Hermitte’s sign
    • Cervical flexion cause tingly sensation down body
  7. Upgoing plantar response
  8. Ankle clonus
24
Q

What are 3 gradings for Ranawat?

A
  1. Normal
  2. Subjective weakness with hyperreflexia & dysesthesia
  3. Objective weakness and long tract signs
    1. can ambulate
    2. cannot ambulate
25
Q

What are 5 gradings for Nurick?

A
  1. Signs of spinal cord disease but no difficulty walking
  2. Slight difficulty walking, employed full-time
  3. Difficulty walking, affects ADLs, still walking
  4. Assistance to walk
  5. Chairbound or bedridden
26
Q

What are the best tests for cervical myelopathy?

A
27
Q

What is likely to happen in cervical myelopathy?

A
28
Q

What is the 2 main treatments for cervical myelopathy?

A
29
Q

What are the 3 treatments (anterior) for cervical myelopathy?

A
  1. multilevel procedure
  2. discectomy
  3. corpectomy
30
Q

What is a treatment (posterior) for cervical myelopathy?

A
  1. laminectomy and fusion
31
Q

What do cervical surgeries look like?

A
32
Q

What does spinal fusion with rods look like?

A

PHTY3260 (27 decks)

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