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First Test For Basic Training > Lumbar Interbody Fusion > Flashcards

Lumbar Interbody Fusion Flashcards

1
Q

PLIF

A

Posterior Lumbar Interbody Fusion

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2
Q

TLIF

A

Transforaminal Lumbar Interbody Fusion

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3
Q

Basic Steps for TLIF Surgical Technique

A
  • Access
    • (retractors, ronguers, pituitary, light source)
  • Diskectomy
  • Trial
  • Implant (Opal, T-Pal)
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4
Q

Modic Change

A

White-ness around anterior aspect of vertebral bodies on xray. Indicates inflammation

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5
Q

Goals of Interbody Fusion

A
  • Anterior column support
  • Restoration of disc height
  • Restore patency of intervertebral foramen
  • Restoration of sagittal balance
  • Bony fusion
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6
Q

Where is muscle retraction taking place on an “open” posterior lumbar approach?

A

Midway-point of transverse process

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7
Q

What are the posterior interbody surgical / surgery options?

A

PLIF
TLIF
Modified PLIF
Modified TLIF

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8
Q

What neural structure must you retract during PLIF?

A

Cauda Equina

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9
Q

What neural structure must you retract during TLIF?

A

Nerve Root

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10
Q

Traditional PLIF involves…

A
  1. Laminectomy or Laminotomy
  2. Retraction of Cauda Equina
  3. Diskectomy
  4. Placement of 2 Spacers
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11
Q

TLIF options

A
  • Opal Spacer
  • Concorde Bullet (Lumbar Interbody System)
  • TPAL Spacer
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12
Q

Interbody spacer material options

A
  • Human Allograft Tissue
  • PEEK (Polyether ether ketone)
  • CFRP (carbon fiber reinforced polymer)
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13
Q

Supplemental fixation (screw and rod construct) during a PLIF or TLIF may be used to ______

A
  1. Compress the graft
  2. Restoration of posterior tension band
  3. Restoration of sagittal alignment
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14
Q

Is pairing Vivigen with TPAL an on-Label use?

A

TPAL, OPAL and Concorde Bullett are only to be paired with AUTOgenous graft.

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15
Q

What device/instrument allowed us to go posterolateral to anterior with our implants.

A

The Pivoting Applicator

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16
Q

Is the Peek cage is Radioluscent or Radioopaque?

A

Radioluscent

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17
Q

Advantages of TLIF

A

Placement

Load-Sharing

18
Q

What does T-PAL Stand for?

A

Transforaminal Posterior Atraumatic Lumbar

19
Q

Challenges to TLIF

A
  • Performing through MIS approach
  • Multiple insertion instruments
    • Answer: Pivoting Applicator=Less instruments
  • Placement of Implant in desired position
    • Answer: Pivoting Applicator
20
Q

TPAL Implant

A

Rails + Pressure = Guidance

21
Q

TPAL Benefits

A
  1. Facilitates self-destraction and insertion
  2. Accommodates individual patient anatomy
  3. Guided is insertion
22
Q

TPAL Features

A
  1. Bullett-Tipped Nose
  2. Guided Rails
  3. Convex superior and inferior implant surfaces
23
Q

Thoracic pedicle screw insertion point

A

Below both, the rim of the superior facet and the base of the transverse process

24
Q

Lumbar pedicle screw entry point

A

Lateral facet of the superior facet and the base of the transverse process

25
Q

Advantages of pedicle screw fixation

A
  1. Provide fixational and control and all 3 columns of the spine
  2. Allows for corrective forces in multiple planes
  3. Do not require intact dorsal elements, to name a few
26
Q

Sacral pedicle screw entry points

A

Lateral border of S1 facet and horizontal line tangential to inferior border of S1 Facet

27
Q

Diameter of pedicle screw should be approximately

A
  • 80% of diameter of isthmus of pedicle
  • screw tip lies in the anterior 1/3 of vertebral body
  • prep films (ct scans, MRI)
28
Q

Steps for pedicle screw insertion

A
  1. Cannulate the pedicles /Pedicle Probe
  2. Balltip Probe
  3. Measure for screw (optional)
  4. Tap (optional)
  5. Seat Screw
29
Q

Complications

A
  • Dural leaks
  • Disc injury
  • Vascular injury
  • CSF Leaks
30
Q

2 types of loading for pedicle screws

A
  1. Side-loading

2. Top-loading

31
Q

Multi-directional screws

A
  1. Polyaxial
  2. Uniaxial
  3. Uniplaner
  4. Favored Angle
32
Q

Matrix Hex Driver is a

A

T25

33
Q

Rod options

A
  1. Titanium
  2. Titanium Allow
  3. Cocr
34
Q

Advantages of box thread

A
  • Less head splay

- Hard to cross-thread

35
Q

Top notch is

A

A major feature of tulip-head technolgy

36
Q

Vivian contains LIVE

A

Bone Cells

37
Q

Freezer temp must be

A

-70

38
Q

Vivian contains NO

A

Stem Cells

39
Q

Vivian Shelf Life is for

A

6 months

40
Q

MIS / LIS Drawbacks

A

Learning curve
OR time
Radiation exposure for patient

41
Q

MIS / LIS Advantages

A

Shorter stay in hospital
Smaller scar for patient
Less soft-tissue dissection / retracting trauma
Less blood loss

42
Q

Traditional TLIF involves

A
  1. Facetectomy
  2. Nerve Root Retraction
  3. Unilateral Diskectomy

First Test For Basic Training (2 decks)

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