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DPT 751 - Musculoskeletal III > Lumbopelvic Medical Procedures > Flashcards

Lumbopelvic Medical Procedures Flashcards

1
Q

What is the probability of continuing opioids for 1 year after 8 days of consuming?

A

13.5%

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2
Q

What is the probability of continuing opioids for 1 year if a second opioid is prescribed or a refill is received?

A

14%

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3
Q

What is the probability of continuing opioids for 1 year after 31 days?

A

30%

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4
Q

Which opioid has the highest probability of dependency?

A

Long-acting opioids (oxycontin, fentanyl)

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5
Q

Which opioid has the second highest probability of long-term use?

A

Tramadol

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6
Q

What percentage of patients remain taking opioids for more than 1 month?

A

64%

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7
Q

Define opioid tolerance.

A

Decreased drug effect over time

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8
Q

What are the complications associated with opioid tolerance?

A

Opioid-induced constipation and respiratory depression

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9
Q

Define opioid-induced hyperalgesia.

A

Paradoxical state of increased nociceptive sensitization

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10
Q

How does opioid-induced hyperalgesia manifest?

A

Diffuse pain less defined in quality, extending to other areas

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11
Q

What were the study’s findings on pain reduction in the ED with ibuprofen/acetaminophen vs opioid/acetaminophen combinations?

A

No significant or clinically important differences in pain reduction

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12
Q

What was the objective of the 12-month randomized trial comparing opioids to nonopioids?

A

To compare opioid vs nonopioid medications on pain-related function, pain intensity, and adverse effects

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13
Q

What were the conclusions regarding opioid therapy for chronic back pain or hip/knee osteoarthritis pain?

A

Opioid therapy was not superior to nonopioid medications for pain-related function improvement

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14
Q

What was the pain severity score in the opioid group?

A

4.0

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15
Q

What was the pain severity score in the non-opioid group?

A

3.5

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16
Q

Describe prolotherapy.

A

Repeated injections of irritant solutions to strengthen ligaments

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17
Q

What are the common solutions used in prolotherapy?

A

Dextrose, glycerine, and other osmotic shock agents

18
Q

What is the conclusion regarding the efficacy of prolotherapy?

A

Conflicting evidence; effective when combined with other treatments

19
Q

What are the effects of PRP injections for low back pain according to the meta-analysis?

A

Significantly reduced pain scores and improved patient satisfaction

20
Q

What were the patient satisfaction results for PRP injections?

A

Relatively good patient satisfaction

21
Q

Were there any increases in adverse events after PRP injection?

A

No increase in adverse events

22
Q

What were the conclusions on stem cell injections for axial back pain?

A

Insufficient data to support efficacy and safety; need more RCTs

23
Q

How many publications and patients were included in the systematic review of stem cell injections?

A

14 publications, 147 patients

24
Q

What were the follow-up periods for the stem cell injection studies?

A

6 months to 6 years

25
Q

What is PLIF in lumbar fusion?

A

Posterior lumbar interbody fusion

26
Q

What is TLIF in lumbar fusion?

A

Transforaminal lumbar interbody fusion

27
Q

What is MI-TLIF in lumbar fusion?

A

Minimally invasive transforaminal lumbar interbody fusion

28
Q

What is OLIF/ATP in lumbar fusion?

A

Oblique lumbar interbody fusion/anterior to psoas

29
Q

What is LLIF in lumbar fusion?

A

Lateral lumbar interbody fusion

30
Q

What is ALIF in lumbar fusion?

A

Anterior lumbar interbody fusion

31
Q

Is there definitive evidence for one lumbar fusion approach being superior?

A

No clear definitive evidence for one approach being superior

32
Q

Which fusion method is preferred for discogenic LBP and lordosis restoration?

A

ALIF

33
Q

Which fusion methods are reasonable for central canal stenosis or recurrent disc herniation?

A

PLIF and TLIF

34
Q

Which approach is preferred for Isthmic spondylolisthesis?

A

PLIF

35
Q

Is OLIF suitable for all cases?

A

No, LLIF is not suitable

36
Q

Describe the SI joint fusion procedure.

A

Minimally invasive procedure, often secondary after failed L5-S1 fusion

37
Q

What percentage of continued pain after failed L5-S1 fusion is from the SI joint?

A

29-40%

38
Q

What is the effectiveness vs risk/complications of SI joint fusion?

A

Mixed evidence

39
Q

What is opioid-induced constipation?

A

Complication of opioid tolerance

40
Q

What is the more serious threat associated with opioid tolerance?

A

Respiratory depression

DPT 751 - Musculoskeletal III (15 decks)

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