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ACVS Phase II 2023 Case Based Only > Neurology > Flashcards

Neurology Flashcards

1
Q

Bonelli and da Costa, JVIM, 2019:
What % were giant breed dogs?
Most common clinical signs?
Most common sites of compression?
What % had 2 or more sites of compression?
What were the most common cause(s) of compression?
What % had intervertebral disc degeneration?

A

80% giant breed dogs
Proprioceptive ataxia (90%), cervical pain (45%)
C5-6, C6-7 or both
60% had 2 or more sites of compression
Articular process proliferation (40%), disc protrusion (10%)
45% had intervertebral disc degeneration

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2
Q

Bok, Vet Surg, 2019:
Cervical fusion
What % improved?
What % subsidence was seen?
What % developed implant failure and what % required plate removal?
Long-term outcome?

A

89% improved
11% subsidence
44% developed implant failure, 22% required plate removal
Long-term outcome was good

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3
Q

Rohner, VCOT, 2019:
DACSM treated with C-LOX anchored intervertebral spacer
What % improved or had normal neuro exam at 3 months post-op?
Most common post-op complication?
Short-term outcome?

A

89% improved or had normal neuro exam at 3 months post-op
Screw loosening was the most common post-op complication, but only 5% had displacement of the implant
Good short-term outcomes

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4
Q

Saunders, Vet Surg, 2018:
Was there an association between a greater rostral projection of the sacral lamina and a diagnosis of DLSS?
Is the height of the vertebral canal at L7/S1 diagnostic or predictive of DLSS?
Risk factor(s) for development of cauda equina syndrome?

A

Saunders, Vet Surg, 2018:
No association between greater rostral projection of the sacral lamina and DLSS
Height of the vertebral canal at L7/S1 was neither diagnostic nor predictive of DLSS
Dogs >5 years of age had a greater risk of developing cauda equina syndrome

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5
Q

Zindl, Vet Surg, 2018:
Pedicle screw-rod fixation system
Effect(s) on motion at L7-S1 and L6-7?

A

Zindl, Vet Surg, 2018:
Significantly reduced primary and coupled motion at L7-S1 with a concomitant increase in motion at L6-7, which may suggest the potential for adjacent level effects

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6
Q

Worth, VCOT, 2018:
Effect(s) of lateral foraminotomy on volume of the LS lateral intervertebral neurovascular foramen?
Regrowth of bone at the foraminotomy site occurred despite having excellent outcomes - true or false?
Increased foraminal volume was still evident at long-term follow-up, but in 33% of those dogs, what was the % increase in foraminal volume compared to pre-op?

A

Worth, VCOT, 2018:
Lateral foraminotomy increased the volume of the LS lateral intervertebral neurovascular foramen to >7 times its initial volume
True
In 33% of the dogs, the long-term increase in foraminal volume was only 125% of the pre-op volume

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7
Q

Nel, Vet Surg, 2017:
Fixation of LS fracture-luxations with pins + PMMA or SOP plates provide similar stability - true or false?

A

Nel, Vet Surg, 2017:
True

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8
Q

Tran, Vet Surg, 2017:
Lateral vs dorsal stabilization of lumbar spinal fracture-luxations
Advantages and disadvantages of the lateral approach?

A

Tran, Vet Surg, 2017:
Advantages: superior for pin angle accuracy and bone purchase - clinically important consequences of breach are less common
Disadvantages: prevents observation of the articular facets

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9
Q

Fujioka, Vet Surg, 2019:
Patient-specific drill guide template
What % of screws were placed without vertebral canal invasion?
Was greater accuracy achieved for screws placed in the cranial lumbar or caudal thoracic vertebrae?

A

Fujioka, Vet Surg, 2019:
90% of the screws were placed without vertebral canal invasion
Greater accuracy of screw placement was achieved in the cranial lumbar vertebrae than the caudal thoracic vertebrae

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10
Q

Gallastegui, VRU, 2019:
What % of fractured vertebrae had complete agreement for exact fracture location between MRI and CT?

A

Gallastegui, VRU, 2019:
Complete agreement between MRI and CT was achieved in only 14-33% of fractured vertebrae

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11
Q

Schmidli, VCOT, 2019:
C2 fractures
What % only showed cervical pain?
What % had fractures involving the dens?
Chances for full or functional recovery with conservatively vs surgically managed cases?

A

Schmidli, VCOT, 2019:
32% showed only cervical pain
23% had fractures involving the dens
Chances of full or functional recovery were very good for both conservatively and surgically managed cases

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12
Q

Kohler, JAVMA, 2018:
Cytoreductive surgery for suspected primary intracranial masses
Mortality rate?
Major complication rate?
What factors were associated with development of major complications or death?
What % were non-tumorous lesions?
What factor was associated with the lowest survival rate?

A

Kohler, JAVMA, 2018:
13% mortality rate
19% major complication rate
Abnormal findings on pre-op neuro exam, dogs undergoing a suboccipital approach
8% were non-tumorous lesions
Dogs that developed aspiration pneumonia had the lowest survival rate

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13
Q

Forward, Vet Surg, 2018:
Post-op complication rate following intracranial surgery?
Most common post-op complication?

A

Forward, Vet Surg, 2018:
47% post-op complication rate
Aspiration pneumonia was the most common post-op complication

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14
Q

Nakano, Vet Surg, 2018:
Agreement between intensities and pattern of pre-op gadolinium enhancement on MRI and intra-op fluorescein sodium staining?

A

Nakano, Vet Surg, 2018:
Intensities and pattern of pre-op gadolinium enhancement on MRI agreed with intra-op fluorescein staining

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15
Q

MacLellan, JAVMA, 2018:
What was predictive of outcome - tumor grade or pre-op tumor volume?

A

MacLellan, JAVMA, 2018:
Tumor grade was predictive of outcome

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16
Q

Noyes, Vet Surg, 2017:
Size of planned laminectomy defects based on MRI vs CT?

A

Noyes, Vet Surg, 2017:
Size of planned laminectomy defects tended to be larger based on MRI compared to CT

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17
Q

Mathieson, Vet Surg, 2018:
Ventral stabilisation of thoracic kyphosis through bilateral intercostal thoracotomies and SOP plates
Post-op complications?
% improvement in neuro scoring long-term?

A

Mathieson, Vet Surg, 2018:
Seroma (33%), screw breakage (33%)
83% improved in neuro scoring long-term

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18
Q

Bertram, VRU, 2019:
Neurologically normal Frenchies, English Bulldogs and Pugs
Most common congenital vertebral malformation?
Most common congenital vertebral malformations by breed?

A

Bertram, VRU, 2019:
Lumbosacral transitional vertebrae most common (34%)
Frenchies: Hemivertebrae (32%), lumbosacral transitional vertebrae (26%)
English Bulldogs: Hemivertebrae (24%), lumbosacral transitional vertebrae (14%)
Pugs: Lumbosacral transitional vertebrae (54%)

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19
Q

De Decker, JVIM, 2019:
Most common location of kyphotic segment?
What factors are associated with higher likelihood of neurological disease?
What Cobb angle corresponds with the highest combined sensitivity and specificity to differentiate between clinically affected and unaffected dogs?

A

De Decker, JVIM, 2019:
Kyphotic segment most often centred at T7-8

-Pug breed
-more severe kyphosis
-fewer rather than more hemivertebrae
-ventrolateral hypoplasia hemivertebrae subtype

Cobb angle of 34.5 degrees

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20
Q

Schneider, VCOT, 2017:
Incidence of C2-3 anomalies in dogs with and without AAI?

A

Schneider, VCOT, 2017:
38% of dogs with AAI vs 12% of dogs without AAI

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21
Q

Leblond, VCOT, 2017:
Safety of implant placement is optimized by limiting implant diameter to what size in toy breed dogs?

A

Leblond, VCOT, 2017:
1.5mm

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22
Q

Leblond, VCOT, 2018:
Transarticular fixation using 2 screws vs multi-implant construct using 5 or 6 screws
Which screw(s) were the most successfully placed?
Which screw(s) were the most challenging to place?
Which constructs were more prone to failure?

A

Leblond, VCOT, 2018:
C2 pedicle screws in the 6-screw construct, but these screws would also inevitably result in vertebral artery injury
Monocortical screws in the C2 caudal vertebral body
The constructs using 2 screws were more prone to failure

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23
Q

Noyes, Vet Surg, 2017:
Planned laminectomy defects tended to be smaller or larger based on MRI compared to CT?

A

Noyes, Vet Surg, 2017:
Planned laminectomy defects tended to be larger based on MRI compared to CT

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24
Q

Chai, JAVMA, 2018:
What was associated with increased odds of IVDD in Pekingese?

A

Chai, JAVMA, 2018:
Presence of calcified discs in the T10-L4 region
greater body weight
female dogs

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25
Hamilton-Bennett and Behr, Vet Surg, 2019: Cats with IVDD treated with hemilaminectomy What outcomes were achieved? What % had dispersal of extruded disc material beyond the disc space evident on MRI? What % had complete degeneration of the extruded disc and lateralization of the extruded disc material?
Hamilton-Bennett and Behr, Vet Surg, 2019: 50% excellent outcome, 17% good outcome, 17% poor outcome 83% had dispersal of disc material beyond the disc space 50% had complete degeneration of extruded disc and lateralization of disc material
26
Gordon-Evans, Vet Surg, 2019: What is associated with a slower recovery post-op in Dachshunds that receive post-op rehab?
Gordon-Evans, Vet Surg, 2019: Increased pre-op disability is associated with slower recovery but not body condition
27
Hermann, VCOT, 2018: Standard ventral slot vs inverted cone slot vs slanted slot vs fenestration Which procedure(s) increased the ROM of the C4-5 VMU? Do the inverted cone slot and slanted slot provide any biomechanics benefit over the standard ventral slot?
Hermann, VCOT, 2018: All procedures increased the ROM of C4-5 VMU No benefit over standard ventral slot
28
Crawford and De Decker, VCOT, 2018: Peri-op complication rate for hemilaminectomy + annulectomy vs hemilaminectomy + partial discectomy? % early post-op neuro deterioration for hemi + annulectomy vs hemi + partial discectomy? Median time to ambulation for hemi + annulectomy vs hemi + partial discectomy? Recurrence rate for hemi + annulectomy vs hemi + partial discectomy?
Crawford and De Decker, VCOT, 2018: 27% vs 21% 55% vs 29% 7 days vs 4.5 days 50% vs 26%
29
Skytte and Schmokel, JAVMA, 2018: Mean interval from surgery to regaining micturition? Correlation between pre-op modified Frankel score and interval to regaining micturition? Mean interval from surgery to regaining ambulation? Correlation between pre-op modified Frankel score and interval to regaining ambulation? What % regained micturition before ambulation and what % regained both at the same time? What % developed UTI post-op?
Skytte and Schmokel, JAVMA, 2018: 4 days to regaining micturition Negative correlation between pre-op modified Frankel score and interval to regaining micturition 14 days to regaining ambulation Negative correlation between pre-op modified Frankel score and interval to regaining ambulation 52% regained micturition before ambulation, 37% regained both at the same time 17% developed UTI
30
Drury, Vet Surg, 2019: Integrated endoscopic thoracolumbar hemilaminectomy What sized lesions and in what locations were accessible? What affected the size of the hemilaminectomy?
Drury, Vet Surg, 2019: Lesions <70% the diameter of the cannula size and located with the area 1/3 cranial and 2/3 caudal to the center of the disc space could be accessed Size of cannula used affected the size of the hemi
31
Nakamoto Progressive Myelomalacia Vet Surg 2021
Extensive hemilaminectomy & Durotomy = 100% survival
32
Woelfel Paraplegia in Med-Large dogs Vet Surg 2021
Factors independently associated with outcome included - clinical severity = poor - number of vertebrae with signal interruption in HASTEi = more extensive epidural hemorrhage - ratio of vertebral sites decompressed to HASTEi = better
33
Fenn Anesthesia duration and outcome JVIM 2020
Median anesthesia time Regain ambulation 4 h Did not 4.5 h
34
Zidan Long-term pain JVIM 2020
15% chronic pain | others normalized by 6 months
35
Longo MRI assessed disc degeneration recurrence in dogs tx for IVDD JVIM 2021
Other degenerate disc at the time of surgery hazard ratio of 2.92 for recurrence of CS
36
Bosch Facetectomy on Biomechanics in C-spine VCOT 2017
Facetectomy increased range of motion of primary motions in all directions. Axial rotation was significantly influenced by facetectomy.
37
Schneider Incidence of abnormalities of C-spine with AA Instability VCOT 2017
The incidence of anomalies affecting the C2/3 - dogs with AAI was 38.46% - control group it was 11.97% The majority of the observed anomalies involved the intervertebral disc.
38
Crawford Compare Hemilaminectomy with anulectomy or partial discectomy VCOT 2018
Early postoperative neurological deterioration HA group 16/29* HPD group 7/24 Sustained clinical improvement HA group 9/22 HPD group 17/23* Clinical Significance Hemilaminectomy with partial discectomy for decompression of thoracolumbar intervertebral disc protrusion was associated with decreased postoperative neurological deterioration and increased sustained clinical improvement compared with hemilaminectomy with anulectomy.
39
Conte T Vertebral Stenosis w/ Screw Tail VCOT 2021
Stenotic ratio of 0.56 associated with clinical signs
40
Caraty Tail avulsion JSAP 2018
11/15 cats recovered voluntary tail function and pain sensation within 14 to 90 days (mean 39 days). 5/8 previously incontinent cats recovered urinary continence within a month of surgery.
41
Skytte Pre-op neurologic score w/ intervals to regain micturition and ambulation JAVMA 2018
regaining micturition was 4.1 d (3 at 2.9, 2 at 6) regaining ambulation was 13.8 d (3 at 6.9, 2 at 28.8) negative correlations with MFS were identified for interval to regaining micturition (r = –0.63) and interval to regaining ambulation (r = –0.64)
42
Tirrito Agreement of Sx decompression and PO MRI JAVMA 2020
The correlation between surgeons' perception and postoperative MRI findings for the degree of spinal cord decompression achieved was only fair. Unsatisfactory spinal cord decompression as assessed via postoperative MRI was associated with ~severity of preoperative neurologic grade ~preoperative compression, thoracolumbar (vs cervical) IVDE ~ventral (vs ventrolateral or dorsolateral) circumferential distribution of extruded material. Satisfactory (vs unsatisfactory) decompression as assessed via MRI was associated with ~lower postoperative neurologic grade ~greater likelihood of a successful outcome ~lower mean recovery time.
43
Spence MRI related to Body Weight JAVMA 2021
IVDD < 15 kg 94.7% ≥ 15 kg 58.4% Dogs weighing < 15 kg had a significantly higher inci- dence of IVDD lesions in the T12-13 segment, compared with dogs weighing ≥ 15 kg. Dogs weighing ≥ 15 kg were Neoplastic 11.9 times FCE 7.4 times
44
Gomes JFMS 2020 Which site was affected in 50% of cases? What was a characteristic MRI feature? Most common Radiographic features of this condition?
The L7–S1 intervertebral disc space (IVDS) was affected in 7/14 (50%) cases. Characteristic MRI features ~hyperintense nucleus pulposus signal ~involvement of adjacent vertebral endplates (n = 11/14 [79%]) ~hyperintense neighbouring soft tissue ~presence of spondylosis deformans (n=10/14 [71%]). Radiographs ~collapse or narrowing of the affected IVDS (80%) ~endplate erosion (60%)
45
Gillespie JFMS 2020 Thoracic vertebral canal stenosis in cats Median age? Improved with medical treatment? Improved with surgical treatment?
Age 9y Medical management 2/5 improvement Sx 2/3 improvement British shorthair over-represented
46
Gomes JFMS 2022 Median age of Discospondylitis? Median duration of clinical sings? All cats had what clinical sign? Neurological dysfunction in what % of cats? Antibiotic therapy for how long?
Median age? ~9 years Median duration of clinical signs? ~3 weeks All cats presented with ~spinal hyperaesthesia Neurological dysfunction? ~64.7% of cats Sustained antibiotic therapy ~3 months
47
Kerr JSAP 2021 What % of Frenchies returned for reoccurrence of IVDD extrusion? Median time between surgery and reoccurrence of sings? Localization of reoccurrence
What % of Frenchies returned for reoccurrence of IVDD extrusion? 51% The median time between surgery and reoccurrence of signs? 9m 21 days Localization of reoccurrence -original TL: 5/29 cervical -original cervical: 5/14 TL
48
Pfund JSAP 2022 Caudal lumber IVDD Urinary continence recovered in what %? Fecal continence recovered in what %? Tail function recovered in what %?
Urinary continence recovered in what %? 86% Fecal continence recovered in what %? 90% Tail function recovered in what %? 87%
49
Argent JSAP 2022 Complete recovery after medical vs. surgical management in cervical IVDD Overall recurrence M vs S In medically managed patients, location of recurrence In surgically managed patients, location of recurrence? 80% of recurrence occurred in what time frame? Significant difference in recurrence between M & S management?
Complete recovery after medical vs. surgical management M: 30.3% S: 69.7% Overall recurrence 34% M: 36% S: 33% In medically managed patients, the location of recurrence -occurred at the same site In surgically managed patients, the location of recurrence -occurred at an adjacent site 80% occurred -within 2 years of diagnosis A significant difference in recurrence between M & S management? NO
50
Murthy JVIM 2021 In serum phosphorylated neurofilament heavy chain (pNF-H) in progressive myelomalacia dogs with T/L IVDD, dogs that developed PMM had an elevation at what time point? What concentration was associated with identifying PMM?
Dogs that developed PMM had significantly higher serum pNF-H concentrations after surgery compared to all other cohorts at 24 hours: 39.88 ng/mL ≥31.39 ng/mL was 83.33% sensitive and 100% specific for identifying PMM in this cohort
51
McBride JVIM 2022 Odds of spinal shock decreased with?
Odds of spinal shock decreased with -increased weight -increased duration -decreased pelvic limb tone -increased presence of paraplegia
52
Johnson JVIM 2022 Hydromyelia is associated with what in IVDD?
Chronicity
53
Bridges JVIM 2022 Which breed was overrepresented for dic-associated epidural hemorrhage? What clinical signs were associated with EH? What MRI findings were associated with EH? Location in Frenchies?
Which breed was overrepresented for dic-associated epidural hemorrhage? -Frenchies What clinical signs were associated with EH? -less than 48h of signs -more likely non ambulatory What MRI findings were associated with EH? -<50% cross-sectional SC compression -longer compression (3 vs 1 space) -greater intrinsic SC change Location in Frenchies? T/L
54
Dongaonkar Vet Surg 2021 T/F: Intermittent bolus irrigation was associated with lower peak vertebral canal temperatures than continuous irrigation
True
55
Schmitt Vet Surg 2021 Vertebral corridors width? Widest corridor at? Corridor length? Shortest corridor? Longest corridor?
Vertebral corridors width 3.8-5.2 mm Widest corridor T1 Corridor length 13.3 to 17.5 mm Shortest corridor T1 Widest corridor T6
56
Falconer-Hall VCOT 2021 Disc Fenestration
Neurologist more likely than surgeons 41% complication rate- hemorrhage
57
Discospondylitis common signalment
Breed: Great Dane Lab Rotti GSD Dobi English Bulldog Male>Female Young to Middle-aged
58
Common sites for discospondylitis
Caudal cervical Mid-thoracic Thoracolumbar Lubosacral intervertebral disk
59
The most common concurrent condition in dogs with discospondylitis
UTI
60
Organisms associated with discospondylitis
Staphylococcus E. coli
61
Radiographic progression of discospondylitis
-Initial narrowing of IVD space -Focal lysis of vertebral end plates -Finally marked lysis, sclerosis and spondylosis
62
MRI changes with discosponylitis
T2 hyper intensity T1 hypo intensity Contrast enhancement w/in IVD, vertebral body end plates, soft tissue ventral to vertebral body and epidural fat
63
Additional diagnostics with discosponylitis to find causative agent
Urine culture Blood culture Echocardiogram TxR Fungal culture in GSD
64
White et al VetSurg 2019 What is the best flexed angle on lateral radiographs to diagnose AA instability?
51 degrees of flexion 90% sensitive and 90% specific
65
Schneider et al VCOT 2017 What is the most common concurrent abnormalitiy associated with AA instability?
IVD anomalies (33.34% of dogs)
66
Noyes et al VetSurg 2017 What are the difference made when planning hemilaminectomies using CT vs MRI?
- Lots of variation in surgical location and size - Would plan a different overall approach ~50% of the time between the two modalities -Side of approach was most consistent between the two modalities
67
Dixon et al JAVMA 2017 What were the conclusions regarding anesthesia related hypotension and oucome of dogs with IVDD?
1. 60% of patients experieinced hypotension 2. Regaining motor or urinary function not associated with occurence of hypotension, duration or severity of hypotension
68
Zidan et al JVIM 2020 What percentage of dogs with spinal cord injury will develop chronic neuropathic pain?
15%
69
Dyall et al VCOT 2018 What is the SSI rate for dogs undergoing hemilaminectomy without perioperative antimicrobials?
0.6%
70
Mari et al JVIM 2019 What are the risk factors/predictors of urinary or fecal incontinence in dogs with TL ANNPE?
1. paraplegia 2. intramedullary hyperintensity >40% of cross sectional area of the spinal cord 3. No NSAID treatment 4. Clinical signs of spinal shock
71
Skytte et al JAVMA 2018 What is the average time to regain micturition and ambulation after TL decompression surgery?
1. Micturition 4.1 days 2. Ambulation 13.8 days
72
Nessler et al JVIM 2018 What was the conclusion regarding prognosis for medical vs surgical treatment of hydrated nucleus pulposus extrusion in dogs?
Medical management and Sx have equivocal outcomes *Lesion relative to length of C3 = longer lesion = more dogs died acutely, less likely to have functional outcome
73
Crawford et al VCOT 2018 Which method had a better clinical outcome when combined with a hemilaminectomy - annulectomy vs partial discectomy?
Partial discectomy Annulectomy - more patients had acute neuro deterioration after surgery
74
Alisauskaite et al JVIM 2019 What is the outcome of pugs treated surgically for T-L spinal arachnoid diverticula?
Good improvement in the short term (80%) Poor long term outcome (86% deteriorated)
75
De Decker JVIM 2019 What findings related to hemivertebrae are assoaciated with clinical signs in Frenchies, Pugs and English Bulldogs?
-Pug breed -More severe kyphosis -fewer hemivertebrae -Ventrolateral hypoplasia hemivertebre All associated wtih higher likelihood of neurological disease
76
Stabilizers of the vertebral column
Body: Buttress to resist bending and axial loading Articular process: resists all forces IVD: rotation lateral bending
77
Funkquist A
Remove: Spinous process Laminae Articular processes 1/2 dorsal portion of pedicles
78
Funkquist B
Remove: Spinous process Laminae Leave articular process & pedicles
79
Modified dorsal laminectomy
Remove: Laminae Spinous process Caudal articular process Cranial articular process remain
80
Radiographic features of disc herniation
-Narrowing of IVD space -Wedging of IVD space -Increased articular process overlap -Mineralized material superimposed over intervertebral foramen or vertebral canal reduced intervertebral foramen diameter
81
Factors that positively affect performance of CT for IVDD
-Multiplaner reconstruction techniques -Chronic history of IVD herniation -Chondrodystrophic breed type -Presence of mineral dense IVD
82
Innervation of bladder
Pelvic n -Parasympathetic S1/S3 *detrusor m. contraction Pudendal n -somatic innervation *external urethral sphincter relax Hypogastric n -sympathetic *internal urethral sphincter contract (alpha) *detursor relax (Beta)
83
Modified Frankel Score
0: Tetraplegia w/ No DP 1: Tetraplegia w/ superficial pain 2: Tetraplegia w/ nociception 3: Non-ambulatory tetraparesis 4: Ambulatory tetra paresis 5: Hyperesthesia
84
Patellar Reflex
L4/L6
85
Biceps Reflex
C7/T2
86
W/d FL
C6/T2
87
W/d HL
L6/S1
88
Perineal Reflex
Sacral n. & Pudendal n. S1-3
89
Paresis/ Plegia
Paresis- voluntary motor Plegia- no motor
90
Nerve Damage Scale
I: interrupt fnx not structure (neuropraxia) II: axon damage, endometrium intact (axontmesis) III: axon and endometrium injury (neurotmesis) IV: perineurium damaged (neurotmesis) V: severed (neurotmesis)
91
Phrenic n
C5/7
92
Anticlinal vertebrae
T10
93
Intervertebral disc anatomy
Annulus fibrosus Nucleus pulposus Cartilaginous end plate
94
Dorsal compartment of vertebral canal
-Spinous Process -Vertebral Laminae -Articular Process -Vertebral Pedicles -Dorsal Ligament
95
Middle compartment of vertebral canal
-Dorsal Longitudinal Ligament -Dorsal Portion of Annulus -Dorsal Vertebral Body
96
Ventral compartment of vertebral canal
-Vertebral Body -Lateral and Ventral Portion of Anulus -Nucleus Pulposis -Ventral Longitudinal Ligament
97
Spinal Fracture Ex Fix Type
Type 1 or 1b
98
Hounsfield units
``` Air Fat Water Brain Acute Clot Bone/Mineral Metal ```
99
Substances with high signal on T1
``` Fat Methemoglobin Protein binding Gadnium Melanin ```
100
Substances with high signal on T2
``` CSF Edema Necrosis Inflammation Demyelination ```
101
Abs with good BBB penetration
``` 3rd Generation Cephlasporin Fluoroquinolones Metronidazole Sulfonamides Chloramphenicol Trimethoprim ```
102
Surgery for AA lux Dorsal approach
AA wiring Nuchal Ligament Dorsal Cross Pin Kishigami AA Tension Band
103
Surgery for AA lux Ventral approach
Transarticular screws or pins - 30 degrees Pins & PMMA - 30 degrees Screws & PMMA - 90 degrees Ventral Plating
104
Cervical IVDD Sx Tx
``` Ventral Slot Slanted Ventral Slot Dorsal Laminectomy Limited Dorsolateral Approach for Hemilaminectomy Fenestration ```
105
Complications associated with Cervical Sx
``` Respiratory Compromise Intraoperative Cardiac Dysrhythmias Blood Loss Neurologic Deterioration Ventral Instability and Subluxation Seroma Formation ```
106
Components of Disc Associated Spondylomyelopathy
Ventral compression by disc protrusion Dorsal compression hypertrophy of dorsal longitudinal ligament and yellow ligament Asymmetric disc protrusion causing compression of SC and nerve root compression
107
Components of Osseous Associated Spondylomyelopathy
OA proliferation of articular process | Dorsal hypertrophy of yellow ligament
108
Components of the Lumbar Intumescence
``` L4/6- Femoral n. L6/S1- Sciatic n. S1/3- Pelvic n. S1/3- Pudendal n. Cd1/5 Caudal n. ```
109
Function of Femoral n.
Flex hip | Extend Stifle
110
Function of Sciatic n.
Extend Hip Flex Stifle Flex/ Ext Tarsus
111
Components of LS Stenosis
``` Bulging annulus & nucleus pulpous Thinking of dorsal annulus Spondylosis deformans Osteophyte within caudal ventral foramen Thickening of joint capsule & zygapophyseal joint Thicking of the yellow ligament ```
112
Position that exacerbates LS Herniation
Extension
113
Postion that alleviates LS Herniation
Flexion
114
Horner's syndrome associated with Cervical Spine
C6/T2
115
Disc Associated Spondylomyelopathy Distraction-Stabilization
``` Pins & PMMA Screw Bar- PMMA PMMA Plug Locking Place Disc Arthroplasty ```
116
Complications associated with Wobler Sx
``` Neurologic Deterioration ~Dorsal 70% ~Ventral 42% Vertebral Foramen & Transverse Foramina Penetration 25-57% Domino Effect 20% Laminectomy Membrane 8% Implant Failure 7-30% Collapse of Intervertebral Foramina Insufficient Decompression ```
117
Fixation of Lumbar Fx/ Lux/ Sublux
Pin & PMMA - 30-60 degrees External Fixator SOP Plates
118
Fixation of Cervical Fx/ Lux/ Sublux
Screws & PMMA | Unilock System

ACVS Phase II 2023 Case Based Only (22 decks)

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