Principles Of Spine Surgery Flashcards
Goals of Spine Surgery
Atraumatic Access
Relieve Patients Symptoms
Restoration of Alignment
Achieve Stability
Direction Decompression
Removing the anatomy directly impacting the pathology
Indirect COmpression
Enlargement of space around neural structures using something else
Formainotomy
Enlargement of intervertebral foramen
Laminotomy
Partial removal of lamina
Hami-laminectomy
Half-removal of lamina
Laminesctomy
Removal lamina
Laminoplasty
Reshaping of the lamina to increase the diameter of the spinal chord
Resection
Removal of something
Debriment
Clean out infection
Rational of spinal fusion
Limit motion
Maintain alignment
Stabilize
Steps of ACDF
Incision; make cut
Dissection; move the muscle
Retraction; moving tissue to gain access
Distraction; pulling two things apart
PLF
Posterior-Lateral Fusion, no interbody fusion
ALIF
Anterior Lumbar Interbody Fusion
Correction of Deformity
Coronal Plane- Scoliosis- Correction- Translation
Sagittal Plane- kyphosis/neutral/ Lordosis- Correction- Reduction
Axial Plane- Rotational Deformity- Correction - Derotation
Potential Surgical Complications
Significant blood loss Neurological injury Instrumentation failure Pseudo art hosts or non union Wound infection Donor site pain
Monopolar
Electrosurgery tool used cut, coagulate, and desiccate
Flow electrode pad attached to patient
Bipolar
Tongs shaped electrosurgery Device, current passes between arms into tissue.
Low voltage, better control
Flow of surgery
Cut/dissect Retract *monitor bleeding Disc removal, bone removal Instruments Implant Close
Scalpel types
10 blade, used for small incisions
15 blade, small, precise
Forceps
Instrument for grabbing
Army Navy retractor
Two sided retractor
Ratched Retractors
Used then kept in place to keep tissue apart
-beckman retractor, has hinge
Rongeurs
Heavy duty instrument with sharp edge for gouging out bone
Kerrison Ronguer or Punch
Used for cutting away small pieces, 45 to 90 degrees, blunt edge and cuts towards surgeon. Good for cutting near sensitive areas
Kelly Hemostatic Forcep
Used to stop bleeding, ratcheting forcep
Sponge stick
Long tongs with circular head
Osteogenesis
Chisel with two beveled edges, used for cutting not chipping
Curettes
Help remove bone in various sizes of cups and lengths
Nerve hooks
Used to explore areas around delicate nerves around the spine
Pituitary Ronguer or Pituitary instrument
Used to disc tissue removal
Cobb Elevator
Rounded edge instrument often used to remove disc from endplates
