Rygkirurgisk traumatologi Flashcards

1
Q

Undersøgelse af ryg

A

Anamnese
Subjektive klager
Objektiv undersøgelse
Billede diagnostik

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2
Q

Typer af rygfrakturer?

A

Ustabile

Relativ stabile

Stabile

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3
Q

Hvordan deles hvirvel?

A

Anterior

median

Posterior

Instabiliteten forværres jo bagerst frakturen kommer i hvirvlen

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4
Q

Behandling hos yngre patienter - rygpatient

A

Operativ
- Ustabile frakturer
- Kompression >50%
sv.til forkanten, eller
kyfosevinkel >20%
- Absolutte
op.indikationer
- Åbne læsioner
- Progradierende
neurodeficit

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5
Q

Fraktur behandling hos ældre - rygpatient

A

Lav energi
- Konservativ beh. m
korset evt
vertebroplastik

Høj energi
- Konservativ beh.
(”stabile”)
- Operativ beh.

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6
Q

Konservativ Behandling af rygskader?

A

Konservativ- stabile frakturer:
- Th1-Th7 :
CervikoTorakalOrtose

  • Th7-L3 :
    3-punktskorset
  • L4-L5 : BOB korset
  • 12 uger
  • Rtg og KK (6) og 12
    uger e. traume
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7
Q

Klassikationer af rygskader?

A

Denis:
3- column cassifikcation

AO

TLICS
- Morfologi
- PCL integritet
- Neurologisk

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8
Q

TLICS - 3 prediktorer?

A

Morfologi (1-4)
- Radiografi
- CT

Integritet af PLC
(0-3)
- MR

Neurologisk status (0-3)
- Fysisk
examination

Predikerer behov for kirurgi:

0-3 –> Non kirurgisk
4 –> Kirurgi (læge vurderer)
>4 –> Kirurgi

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9
Q

Beskriv TLICS - morfologi?

A

Kompression (1 point)
- Simpel, deformitet.

Burst (2 points)
- Retropulsion af superoposterior corpus fragment

Translation/rotation
(3 point)
- Rotering, anterior og lateral displacement, facet led displacement.

Distraction (4 point)
- Horisontal fraktur af posterior fragment. Seperation af posterior elementer.

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10
Q

Beskriv TLICS - Integritet af PLC?

A

Intakt (0 point)
Suspekt (2 point)
Skadet (3 point)

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11
Q

Beskriv TLICS - Neurologisk status?

A
  • Intakt (0 point)
  • Nerverod (2 point)
  • Complete cord (2 point)
  • Inkomplete cord (3 point)
  • Cauda equina (3 point).
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