SPINE Flashcards
Tx pannus assoc w RA
occipitocervical fusion +/- posterior decompression
when vertebral artery can’t be controlled w tamponade
embolization/stent/clip
cervical decompression alone contraindicated when
in pts w cervical kyphosis
fx pattern of type 2 odontoid assoc w incr nonunion
posterior displ/angulation
degradation of large proteoglycans in nucleus pulposus
intervertebral disc degeneration
water content change with intervertebral disc degen
water content decr
where is vertebral artery at risk
cephalad to posterior arch of C1 when more than 1.5 cm lateral to midline
surgery for symptomatic disc herniation
good early pain relief to 2 yrs
synovial cyst histology
synovial cells surround vascular granulation tissue
is smoking assoc w airway complications after ACDF
no
fasciculations UMN or LMN
LMN
nerve root risk w laminoplasty
C5
Tx cervical spondylolysis wo gait changes or pathologic reflexes
nonop w PT, NSAIDs
MC nerve inj assoc w halo traction
CN 6 - lateral eye movment
changes w disc aging
water
cartilage
proteoglycan
pH
water = decr cartilage = fibrocartilage proteoglycan = decr pH = decr
Laminoplasty contraindicated
pts w more than 10 deg of rigid cervical kyphosis
far lateral disc herniation at L3-4 affects which
L3 nerve root
far lateral affects which
exiting nerve root (nerve root above)
central/paracentral affect which
traversing nerve root (nerve root below)
C7 root exits btwn
C6-7
posterolateral pathologies impinge on ___ roots
foraminal pathologies impinge on ___ roots
posterolateral = traversing (root below)
foraminal = exiting (root above)
DISH affects anterior or postrior bone formation
DISH affects disc space
DISH affect RIGHT or LEFT T spine
anterior bone formation
NO DISC
RIGHT t spine
if compression fx exhausts nonop tx
kyphoplasty
when can u determine asia level
when out of spinal shock
if no bulbo reflex, pt still in spinal shock
variable loss of motor/pain/temp w preserved proprioception
anterior cord syndrome
cervicomedullary angle less than 135 suggests
basilar invagination
posterior ADI indication for surgery
anterior ADI indication for surgery
pADI less than 14
aADI greater than 10
peds Halo configurations
6-12 pins 2-4 lbs torqque
adult Halo configuration
4 pins 6-8 lbs torque
C6-7 disk herniation typically affects what
C7 nerve root
TX transverse lig disruption
C1-2 fusion w sublaminar wiring
myelopathy hand incl
+hoffman
weak grip/pinch
small finger escape
impaired rapid alternating movement (dysdiadochokinesia)
ADI more than 7 mm means
ruptured transverse, alar lig + tectorial membrane
what is predictive of risk of incr slip w spondy
slip angle
smallest pedicle at lvl
L1
if sum of lateral mass displacements more than 7 mm means
transverse lig rupture and unstable
AS vs DISH
higher rate of neuro injury w trauma
mortality rate
AS
Same mortality rate
which has incr rate of isolated R thoracic spine dz
AS vs DISH
DISH
mc complication with PSO
Pseudarthrosis
define hangman fracture
tx type 1
2-3
hyperextension compression
type 1- rigid c collar
type 2- disrupt PLL reduction w extension then halo
if pt has cervical myelopathy with kyphosis how does that change tx
must do anterior decompression to correct kyphosis
then posterior decompression
mc location of tb in kids
anterior aspect of lower thoracic spine
tx thoracic disk herniation
anterior diskectomy with or without fusion
PSO yields how much correction
30 deg
VCR yields how much correction
45 deg
smallest pedicle diameter
T6
largest pedicle diameter
T1, T12
how does safe approach zone for lateral transpsoas approach change as move down lumbar spine
decr due to more ventral position of lumbar plexus
center of rotation for soft tissue chance fx
abdominal viscera
what has highest numeric contribution to TLICS
Posterior lig complex integrity
which pedicle has largest diameter
T12
smallest pedicle diameter
L1
mech of burst fx
axial load + flexion
structures in anterior column
ALL
anterior 2/3 body
structures in middle column
PLL
posterior 1/3 body
structures in posterior column
pedicle lamina facet lig flavum spinous process PLC
conus medullaris syndrome
paralysis of bowel/bladder w sparing of motor nerve roots to lower extremity
