Spine Flashcards
What two components make up the intervertebral discs?
Annulus fibrosis (outside)
Nucleus pulpouses (inside)
What is the cause of a bulging disk?
Swelling in the annulus
What is the cause of a disc herniation?
Nucleus polpouses extrudes into the periphery
What is a laminectomy defect?
Removal of the Lamina in order to remove an affected disc
What is a discogram?
Invasive diagnostic study that uses x-rays to view the intervertebral discs.
Dye must be injected into the discs in order for them to be visible
What is a myelopathy?
Compression of the spinal cord
What is radiculopathy?
Disease in the root of the nerve (pinched nerve/tumor)
What is a spinal stenosis?
Narrowing of the spinal canal/Forman
What is double crush syndrome?
Injury to one area increases the susceptibility of injury to the same structure in a different area
Cervical herniation and carpal tunnel result in compression of the median nerve
What is spondyloisthesis? What causes this defect?
Slipped disc
Caused by a defect in the pars articularis
Most are benign and developmental
What is the classic representation of AAA?
Back pain
What is a retroperitoneal neoplasm?
Pancreatic tumor
What is a biliary colic?
Gall stones
What is spinal shock? What reflex is used to test for spinal shock?
Combination of areflexia and hyporeflexia that occurs after an SC injury
Bulbocaverneous reflex
List the 5 incomplete cord syndromes.
Anterior Cord Syndrome Posterior Cord Syndrome Central Cord Syndrome Brown-Sequard Syndrome Cauda Equina Syndrome
What kind of damage is seen in anterior cord syndrome?
Common, profound motor loss
What kind of damage is seen in posterior cord syndrome?
Uncommon, sensory and proprioceptive loss
What kind of damage occurs with central cord syndrome?
MOST COMMON CERVICAL SC INJURY
Loss of motion and sensation in UE
What kind of damage is seen in Brown Sequard syndrome?
Ipsilateral motor loss
Contralateral sensory loss
What kind of damage is seen in cauda equina syndrome?
MEDICAL EMERGENCY, SURGERY ASAP
Pain, numbness, poor bowel/bladder control
What are the indications and advantages of an anterior lumbar interbody fusion (ALIF)?
Painful DJD of lumbar spine
Does not disturb lumbar musculature
What approach is typically taken for a cervical fusion? What is the exception to this approach?
Done anteriorly for safety
If spinal stenosis is present, posterior approach is taken
What are the objectives/goals of surgery for vertebral compression fractures? (Kyphosis/vertebroplasty)
Pain reduction
Reduce deformity
What is the difference between a kyphoplasty and a vertebroplasty?
Kyphoplasty uses a small balloon to reduce fracture
Vertebroplasty inserts cement into affected area to reduce fracture
BOTH LIFT BONE GENTLY INTO PROPER ALIGNMENT
What are the potential complications of kyphoplasty/vertebroplasty?
Allergic reaction
Nerve damage
Pulmonary embolus
Cement leakage into epidural space
Kyphoplasty and vertebroplasty should be down within how many weeks of a fracture?
8 weeks
What are the indications for a posterior lumbar interbody fusion? (PLIF)
Spondlyolisthesis
Discogenic LBP
Radicular Pain
What are the advantages of a ALIF?
Allows for decompression of the SC
Increased fusion rate as compared to PLIF
Better stabilization because of larger implants
Better ability to reduce compression with combined approach
What are the disadvantages of PLIF?
Lower fusion rate
Small risk of retro pulsed cage
