Spine

Question 1

What are the joints of luschka? Which levels are do they exist?

Answer 1

Uncovertebral joints in cervical spine C2-C3 through C6-C7

Question 2

Degeneration of joints of luschka result in what kind of issues?

Answer 2

Neural foraminal stenosis or central stenosis

Question 3

What are facet joints? What is the purpose of the Joints?

Answer 3

Articulations between adjacent vertebral bodies

Formed by superior and inferior articular processes

Allows for bending motion

Question 4

How are facet joints innervated?

Answer 4

Dual innervation from medial branches of dorsal primary rami Comes from level above and same level

Question 5

How are cervical, thoracic, and lumbar facet joints oriented?

Answer 5

Cervical - obliquely from superior to posterior withh ventral to dorsal angle

Thoracic- Angled in coronal plane (limits access)

Lumbar- Posterior is oblique in sagittal plane, and anterior is in coronal plane

Question 6

What are the contents of the cervical transverse foramina?

Answer 6

Vertebral artery, , vertebral venous plexus, sympathetic chain, fat

Question 7

Which nerve root exits at the C3-C4 level? How about T8-T9?

Answer 7

C4 nerve root T8 nerve root

Question 8

What are the 3 components of an intervertebral disc?

Answer 8

1. Nucleus pulposus
2. Annulus fibrosis
3. Cartilaginous end plate

Question 9

What are the 5 main ligamentous structures in spinal column?

Answer 9

1. Anterior longitudinal ligament 2. Posterior longitudinal ligament 3. Ligamentum flavum 4. Interspinous ligament 5. Supraspinous ligament

Question 10

What are x-ray films good for determining in the spine?

Answer 10

Alignment, disc disease, fractures, dislocations, and mineralization

Question 11

What is myelography?

Answer 11

Evaluation of contents of spinal canal by use of non-ionic water soluble radiographically dense iodinated contrast material into spinal subarachnoid space

Question 12

What can myelography detect?

Answer 12

Disc abnormalities, ligament thickening, hypertrophic facet degenerative changes, spinal stenosis, nerve root impingment, arachnoiditis

Question 13

When is myelography used?

Answer 13

Mainly only used when CT or MRI exam cannot be performed, are equivocal, or limited due to artifact from surgical hardware

Question 14

What are CT scans good for?

Answer 14

Detecting ligamentous issues, disc herniations, bone sclerosis or lysis

With contrast can view venous or arterial vasculature, or demonstrate abnormal soft tissue enhancement (tumors)

Question 15

What are the conventional radiographic findings in DDD?

Answer 15

1. Disc space narrowing
2. Vacuum disc
3. End plate sclerosis
4. Osteophyte formation

Question 16

What is the main significance of loss of Disc height in DDD?

Answer 16

Loss of intervertebral foraminal space and potential for nerve root compression

Question 17

What is the “lateral recess” in vertebra?

Answer 17

Area along medial border of the pedicle, below the level of the disc and superior vertebral end plate (contains exiting nerve root)

Question 18

Which nerve roots do central or paramedian disc herniations likely affect?

Answer 18

The nerve roots to the level below

i.e. Paramedian herniation at C3-C4 affects C5 nerve root below

Question 19

Which nerve roots do foraminal narrowing affect?

Answer 19

Exiting nerve roots at the same level

Question 20

What is spondylosis?

Answer 20

Discontinuity of the pars inter-articularis of the articular pillar

Question 21

What is an interventional treatment for vertebral compression fractures?

Answer 21

Kyphoplasty or vertebroplasty have been shown effective for compressionn fractures < 6 weeks