Spine Flashcards
What are the joints of luschka? Which levels are do they exist?
Uncovertebral joints in cervical spine C2-C3 through C6-C7
Degeneration of joints of luschka result in what kind of issues?
Neural foraminal stenosis or central stenosis
What are facet joints? What is the purpose of the Joints?
Articulations between adjacent vertebral bodies
Formed by superior and inferior articular processes
Allows for bending motion
How are facet joints innervated?
Dual innervation from medial branches of dorsal primary rami Comes from level above and same level
How are cervical, thoracic, and lumbar facet joints oriented?
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
What are the contents of the cervical transverse foramina?
Vertebral artery, , vertebral venous plexus, sympathetic chain, fat
Which nerve root exits at the C3-C4 level? How about T8-T9?
C4 nerve root T8 nerve root
What are the 3 components of an intervertebral disc?
- Nucleus pulposus
- Annulus fibrosis
- Cartilaginous end plate
What are the 5 main ligamentous structures in spinal column?
- Anterior longitudinal ligament 2. Posterior longitudinal ligament 3. Ligamentum flavum 4. Interspinous ligament 5. Supraspinous ligament
What are x-ray films good for determining in the spine?
Alignment, disc disease, fractures, dislocations, and mineralization
What is myelography?
Evaluation of contents of spinal canal by use of non-ionic water soluble radiographically dense iodinated contrast material into spinal subarachnoid space
What can myelography detect?
Disc abnormalities, ligament thickening, hypertrophic facet degenerative changes, spinal stenosis, nerve root impingment, arachnoiditis
When is myelography used?
Mainly only used when CT or MRI exam cannot be performed, are equivocal, or limited due to artifact from surgical hardware
What are CT scans good for?
Detecting ligamentous issues, disc herniations, bone sclerosis or lysis
With contrast can view venous or arterial vasculature, or demonstrate abnormal soft tissue enhancement (tumors)
What are the conventional radiographic findings in DDD?
- Disc space narrowing
- Vacuum disc
- End plate sclerosis
- Osteophyte formation
What is the main significance of loss of Disc height in DDD?
Loss of intervertebral foraminal space and potential for nerve root compression
What is the “lateral recess” in vertebra?
Area along medial border of the pedicle, below the level of the disc and superior vertebral end plate (contains exiting nerve root)
Which nerve roots do central or paramedian disc herniations likely affect?
The nerve roots to the level below
i.e. Paramedian herniation at C3-C4 affects C5 nerve root below
Which nerve roots do foraminal narrowing affect?
Exiting nerve roots at the same level
What is spondylosis?
Discontinuity of the pars inter-articularis of the articular pillar
What is an interventional treatment for vertebral compression fractures?
Kyphoplasty or vertebroplasty have been shown effective for compressionn fractures < 6 weeks
