Surgery For Cervical Spine (2) Flashcards

1
Q

What are the indications to get cervical surgery?

A

Severe progressive neurological signs and symptoms

Failure of conservative care

Traumatic instability

Metastatic disease

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2
Q

What are the common disc procedures?

A

Discectomy

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3
Q

What are the common decompression procedures?

A

Laminoplasty

Laminectomy with fusion

Foraminotomy

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4
Q

What are the common fusion procedures?

A

Anterior cervical discectomy fusion

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5
Q

What are the common arthroplasty procedures?

A

Total disc replacement

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6
Q

What is cervical discectomy?

A

Removal of disc material to treat radiculopathy (followed by fusion)

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7
Q

When is cervical discectomy not followed by fusion?

A

When it is done on a young healthy patient

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8
Q

What is the gold standard surgical procedure for treating cervical radiculopathy?

A

Anterior cervical discectomy fusion

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9
Q

How is anterior cervical discectomy fusion performed?

A

Remove disc

Prepare site

Insert graft

Fixation

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10
Q

What is the re operation rate of anterior cervical discectomy fusion within 2 years?

A

8-12%

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11
Q

What is the biggest concern for anterior cervical discectomy fusion?

A

Adjacent segment degeneration

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12
Q

What are the possible adverse effects of anterior cervical discectomy fusion?

A

Esophageal injury

Vertebral artery injury

Dural tear

Postoperative airway compromise

Spinal cord injury

Hematoma

Dysphagia

Dysphonia

Graft dislodgement

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13
Q

What is the best surgical treatment for cervical spinal stenosis?

A

Cervical laminoplasty

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14
Q

What is performed during a cervical laminoplasty?

A

Lamina is removed and rebuilt with metal scaffolding to increase space

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15
Q

What is a good option after failed anterior cervical discectomy fusion?

A

Cervical laminoplasty

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16
Q

What are the differences between laminoplasty and laminectomy?

A

Laminoplasty- preserve spine motion

Laminectomy- heavy fusion

17
Q

What surgery is performed for cervical total disc replacement?

A

Cervical arthroplasty

18
Q

What are the ROM limitations post cervical surgery?

A

Limited until cleared by surgeon

19
Q

What are the lifting limitations post cervical surgery

A

Limited for 2-4 weeks

20
Q

What are the walking limitations post cervical surgery

A

Excellent post surgical activity

21
Q

What are the balance limitations post cervical surgery

A

Potentially very limited in acute phase

22
Q

What are factors that negatively impact surgical improvement of cervical spinal stenosis?

A

Age > 50

Duration of symptoms greater than 12 months

Involvement of multiple levels

Smoking history