T spine

Question 1

3 column concept for thoraculumbar stability

Answer 1

1: anterior column
2: middle column
3: posterior column

Question 2

anterior column

Answer 2

• anterior longitudinal ligmanet

- anterior 2/3 of the vertebral body and annulus fibrosis

Question 3

middle column

Answer 3

• posterior 1/3rd of the vertebral body and annulus

- posterior longitudinal ligament

Question 4

posterior column

Answer 4

• posterior ligament complex

- vertebral arch structures

Question 5

a fracture of 1 column=

Answer 5

stable

Question 6

fracture of 2 columns=

Answer 6

stability depends on the extent of the fractures

Question 7

fracture of 3 columns=

Answer 7

unstable and requires external fixation

Question 8

compression fractures

Answer 8

flexion forces collapse anterior vertebral body

• kyphosis converts axial load to flexion force (^anterior loads)
• if just fx anterior vertebrae=stable
• if force is high enough, posterior elements are involved (+/- stable)

*common in Caucasian woman w/ osteoporosis

(stable will heal itself but the ant wedging will not resolve- *kyphosis)

Question 9

vertebroblasty

Answer 9

cement injected into a painful fractured vertebral body

• immediate (w/in 48 hrs) relief of pain and restoration of mobility
• prevents fracture movement
• success rate 73-90%
• does not correct deformity but prevents further collapse

Question 10

kyphoplasty

Answer 10

• like vertebroplasty but also corrects deformity
• balloon is inserted and inflated to restore vertebral body size
• balloon is then removed and the cavity is filled w/ cement

Question 11

idiopathic scoliosis types

Answer 11

infantile

juvenile

adolescent

Question 12

infantile scoliosis

Answer 12

< 3 y/o

-often spontaneous resolution

Question 13

juvenile scoliosis

Answer 13

3-10 y/o
girls>boys
high risk for progression
tx necessary

Question 14

adolescent scoliosis

Answer 14

10 on
skeletal maturity
girls= 7x >boys
often shows up during growth spurts
progression (and effectiveness of conservative tx) halts at skeletal maturity

Question 15

naming scoliosis curves

Answer 15

named after the location of the APEX (convex side)

Question 16

common curve types

Answer 16

thoracic
thoracolumbar
lumbar
double w/ opposite directions

Question 17

Cobb angle

Answer 17

measurement of scoliosis

standing AP view
-equalize leg lengths first

use most tilted vertebra superior and inferior to apex (document which one)

angle between the perpendiculars

measurement error <10 deg

Question 18

pedicle method

Answer 18

measurement of scoliosis

standing AP view
-equalize leg lengths

postion of pedicles at the apex
-rated 1+ to 4+

*as the vertebrae rotate, the position of the pedicle changes: