T-spine Flashcards
What is found in the anterior column of the thoracolumbar region?
- ALL
- Anterior 2/3rds of body
What is found in the middle column of the thoracolumbar region?
- Posterior 1/3rd of body
- Posterior longitudinal ligament
What is found in the posterior column of thoracolumbar region?
- Posterior ligaments
- Vertebral arches
What type of fracture in the thoracolumbar region is stable?
Through one column
How can a two column fracture through the thoracolumbar region be stable?
- Depending on the extent of the fracture
What is required in a 3 column thoracolumbar fracture?
- Internal fixation
What is the mechanism of a compression fracture in the thoracic spine?
- Flexion force collapses the anterior vertebral body
What posture contributes to and is a result of compression fractures?
- Kyphosis
- Axial forces create flexion force
- Crushed bodies create kyphotic posture
What shape do the vertebral bodies take on in a compression fracture?
Wedge shaped
How can a compression fracture be stable?
- If the fracture is only through the anterior body
Who is most at risk for compression fractures?
- Caucasian, post-menopausal women
What is the treatment for a compression fracture?
- Cement injected into a painful fractured vertebral body
Vertebroblasty
How quickly do vertebroblasties provide pain relief and restoration of mobility?
Within 48 hours
What type of movement is prevented with a vertebroblasty?
- Fracture movement
What is the success rate of vertebroblasty?
73 - 90 %
Does vertebroblasty correct vertebral deformities?
No, but it does prevent further collapse
Through what structures is the needle passed through in a vertebroblasty?
- Pedicle and vertebral body
What is the difference between a kyphoplasty and a vertebroblasty?
- Corrects deformity and relieves pain and restores mobility
When must a kyphoplasty be performed?
When the fracture is acute.
What is the procedure of a kyphoplasty?
- Patient recumbent
- Balloon inserted into vertebral body and inflated
- Balloon removed, and cavity filled with bone cement
What are the 3 scoliosis types?
- Infantile
- Juvenile
- Adolescent
At what age does infantile scoliosis occur?
< 3 yo
How does infantile scoliosis resolve?
Spontaneously
What age groups are affected by Juvenile scoliosis? What gender is more effected?
- 3 - 10 yo
- Girls > Boys
At what age does adolescent scoliosis occur?
- 10 yo to skeletal maturity
How more likely are girls to develop adolescent scoliosis than boys?
7Xs more.
What event does adolescent scoliosis typically coincide with?
- Growth spurts
What type of scoliosis is at particular risk for progression?
Juvenile
When does progression halt in adolescent scoliosis? What else ends here?
- Ends at skeletal maturity
- Conservative treatment no longer affective
How the curves of scoliosis named?
For the location and side of the apex as viewed clinically from behind.
Can there be multiple apexes in a scoliotic spine?
- Yes
What is the Cobb angle?
- Standard AP view with equalized leg lengths
- Draw lines from the most tilted inferior and superior vertebraes
- Drop perpendiculars off the lines, and measure the angle
What is the measurement error in a Cobb angle?
< 10 degrees
How is the Cobb Angle documented? (besides the degrees)
Which vertebrae were used to calculate
What is the pedicle method of scoliosis measurement?
- Drop a plumb line down the middle of the vertebrae
- Measure position of pedicles against the midline from 0 to 4+
Where are the pedicles positioned in 0, 1+, 2+, 3+, and 4+?
0: Normally 1+: Slightly off-center 2+: One pedicle almost obscured 3+: Pedicle at midline 4+: Pedicle past midline
What 3 ways are the vertebrae deformed in scoliosis?
- Wedge shaped body
- Shorter pedicles and laminae on the concave side
- Deformed spinous process
What 2 ways are the ribs deformed in scoliosis?
- Deformed on both sides
- Rotation causes rib hump on convex side
How is scoliosis “corrected”?
- Stretch concave
- Strengthen convex
