Thoracic/Lumbar Spine Flashcards

1
Q

Sheuermann’s disease

A
  • AVN or steroid use

- Involves inferior and superior end plates

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2
Q

Thoracic Kyphosis

A
  • Draw right angles on T1 and T12 (superior end plate T1 and inferior endplate T12_
  • Normal range
    o 7-40ª adult males
    o 30-56ª Older males
    o 13-48º adult female
    o 32-66º older female
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3
Q

Common Trauma with T spine

A
  • MVA or OP
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4
Q

Hyperflexion Thoracic

A

compression burst fractures w/ bony fragments into spinal canal

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5
Q

Lumbar Acute injury + Red Flags

A
  • X rays not recommended for acute LBP w/in first month of symptoms
  • Red Flags
    o Recent significant trauma
    o Mild trauma (age 50 or greater)
    o Patient over 70
    o History of prolonged steroid use or OP
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6
Q

Lumbar chronic injury

A
  • Conditions beyond 4-6 weeks of conservative intervention

- Oblique views for spondylothesis or spondylolysis

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7
Q

Spondylolisthesis

A

= inverted napoleons hat sign

- Spinous process or step off sign

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8
Q

Oblique L spine projection

A
  • Scottie Dog
    o Interarticuarlis fx = neck of dog
    o Posterior translation of body/tail of dog = spinous process
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9
Q

Anterior Column Thoracolumbar spine

A
  • Ant 2/3 of vertebral bodies and AF, ALL
  • Usually stable disruptions
  • WEDGE Fx
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10
Q

Middle Column Thoracolumbar spine

A
  • Posterior 1/3 vertebral bodies AF PLL
  • Potentially unstable
  • Compression/Burst Fx
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11
Q

Posterior column

A
  • Post Arch, facet joints, capsule, post lig complex, lig flavum
  • Unstable
  • Fx pars articularis (spondylosis) bilateral subluxation (spondylolisthesis)
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12
Q

Wedge compression Fx

A
  • Anterior column Compression (compression forces – anterior or lateral flexion)
  • Loss of disc height
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13
Q

Compression Burst Fx

A
  • Failure of anterior and middle column from compression

- CT or MRI are essential

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14
Q

Chance Fx

A
  • Flexion distraction injury of L1-2
  • Seat Belt Fx for rear passenger
  • Horizontal Fx splitting spinous process, lamina, pedicles and vertebral body
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15
Q

Spondylosis

A

pars interarticularis w.o separation

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16
Q

Spondylolisthesis

A

less stable and translation of columns anteriorly or posterior slide

17
Q

Primary Osteoporosis

A
  • Age related disorder in which density of bone is reduced (aging and estrogen deficiency)
18
Q

Secondary Osteoporosis

A
  • Other causes: hyperparathyroidism, excess glucocorticoids, malabsorption, multiple myeloma
19
Q

Best imaging for osteoporosis

A

DEXA

20
Q

Scoliosis

A
  • Severe >50 w/ asymmetry of trunk
21
Q

Spine metastases

A
Bone scan 
-	Indications
o	Staging of lung, breast, prostate
o	Bone pain
o	Elevated alkaline phosphate
o	Elevate the response to chemotherapy