Thoracolumbar Flashcards
Which vertebrae are affected with intervertebral disc protrusion?
T12-T13
Why do you get hypoxia of the spinal cord?
Segmental blood supply
A spinal case comes into your clinic what do you do?
Do your best to diagnose and refer as soon as possible - surgery is required
What’s the difference between Hansen Type 1 and Hansen Type 2 IVD protrusion?
Type 1 is total annulus fibrosis rupture.
Type 2 is partial rupture and bulging
What is the most important difference between cervical and thoracolumbar spinal issues? ***
Cervical has better prognosis (wider canal).
Thoracic and lumbar is worse prognosis (narrow canal).
What are the first signs of spinal disease? ***
Pain - cervical region
Paresis/paralysis/abdominal muscle tension - thoracolumbar
Is chronic or acute IVD better?
Chronic because you get adaption and progress rather than fast change
What does spinal cord hypoxia cause?
Necrosis
Haemorrhagic myelomalacia
Paralysis
What is the pathophysiology of intervertebral disc protrusion?
Chondrodystrophoid breeds get chondroid degeneration & mineralisation of IVD begins rapidly between 2m-2yo.
Can get 75% IVD degeneration by 1 yo.
Non-chondrodystrophoid breeds get fibroid IVD degeneration (aging), slow disc degeneration.
What factors affect clinical signs of spinal cord compression?
Force of compression
Size of protrusion
Location of lesion
Duration of lesion
What are the DD’s of IVD?
Vascular accident Neoplasia Trauma to spine Pathologic vertebral number Psooas muscle injury
How do we treat IVD?
NSAIDs - Carprofen, Meloxicam
Anti-ulcerogenic drugs - H2 blockers, sucralfate
Fenestration surgery
Laminectomy treatment
What is post operative care involved in IVD treatment?
Analgesia, bladder expression, UTI, perineal area clean, manage feet, monitor GI ulceration.
