VERTEBRAL FRACTURES: 34

Question 1

Vertebral fractures/luxations/subluxations on overall dog subjected to severe blunt trauma… %

Answer 1

10%

Question 2

most common regions involved in vertebral trauma?

Answer 2

1) thoracolumbar (T3-L3)
2) lumbar (L4-S1)

4,24

Question 3

difference between primary and secondary injury to neural tissue

Answer 3

primary: direct mechanical insult (can lead to vascular, molecular events)

secondary: release of factors like free radicals, exitatory neurotransmitters, cathecolamines, inflammatory mediators, ionic dysregulation

Question 4

how often patients with vertebral column injury would have thoracic trauma?

Answer 4

15 to 35%. pulmonary contusions, rib fractures, pneumotorax

Question 5

a L4-S1 lesion would render the diagnosis of a T3-L3 disease easier because of absence of muscolar tone.
T or F

Answer 5

F, there would be lower motoneuron weakness (L4-S1), so difficult to identify upper motoneuron (T3-L3)

Question 6

difference in prognosis between dogs with or without lack of nociception

Answer 6

-12% ambulant with lack of nociception (not recovered completely)

-80-90% with intact nociception

Question 7

lack of nociception between dogs with disc herniation and fracture, subluxation.. has a similar prognosis T or F

Answer 7

F, disc herniation 47 to 70% of return to function

Question 8

name two possible classification for vertebral fractures

Answer 8

1) divided in
-dorsal compartment
-middle compartment floor of the vertebral canal.
-ventral compartment

2) assesses three principal contributors to vertebral column stability at the articulation of adjacent vertebrae: the intervertebral disc, the vertebral body, and the articular processes.

Question 9

structures of ventral compartment vertebral fracture classification scheme

Answer 9

includes the remainder of the vertebral body, the lateral and ventral portions of the annulus fibrosus, the nucleus pulposus, and the ventral longitudinal ligament

Question 10

structures of middle compartment vertebral fracture classification scheme

Answer 10

(dorsal longitudinal ligament, the dorsal portion of the annulus fibrosus, and the dorsal portion of the vertebral body—essentially the floor of the vertebral canal.

Question 11

structures of dorsal compartment vertebral fracture classification scheme

Answer 11

(supraspinous ligament, interspinous ligament, joint capsule of the zygapophyseal joints, and ligamentum flavum).

Question 12

fractures of the articular processes, especially when bilaterally, led always to an extreme instable joint

Answer 12

False, even bilaterally can be relatively stable

Question 13

name the only neuroprotective agent and it’s mechanism

Answer 13

methylprednisolone. seem to be related to anti-ox activity (lots of oxygen derived radicals are released after trauma)

Question 14

when should you administer methyprednisolone

Answer 14

within 8 hr of injury. improved sensosy and motor to placebo

Question 15

methylprednisolone in dogs: evidence?

Answer 15

lack, one study did not find association between therapy and better outcome. can generate adverse gastrointestinal effects.

Question 16

choose of pin diameter for vertebral stabilization

Answer 16

20 to 25% vertebral body diameter

Question 17

unilateral 4 pin with a lateral approach is significantly stiffer than 4 pinbilateral dorsal approach. T or F

Answer 17

False, same stiffness. Lateral may be beneficial for reduced dissection and ease of closure.

Question 18

sensitivity of radiography for evaluation of pin penetration of the vertebral canal

Answer 18

as low as 50%

Question 19

best arrangement of pin for external fixations of the spine

Answer 19

Type 1B with 8 pins (using spinal arches) was stronger than type 1 with 4 pins bilateral

Question 20

what’s stronger? unilateral 4 screws LCP plate or bilateral 4 pin and PMMA for vertebral stabilization?

Answer 20

PMMA

Question 20

how are called plates secured on spinal processes sides?

Answer 20

auburn spinal plate (metal), or plastic (Lubra).

Question 21

cervical lesions cranial to C……. can affect diaphragm function

Answer 21

cranial to c5 (phrenic nerve arising from C5 to C7).

Question 22

general guidelines for pin insertion angle in cervical vertebrae

Answer 22

from 34.2 to 37.5.
angle increase –> risk transverse foramen penetration
angle decrease–> vertebral canal penetration

Question 23

how many cervical vertebrae lack a transverse foramen

Answer 23

just C7

Question 24

averag safe corridor angle in C7

Answer 24

47.5°

Question 25

where does the spinal cord ends?

Answer 25

L6 in most dogs, usually from L4 in large dogs to L7 in small dogs.

Question 26

lumbosacral injuries7luxation with as much as 100% of dislocation ohave a poor prognosis T or F

Answer 26

F: can be without major neurologic deficits.
Dislocation NOT a prognostic factor in lumboscaral vertebrae