Vertebroplasty / Vertebral Augmentation

Question 1

Ancef

Answer 1

Antibiotic frequently used intravenously in Vertebroplasty - mainly used to treat bacterial infections of the skin. It can also be used to treat moderately severe bacterial infections involving the lung, bone, joint, etc

Question 2

Anterior 1/3

Answer 2

In the lateral fluoroscopic view, the area in the vertebral body where the needle should be placed to enable a safe, effective injection of cement

Question 3

Bolus

Answer 3

Technically large dose of a medication that is given by injection - in vertebroplasty a cement bolus can occur with a build up of pressure in the injector

Question 4

Bone Scan

Answer 4

A bone densitometry scan is a special type of X-Ray test used to measure the calcium content of the bone, usually in the lumbar region and the hips. Also called a DEXA scan, QDR Scan, or BMD (bone mineral density) measurement. It measures the calcium content in the bones, which cannot be evaluated in an ordinary X-Ray. Although an X-Ray may appear to show that the bones have low calcium content, the information is unreliable, so an individual with osteoporosis may have a normal X-Ray. X-Ray is better for detecting recent bone fractures.

Question 5

Barium Sulfate

Answer 5

A good X-Ray absorber used in diagnostic work. Barium is a metallic element that is chemically similar to calcium, but more reactive. Spineplex has 30% Barium Sulfate

Question 6

Biopsy

Answer 6

A medical test involving the removal of cells or tissues for examination. Pre-Vertebroplasty, the cancellous bone is harvested with a coring mechanism to test for malignancies.

Question 7

Bipedicular

Answer 7

Vertebral approach through both pedicles on a vertebral body.

Question 8

Cannula

Answer 8

A tube, which when inserted into the body is used to either withdraw fluid or insert something. Cannulae normally normally come with a trocar (a sharp pointed needle) attached which allows puncture of the body to get into the intended space

Question 9

Cortex

Answer 9

Opening of the vertebral body, the margin between cortical and cancellous bone.

Question 10

Embolism

Answer 10

An embolism occurs when an object (the embolus of plural emboli) migrates from one part of the body (through circulation) and cause a blockage (occlusion) or a blood vessel in another part of the body. In vertebroplasty this can occur with cement or fat that is displaced from the vertebrae during cement injection. usually occurs in the lungs.

Question 11

Fluoroscopy

Answer 11

An imaging technique commonly used by physicians to obtain real-time images of the internal structures of a patient through the use of a fluoroscope. Consists of an x-ray source and a fluorescent screen

Question 12

kyphoplasty

Answer 12

procedure involving percutaneous placement of a balloon into a collapsed vertebrae, followed by injection of bone cement to stabilize the fracture.

Question 13

Kyphosis

Answer 13

an exaggerates posterior curvature in the thoracic region - produces the “humpback”

Question 14

Hemangioma

Answer 14

A benign tumor formed by a collection of excess blood in the region

Question 15

Lateral

Answer 15

the view in which cement is injected - enabling the practitioner to monitor the posterior parts of the vertebral body and prevent cement from entering the foramen.

Question 16

Lidocaine

Answer 16

A common local anesthetic - often used to anesthetize the soft tissues and pedicles before a vertebroplasty

Question 17

Lordosis

Answer 17

An exaggerated anterior curvature of the lumbar region (swayback)

Question 18

Myeloma

Answer 18

A tumor composed of cells derived from homopoietic (blood forming) tissues of the bone marrow

Question 19

Myelopathy

Answer 19

disturbances or diseases of the spinal cord

Question 20

Metastasis

Answer 20

Transmission of pathogenic microorganisms or cancerous cells from an original sire to one of more sites elsewhere in the body

Question 21

MRI

Answer 21

The MRI scan uses magnetic and radio waves, and can be used to make images of almost the tissues of the body. the tissue that has the least hydrogen atoms (like bones) turns out dark, while the tissue that has many hydrogen atoms (like fatty tissues) look much brighter.

Question 22

Neoplasm

Answer 22

Another word for a tumor

Question 23

Oblique view

Answer 23

the fluoroscope is placed in an approximate 45 degree angle. After squaring the endplates, the pedicle is centered in the vertebral body, and a needle is placed in a “down the barrel” approach to attain the proper trajectory into the vertebral body. Cement should never be placed in this view.

Question 24

Parapedicular

Answer 24

needle enters the vertebral body through the lateral wal, adjacent to the pedical

Question 25

Plana

Answer 25

total endplate collapse of the vertebra

Question 26

PMMA

Answer 26

Polymethyl Methacrylate - the fine powder contained in each pack of Spineplex. When this is mixed with Methyl methacrylate-styrene copolymer, containing Benzoyl Peroxide (1.5%) an exothermic polymeric formation occurs resulting in a soft, pliable, dough-like mass. As the reaction progresses, a hard, cement like complex forms. This is acrylic bone cement.

Question 27

Posterior 1/3

Answer 27

In the lateral view the cement should never begin to fill this section of the vertebral body - this in dangerously close to the foramen, which houses the spinal cord.

Question 28

Sacralization

Answer 28

Developmental abnormality in which the first sacral vertebra becomes fused with the fifth lumbar vertebra

Question 29

Sclerosis

Answer 29

An of the various diseases characterized by thickening or hardening

Question 30

Scoliosis

Answer 30

Lateral curvature, the most common abnormal curvature, occurring in .5% of the population, more common among females and may result from unequal growth of the two sided of one or more vertebrae

Question 31

Stenosis

Answer 31

Spinal stenosis is where the spinal canal narrows and pinches the spinal cord and nerves, usually due to disc herniation or tumor. Lumbar stenosis results in low back pain as well as pain or abnormal sensations of the legs

Question 32

Tantalum

Answer 32

like Barium, an opacifying agent used in bone cement

Question 33

Translateral

Answer 33

See “perpendicular”

Question 34

Trocar

Answer 34

A sharp needle that fits down a cannula, used to pierce the skin for access

Question 35

Tumor

Answer 35

abnormal growth of tissue, can be malignant or benign

Question 36

Unipedicular

Answer 36

access to the vertebral body through one pedicle only

Question 37

Vertebroplasty

Answer 37

procedure in which bone cement is percutaneously injected into a fractured vertebra in order to stabilize it

Question 38

X-Ray (plain films_

Answer 38

X-Rays are especially useful in the detection of pathology of the skeletal system, but can also be useful for detecting some disease processes in soft tissue.