Spinal Surgeries, Fx & PCA Flashcards
disectomy
removes disc fragments and herniated disc material that compress adjacent nerve roots
decompression
removal of posterior elements of vertebral column
foramen widened to provide pressure relief on neural elements
creating space - radicular pain
laminectomy
lamina excised to provide more space and relieve pressure
spinal fusion
stabilizes hypermobile or unstable joints
total disc replacement
alternative to fusion
complications
neurologic injury infxn cauda equina syndrome dural tear with cerebrospinal fluid leak nonunion
delayed union
slowed bone healing
more than 10 weaks
nonunion
bone doesnt heal
malunion
bone heals but in the wrong way
fx complications
delayed union, nonunion, malunion loss of fixation or reduction deep vein thrombosis, pulmonary or fat emboli nerve damage arterial damage compartment syndrome infxn
what factors are good for bone healing
early mob early WB maintenance of fx reduction younger age good nutrition minimal soft tissue damage pt compliance presence of growth hormone
what factors are bad for bone healing
smoking disease vit deficiency OP infxn bone loss soft tissue damage etc.
what are the options for PCA
small pump worn by pt
implantable device
large size pump attached to pole
benefits of PCA for PT
earlier participation in post op rehab
pt may be more alert and experience fewer side effects
more mobile
disadvantages for PCA
meds may make pt drowsy
be aware of potential pump malfunctions
