Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase II Cards from RC > Cervical > Flashcards

Cervical Flashcards

1
Q

what is the overall recurrence rate for disc-associated CSM (cervical spondylomyelopathy)?

A

24%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is success rate for medical management of CSM?

A

38 -54%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is success rate of IVD fenestration alone?

A

30-33%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

where do meningioma of spinal cord most commonly occur?

A

cervical - often cranial to C3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what breed is predisposed to meningioma?

A

boxer
lrg breed dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is prognosis with surgery for meningioma

A

19 mo.

those that survive 3 months and neuro signs improve have good prognosis

recurrence possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are advantages of cervical disc arthroplasty? long term success?

A
  • allowing decompression of spinal cord with dorsal annulectomy, assuring direct decompression
  • can be used to treat 2-3 consecutive cases
  • 91% BUT subsidence in all dogs
    AND intravertebral mobility lost or not detectable in 77% of operated sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is chemonucleolysis?

A

inject IVD with chondroitirase ABC
- 7 d post injection 92% have some improvement
- 77% have excellent improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a piezoelectric device? what are the benefits?

A
  • ultrasonic tool for osteotomy/osteoplasty (use low freq 25-50 Hz) to help cut bone for ventral slot
  • benefit - can adjust so only cuts mineralized tissue and not soft tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

which cervical vertebrae is associated with better prognosis?

A

cranial to C4 (some papers disagree)
- <15kg dog with caudal have poorer prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is prognosis for cervical IVDD with relation to:
- degree of CNS injury

  • duration of disease
  • type of treatment:
A
  • degree of CNS injury: even tetraplegia can make full recovery
  • duration of disease: dogs that dont walk within 2 week more likely to have residual effects
  • type of treatment:
    1 - recurrence rate >/= 36% with conservative treatment
    2 - V slot = 90% recovery in 1 month; 97% recovery in 12 months; recurrence 5-10%
    3 - dorsal lam - 100% in one study
    4 - hemilam - better smaller breeds 78-90%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are 3 factors associated with disc associated compression? age of dogs with DACSM?

A

vertebral canal stenosis

pronounced torsion of caudal cervical intervertebral column - IVDD

protrusion of larger IVD in caudal cervical column

Age = middle age large breed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what causes narrowing of osseous associated CSM? age?

A

stenosis - proliferation of lamina, articular process, or pedicles

Age = young giant breeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what angle between atlas and axis is predictive of instability?

A

<162 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

complications of conservative management for AAI?

A

recurrence of disease, corneal ulcers, migration of splint (ineffective), moist dermatitis, decubital ulcers, hyperthermia, respiratory compromise, anorexia, otitis externa, accumulation of food in badnage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the main contraindication for dorsal technique for AAI?

A

spinal cord compression from dorsal deviation of dens

17
Q

list dorsal techniques to address AAI

A

atlantoaxial wiring (or w suture)
nuchal ligament technique
dorsal cross-pinning (+PMMA)
kishigami AA tension band

18
Q

what is the toughest (cautious) step of kishigami?

A

insert over dorsal arch of atlast in subarachnoid space

19
Q

what/how is slanted ventral slot created?

A

removes caudal aspect of cranial vertebral body of affected IVD
- window created cranial to IVD few mm from ventral crest of body
- ~20% width (20-25% length) direct toward vertebral endplate

20
Q

what size dog dog we not recommend doing cervical fenestration

A

> 30kg (arbitrary?)

21
Q

list complications of sx to treat cervical IVDD

A

resp compromise:
1- type 1 - ventilatory failure 2ndary to paralysis/paresis
2- type 2 - ventilating normal. pneumothorax or atelactasis with recumbency/anesthesia

cardiac dysrhythmias

hemorrhage: 19% in Ross. study

neuro deterioration: + lar par/Horners

vertebral subluxation: 8% in one 2000 paper

seroma

22
Q

what is overall complication rate of sx cervical IVDD?

A

9.9% (Rossmerzel 2013)

minor - 3.5%
major - 6.4%

hemorrhage 18.9% (only 5 needed transfusion)

23
Q

list ventral techniques of AAI surgery?

A

transarticular screw + pins
pins and PMMA
screws and PMMA
Ventral plating:
1- mini H plate variant
2 - butterfly plate variant

24
Q

what are the 2 patterns for screw placement in body of axis for AAI stabilization?

A

1 - 4 cortical screws in body; 1 in middle of caudal aspect of each cranial articular surface of axis at insertion point of longus colli

2 - 2 cortical screws, 1 screw to facilitate secure realignment. 2nd screw placed in cranial 1/2 of vertebral body of axis (this technique uses transarticular pins)

25
Q

what is typical gait in dog with CSM?

A

general proprioceptive ataxia even with absence of postural reaction deficit (typical PL ataxia, mild changes in TL)

26
Q

what % are non-ambulatory tetraparetic?

A

10%

27
Q

what % normal Dobies have changes on rads similar to dogs with CSM

A

25%

28
Q

what is the % seizure complication rate in performing myelography in dobies?

A

25-27%

29
Q

for disc-associated cervical spondylomyelopathy, what are typical sx tx plans for:
- ventral static compression
- dynamic compressive
- multiple compressive sites

A
  • ventral static - ventral slot or inverted cone
  • dynamic compressive - distraction and stabilization (PMMA plug or pins/screws + PMMA)
  • multiple compressive sites - distract and stabilize (most often PMMA plug)
30
Q

what are 2 additional techniques for multiple ventral compressions?

A

continuous dorsal laminectomy

cervical disc arthroplasty

31
Q

what are alternatives options to repair cervical fracture if concerned about transverse foramen

A

screws in transverse process, joined curve steel bar and encased PMMA

ventrally applied monocortical screw and PMMA fixation (3 screws/vertebra)
- 9.7% monocortical screws penerated vertebral canal

32
Q

cervical IVD - prevalence of those with IVD?

most common breeds? age?

A

14-25% (most extrusion)

small - toy poodles/ beagles (chondrodystrohpic)
large - labs, dalmatians, dobies (24% of all cases)
age - mean age 6-8 years; BUT shih tzu/yorkies (older; around 9-10 years)

33
Q

cervical IVD - which sites are more often affected?

A

chondrodystrophic - 80% are C2-C4
44-59% C2-C3 aloine

yorkies/chihuahua - caudal C5-6 or C6/7

34
Q

what are advantages of paramedian approach to ventral cervical column?

A

protects carotid sheath, exposes caudal vertebrae, decrease risk of hemorrhage from right caudal thyroid artery

35
Q

with lateral approach to brachial plexus, what muscle needs transecting to show ventral branches of 5-8th cervical nerves?

A

scalenus muscle

36
Q

what are indications of lateral approach to cervical region?

A

lateral or foraminal IVD herniation, nerve sheath neoplasms involve spinal nerve or spinal nerve roots and lesions in lateral epidural space

Phase II Cards from RC (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions