Complex Spine

Question 1

Wiltse-Newman classification of spondylolisthesis

Answer 1

DID PPP

Dysplastic
Isthmic
Degen
Post traumatic
Pathological
Post-op

Question 2

Pathophysiology of isthmic spondylolisthesis

Answer 2

pars defect typically onset early teens, symptoms compensated by healthy discs.

Degeneration of the discs lead to foraminal stenosis and slip, typically a worse grade spondylolisthesis than a degenerative spondylolisthesis.

Usually L5/S1 level affected. Treatment is with fixation.

Question 3

Pathophysiology of degenerative spondylolisthesis

Answer 3

Facet hypertrophy, central and lateral recess stenosis.

Usually lower grade spondylolisthesis (grade 1 or 2).

Can sometimes just do a decompression without fusion if symptoms are only pain.

Question 4

Blood supply to odontoid peg

Answer 4

Apex supplied by ICA
Base supplied by branches of vertebral artery.

Therefore watershed zone

Question 5

Two types of os odontoideum

Answer 5

Orthotopic: ossicle moves with anterior arch of C1

Dystopia: ossicle fused to basion

Question 6

Peg fracture fusion rates when conservatively managed

Answer 6

Type 1: 100%
Type 2: 60%
Type 3: 90%

Question 7

Chances of walking 1 year after ASIA A SCI

Answer 7

5%

Question 8

% of patients regaining ability to walk if sacral sparing is present

Answer 8

75%