Ortho(2) Flashcards
(23 cards)
What’s an indication that someone has done surgery?
Weakness in hands and arm
Failure to improve with medication or PT
Various test confirm a ruptured disc
What are the risks and complications of an anterior cervical disectomy?
Bleeding
Infection
Graft dislodgement
Damage to spinal cord
Nerve root damage
Continual pain
Why is an anterior cervical decompression done?(disectomy)
To allow offending disc to be removed and to relieve pressure on 1 or more nerve roots
Why is an anterior cx fusion done?
As part of a cx discectomy to prevent disc space collapse (kyphosis)
Treating Instability to Tumor,infection and trauma
Prevent motion at a vertebral segment
What is the physio management post surgery?
-Chest-Risks and effects should be minimized by deep breathing exercises and positioning and MOB
-Attention is given to left lower limb and especially with hip movement so maintained exercises are done there
-Gentle ROM of shoulder
-Static contractions of neck and shoulder muscles
-Gentle active rom of cx once collar off
What are the types of general lower back surgery?
Decompression-small portion of bone over nerve root or disc material from under nerve root or disc from under nerve root to relieve pinching of nerve to stop nerve impingement
And -Lumbar spinal fusion (bone graft is used to stop motion at a painful vertebral segment
What may cause nerve impingement?
Spinal stenosis
Disc herniation
Tumors
What are the types of decompression procedures?
Micro disectomy
Laminesectomy
What conditions require a spinal fusion?
Spinal tumor
Kyphosis
Scoliosis
Spondylothesis
Other degenerative conditions (spinal)
What is spondylodesis?
It’s a lumbar spinal fusion to stop motion at a painful vertebral segment which decreases pain from the joint
Adding a bome graft to an area of the spine
Where can a bone graft be harvested?
From a patient(autologous) or cadaver(allograft)
What is a posterior lamenectomy?
Stenosis can cause pressure on the spinal cord and if compression is in the back then lamina and spinous process is removed to give spinal cord more room
What are the benefits of a lamectomy?
Spinal cord function
Improvement in hand function and walking
Less or numbness in hands
What are the risks and complications of a laminectomy ?
Infection
Bleeding
Increased pain
Dural tear
What is the PT management post surgery?
Postop exercises
Gait training
Wound care
Education
Putting on and taking off brace
Stabilized based exercises
What is the laminectomy protocol post op?(5-7days after)
Log roll is taught
Pt is mobalized and taught protective techniques
Strengthening of lumbar extensor and abs
Lower limbs muscles should be Strengthened
Stretch for tight hammies and hip flexors
Kinetic handling
Pelvic tilt and posture should be corrected
What is failed back surgery syndrome?-Post laminectomy syndrome
Chronic back pain or leg pain after surgery
Common symp-difuse,dull and aching pain
Abnormal sensation (sharp,pricking and stabbing pain)
What is a TLSO?
Provides fixation of an individuals vertebra in relation to others as well as fixation of spine to pelvis
What is khyphoplasty?
Original height of khyphosis of fractured vertebra are restored followed by its stabilization using injected bone filler material
What are the non invasive approaches?
A facet block-local anesthetic and steroid injected into one or more facet joints
-epidural-local anesthetic into epidural space
What are the minimal invasive techniques?
Rhizectomy-cutting or damaging nerve fibers to relieve chronic pain by disrupting the transmission of pain signals
Verterbroplasty-bone cement is injected into a fractured vertebra to stablize the spine and relieve pain
