Spinal Degeneration & Infection & Congenital Flashcards
A disc displacement of <25% of the circumference is termed?
Focal
A disc displacement of 25-50% of the circumference is termed?
Broad-based
What is a contained vs. uncontained disc fragment?
Contained = displaced disc is covered by outer annulus Uncontained = displaced disc is not covered by outer annulus
Tells about the integrity of outer annulus covering disc herniation.
How will scar tissue (from failed back surgery syndrome) present on MRI?
ENHANCES! (Fibrous tissue is very vascular.)
What is arachnoiditis?
- Inflammation of spinal leptomeninges (esp. nerve roots)
- Results in intradural adhesions
- Causes: infection (eg. TB or pyogenic meningitis); inflammatory disease, subarachnoid hemorrhage
What % of recurrent disc herniation is implicated in failed back surgery syndrome?
~10%
What are the causes for “late” failed back surgery syndrome?
i) foraminal/central stenosis (M/C)
ii) pseudoarthrosis/instability
iii) recurrent herniation
iv) epidural fibrosis
v) arachnoiditis
What are the causes for “early” surgical failure?
i) post-operative hemorrhage w/ neural compression
ii) disc space infection (VB osteomyelitis, meningitis)
iii) dural tear w/ pseudo-meningocele
iv) hardware malposition
v) wrong level for surgery
Where is the M/C location within the spine for discitis/osteomyelitis and what is the M/C organism?
Lumbar spine & staph aureus
Where within the spine does TB M/C occur?
Thoracic spine
What % of TB in the spine also has pulmonary involvement?
50%
What is Currarino’s triad?
i) anorectral malformation
ii) bony sacral defect (meningocele)
iii) pre-sacral mass
Spinal dysraphisms occur in which 2 forms?
a) Open (eg. meningocele etc.)
b) Closed (eg. spina bifida occulta)
