Spine Implants Flashcards by Meg Flannery

What is the function of the spine?

A multi-segmented beam that transmits the weight of the upper body to the pelvis. It is subjected to internal forces many times the entire body weight.

How well did you know this?

Not at all

Perfectly

Name the four sections of the spine and the type of curve each has.

Cervical spine (neck portion). 7 vertebrae. Lordotic. Thoracic spine. 12 vertebrae. Kyphotic. Lumbar. 5 vertebrae. Lordotic. Sacrum and coccyx (tailbone). 5 fused vertebrae.

How well did you know this?

Not at all

Perfectly

What is a functional spinal unit?

Vertebral body Intervertebral Disc Vertebral body

How well did you know this?

Not at all

Perfectly

What is the costal vertebral joint?

Between rib and thoracic spine vertebrae.

How well did you know this?

Not at all

Perfectly

What is lordosis?

Natural curve of the lumbar and cervical spine.

How well did you know this?

Not at all

Perfectly

What is kyphosis?

Natural curve of the thoracic spine.

How well did you know this?

Not at all

Perfectly

What is scoliosis?

A complex 3D deformity of the spine associated with lateral bending and vertebral rotation.

How well did you know this?

Not at all

Perfectly

Explain the difference in vertebrae size between the top and bottom regions of the spine.

Vertebrae at top of spine are smaller than those at the bottom. This is because as you go down the spine, the weight needed to be supported is greater. This increasing size means that stress is largely constant down the spine.

How well did you know this?

Not at all

Perfectly

What is a pedicle?

Bony connection between posterior and anterior elements.

How well did you know this?

Not at all

Perfectly

What type of joint are facets? Name the two types.

Synovial joints. Inferior and superior.

How well did you know this?

Not at all

Perfectly

Describe the anatomy of an intervertebral disc.

Anisotropic and composite. The disc is comprised of: - nucleus pulposus (viscous) - annulus fbrosis (layered fibers)

How well did you know this?

Not at all

Perfectly

What does the degeneration of an IVD involve?

It causes a collapse in height between vertebral bodies and involves: - rupture in the annulus fibers - nucleus pulposus shrinks - herniation of nucleus pulposus

How well did you know this?

Not at all

Perfectly

What is back pain related to?

Disc degeneration.

How well did you know this?

Not at all

Perfectly

What are two common solutions to alleviate compression on the nervous tissue?

Spinal fusion. Endoscopic Microdiscetomy.

How well did you know this?

Not at all

Perfectly

What is spinal fusion?

Highly invasive procedure that stabilizes the joint.

How well did you know this?

Not at all

Perfectly

What is endoscopic microdiscetomy?

Minimally invasive procedure which does not correct stability or alignment and is only able to remove small quantities.

How well did you know this?

Not at all

Perfectly

What is adjacent disc degeneration and how is it caused?

Degeneration of discs either side of spinal fusion due to extra force being shunted into them.

How well did you know this?

Not at all

Perfectly

What is the ideal outcome of spinal fusion?

Bone, bone, bone. Not bone, damaged disc, bone.

How well did you know this?

Not at all

Perfectly

What are the four components of spinal fusion?

Pedical screws, rods, spacers and set screws.

How well did you know this?

Not at all

Perfectly

What is the spacer made of?

PEEK material which is a radioluscent polymer that cannot be seen on an x ray. This allows the doctor to see the new bone fusing.

How well did you know this?

Not at all

Perfectly

Name the four main types of spinal fusion (surgical approaches).

Lumbar Interbody Fusion (LIF) - Anterior - Posterior - Lateral - Transforaminal

How well did you know this?

Not at all

Perfectly

What is ‘off label use’?

Use of something not approved by the FDA.

How well did you know this?

Not at all

Perfectly

What is dysphoria?

Inability to speak or breathe.

How well did you know this?

Not at all

Perfectly

What is dysphagia?

Study These Flashcards

Inability to swallow.

What is the advantage of a polyaxial pedical screw?

Swivelling capacity allows for angle of approach to be changed.

What is the surgical intervention involved with disc herniation?

Anterior Cervical Discectomy Fusion (ACDF)

What is an allograft?

Graft tissue from another human.

What is dynamic stabilization?

A new type of soft fusion which promotes fusion through small movements.

What are some advantages to dynamic stabilization?

Less stress on adjacent vertebrae which means no adjacent disc degeneration.

What are some disadvantages to dynamic stabilization?

Doesn't restore stability so is currently not FDA approved.

What is scoliosis caused by?

Congenital Neuromuscular Idiopathic

Name some side effects of scoliosis.

Creates shoulder and pelvic asymmetry. Seriously affects ability to breathe.

What are the tests used to find scoliosis? (4)

Adam's Test (forward bend test) Scoliometer Screening to measure curvature of spine. Spine X rays to see Cobb angle MRI

What are the three main objectives to bracing?

1. Controlling back pain by limiting motion and unloading spinal structures. 2. Stabilizing weak or injured structures by immobilizing the spine. 3. Providing a 3 point force system to provide a correction or prevent progression of deformity.

Name two types of brace.

Boston brace for scoliosis. Milwaukee brace for kyphosis.

What is the Cobb Angle?

Measurement of the degree of side to side spinal curvature. 15-20: physical therapy and regular check ups. 20-45: back brace 45+: surgical procedures.

What is goal of spinal surgery of scoliosis?

To fuse the vertebrae so the spine cannot bend and to correct deformity by 50% or more.

What are the surgical steps involved with spinal fusion?

Incision made in middle of back. Facets joints between vertebrae are removed. Vertebrae are roughened up so body responds by producing new bone. Metal implants are put in to hold the spine while vertebrae fuse.

What is involved in the future of spine fusion?

Electronic/chemical stimulant for bone growth.

What is intevertebral disc replacement?

A composite implant that mimics the function of an IVD by preserving motion. Made of a polymer center with metal endplates, which fuse to adjacent vertebrae.

Name the three types of artificial disc.

ProDisc Charite Secure C

Describe the IVD replacement procedure.

Anterior approach Radiograph checks alignment Discectomy removes damaged or diseased disc Artificial disc inserted between vertebral bodies.

What are the benefits of an IVD replacement? (5)

Maintain or increase flexibility and r.o.m. Maintain joint stability. Decrease stress transfer to adjacent discs. Maintain disc height Pain reduction

What are the repeat surgery rates of spinal fusion and IVD replacement?

IVD replacement: 2.4-4.2% every 2-5 years. Spine Fusion: 8.2-13.3% every 2-5 years.

Compare IVD replacement to spinal fusion.

IVD more invasive surgery, less narcotic use after 24 months. Fusion more complex but less pain and less morbidity.

What are some disadvantages and risks to IVD replacement? (5)

Highly invasive. Limited FDA approval. Potential material rejection. Potential nerve damage. Poor insurance coverage.