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Flashcards in T-spine Deck (39):
1

What is found in the anterior column of the thoracolumbar region?

- ALL
- Anterior 2/3rds of body

2

What is found in the middle column of the thoracolumbar region?

- Posterior 1/3rd of body
- Posterior longitudinal ligament

3

What is found in the posterior column of thoracolumbar region?

- Posterior ligaments
- Vertebral arches

4

What type of fracture in the thoracolumbar region is stable?

Through one column

5

How can a two column fracture through the thoracolumbar region be stable?

- Depending on the extent of the fracture

6

What is required in a 3 column thoracolumbar fracture?

- Internal fixation

7

What is the mechanism of a compression fracture in the thoracic spine?

- Flexion force collapses the anterior vertebral body

8

What posture contributes to and is a result of compression fractures?

- Kyphosis
- Axial forces create flexion force
- Crushed bodies create kyphotic posture

9

What shape do the vertebral bodies take on in a compression fracture?

Wedge shaped

10

How can a compression fracture be stable?

- If the fracture is only through the anterior body

11

Who is most at risk for compression fractures?

- Caucasian, post-menopausal women

12

What is the treatment for a compression fracture?

- Cement injected into a painful fractured vertebral body

(Vertebroblasty)

13

How quickly do vertebroblasties provide pain relief and restoration of mobility?

Within 48 hours

14

What type of movement is prevented with a vertebroblasty?

- Fracture movement

15

What is the success rate of vertebroblasty?

73 - 90 %

16

Does vertebroblasty correct vertebral deformities?

No, but it does prevent further collapse

17

Through what structures is the needle passed through in a vertebroblasty?

- Pedicle and vertebral body

18

What is the difference between a kyphoplasty and a vertebroblasty?

- Corrects deformity and relieves pain and restores mobility

19

When must a kyphoplasty be performed?

When the fracture is acute.

20

What is the procedure of a kyphoplasty?

- Patient recumbent
- Balloon inserted into vertebral body and inflated
- Balloon removed, and cavity filled with bone cement

21

What are the 3 scoliosis types?

- Infantile
- Juvenile
- Adolescent

22

At what age does infantile scoliosis occur?

< 3 yo

23

How does infantile scoliosis resolve?

Spontaneously

24

What age groups are affected by Juvenile scoliosis? What gender is more effected?

- 3 - 10 yo
- Girls > Boys

25

At what age does adolescent scoliosis occur?

- 10 yo to skeletal maturity

26

How more likely are girls to develop adolescent scoliosis than boys?

7Xs more.

27

What event does adolescent scoliosis typically coincide with?

- Growth spurts

28

What type of scoliosis is at particular risk for progression?

Juvenile

29

When does progression halt in adolescent scoliosis? What else ends here?

- Ends at skeletal maturity
- Conservative treatment no longer affective

30

How the curves of scoliosis named?

For the location and side of the apex as viewed clinically from behind.

31

Can there be multiple apexes in a scoliotic spine?

- Yes

32

What is the Cobb angle?

- Standard AP view with equalized leg lengths
- Draw lines from the most tilted inferior and superior vertebraes
- Drop perpendiculars off the lines, and measure the angle

33

What is the measurement error in a Cobb angle?

< 10 degrees

34

How is the Cobb Angle documented? (besides the degrees)

Which vertebrae were used to calculate

35

What is the pedicle method of scoliosis measurement?

- Drop a plumb line down the middle of the vertebrae
- Measure position of pedicles against the midline from 0 to 4+

36

Where are the pedicles positioned in 0, 1+, 2+, 3+, and 4+?

0: Normally
1+: Slightly off-center
2+: One pedicle almost obscured
3+: Pedicle at midline
4+: Pedicle past midline

37

What 3 ways are the vertebrae deformed in scoliosis?

- Wedge shaped body
- Shorter pedicles and laminae on the concave side
- Deformed spinous process

38

What 2 ways are the ribs deformed in scoliosis?

- Deformed on both sides
- Rotation causes rib hump on convex side

39

How is scoliosis "corrected"?

- Stretch concave
- Strengthen convex