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Flashcards in Thoracic spine II Deck (56)
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1

Classic radiologic hallmarks of osteoporosis:

increased radiolucency
cortical thinning
trabecular changes

2

Increased radiolucency of vertebrae:

first evidenced at cancellous vertebral bodies
empty box appearance of vertebral body

3

Thinning of cortical margins:

first noted at vertebral body margins, especially at endplates, where cortical outline normally relatively thick
Cortical margins of vertebral arches also become thinned

4

Alterations in trabecular patterns:

Trabecular changes within vertebral bodies often leave distinct vertical striations

5

Wedge deformity in osteoporosis:

Structurally weakened vertebral bodies often collapse under flexion or axial compressive forces

6

What happens in severe osteoporosis?

vertebral compression fractures may be due to relatively minor or normal everyday forces
Preponderance toward fracture directly related to severity

7

What do chronic microfractures produces?

biconcave appearance of vertebral body
Configuration results from structural weakness and expansile pressures of disk

8

What does a single traumatic event result in?

vertebra plana
flat appearing vertebra

9

Endplate deformities in osteoporosis:

Smooth indentations seen in endplates centrally, in region of NP

10

Sclerosis along endplates most common where?

thoracic and lumbar spines

11

Schmorl's nodes in osteoporosis?

Focal intrusion of nuclear material into vertebral body through structurally weakened endplates results in these radiolucent “nodes”

12

How is bone mineral density measured?

DEXA scan

13

Early treatment for osteoporosis:

improvement of posture via strengthening and flexibility exercises and improvement of general conditioning via weight-bearing activities and ambulation

14

Treatment for later stages osteoporosis:

rehabilitation important in providing adaptive modifications to preserve functional independence in ADL’s and ambulation

15

What is scoliosis?

lateral deviation of spine from mid-sagittal plane combined with rotational deformities of vertebrae and ribs

16

Pathological changes due to compressive forces on concave side of curvature include

Narrowed disk spaces
Wedge-shaped vertebral bodies
Shorter/thinner pedicles and laminae
Narrowed IVF and spinal canal spaces

17

Pathological changes on convex side of curvature include

Widened rib spaces
Posteriorly positioned rib cage (resulting in deforming “rib hump”)

18

Curves over 5 degrees appear in:

5% of population

19

Curves over 10 degrees appear in:

2-4% of population

20

Curves over 25 degrees occur in:

1.5/1000 individuals

21

How many children will develop scoliotic curves large enough to warrant treatment?

3-5 out of 1000

22

What percentage of scoliosis cases are idiopathic?

80%

23

What are the three types of idiopathic scoliosis:

1. infantile
2. juvenile
3. adolescent

24

Infantile scoliosis:

appears before age 3 and may include neurological involvement
Many cases resolve spontaneously, although some progress to severe deformity

25

Juvenile scoliosis:

appears b/w ages 3-10, more often in girls, and presents high risk for progression

26

Adolescent scoliosis:

appears b/w age 10 and skeletal maturity at 7:1 female:male ratio

27

What are the distinct patterns of curvature in scoliosis:

1. right thoracic curve
2. right thoracolumbar curve
3. left lumbar curve
4. left lumbar, right thoracic curve

28

Right thoracic curve:

Most frequently seen curve is right convex thoracic curve
Major curve extends from T4–T6 to T11–L1
Secondary/minor curves seen above and below major curve as compensatory curves that aid in balancing spine and keeping eyes oriented to horizontal

29

Right thoracolumbar curve:

Major curve longer, extending from T4–T6 to L2–L4
It can appear to either side, but right is most common

30

Left lumbar curve:

Curve extends from T11 or T12 to L5
It also can appear to either side, but left is most common