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21 Cards in this Set
- Front
- Back
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Benefits of using radiographs
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– Best tool for looking out alignment [scoliosis and kyphosis]
- Simple to perform |
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Drawbacks of using radiographs
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– Ionizing radiation
– Very little soft tissue detail – Not useful for herniation |
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CT is best tool for
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– Cortical bone
– calcification – Surgical hardware Primary modality for trauma |
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Drawbacks to using MRI
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– Takes 30 – 90 minutes
– Less accessible – Contraindications common – Claustrophobia – Poor for cortical bone |
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Benefits of using MRI
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Best tool for imaging:
- Marrow – Soft tissue – Spinal cord – Infections |
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In which circumstance way IV contrast to use with CT
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– Infection
– Abscess – Tumor – Post op – Vessels |
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Contraindications for CT
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– Pregnancy [especially first trimester]
– Young patients If with contrast: – Contrast allergy – Hyperthyroidism – Renal impairment – Diabetic treated with metformin |
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Difference between T1 and T2 on MRI
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T1 dark CSF
T2 white CSF |
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MRIs are the best tool for
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Evaluating soft tissues
– Disc – Spinal cord – Bone marrow |
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Myelogram
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Lumbar puncture under x-ray guidance
With injection of iodinated contrast into thecal sac |
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Myelogram useful for
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– Detecting canals enosis post surgery with hardware
– Detecting CSF leak |
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Inner nucleus pulposus
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– Primarily hydrated proteoglycans
–Distributes compressive radial force over vertebral end plate |
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Outer annulus fibrosis
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– Inner fibers [ fibrocartilage]
– Outer fibers [collagen type 1] – Contains the radial forces from the nucleus pulposis |
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Supplemental supply to ASA
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Cervical and thoracolumbar radicular artery
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Characteristics of spinal venous drainage
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– Large valveless network
– Sacral hiatus to foramen magnum – Bidirectional flow [dependent on abdominal pressure] – Arrangement more symmetrical less variable than artery supply – Connection to prosthetic plexus is likely route for metastatic prostate cancer |
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Three major external complexes for spinal venous drainage
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– Basivertebral veins
– Internal vertebral venous plexus – External vertebral venous plexus |
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How does anterior longitudinal ligament attached to the vertebral body
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Via sharpies fibers of the periosteum of the vertebral body along with outer part of the disk [annulus fibrosis]
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Why are cervical infarct rare
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Due to the extensive collateral supply
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Characteristics of vertebral arteries
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– Travel within the transverse foramina of the cervical spine
– Vulnerable to injury |
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Symptoms of disc herniation
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Often asymptomatic
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Traversing nerve root
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Lies in the lateral aspect of the thecal sac as it passes inferiorly to exit a more caudal formen
- may be affected by paracentral or subarticular herniations |
