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37 Cards in this Set
- Front
- Back
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posterior ligamentous complex
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supraspinous ligament (SSL)
interspinous ligament (ISL) ligamentum flavum (LF) facet joint capsules |
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liagmentus nuchae
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interspinous ligament
supraspinous ligament |
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ASIA grading
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Grade A: complete - no motor or sensory
Grade B: no motor, sensory present Grade C: motor <3/5, sensory present Grade D: motor >/=3/5, sensory present Grade E: normal |
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sensory present on ASIA scale
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sensation at anal mucocutaneous junction
deep anal sensation |
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motor present on ASIA scale
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voluntary anal schincter contraction
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motor grading
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0 = no visible or palpable contraction
1 = any visible or palpable contraction 2 = able to move with gravity eliminated 3 = able to move against gravity 4 = able to move against some resistance 5 = able to move against resistance |
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anterior column
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anterior longitudinal ligament
anterior part of the vertebral body anterior portion of the annulus fibrosis |
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middle column
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posterior longitudinal ligament
posterior part of the vertebral body posterior portion of annulus fibrosis |
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posterior column
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facet joints
laminae pedicles supraspinous ligament (SSL) interspinous ligament (ISL) ligamentum flavum (LF) facet joint capsules |
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SLIC components
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morphology
ligamentous neurologic status |
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SLIC morphology
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no abnormality = 0
compression = 1 burst = 2 distraction = 3 (perch, hyperex) rotation/translation = 4 (facet dislocation, unstable teardrop) |
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SLIC ligamentous
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intact = 0
indeterminate = 1 (interspinous widening, MRI signal change) disrupted = 2 (disc space wide, facet perch/dislocation) |
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SLIC neurologic
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intact = 0
root injury = 1 complete = 2 incomplete = 3 continuous cord compression = 4 |
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Denis scheme: compression
A: both endplates B: superior endplate C: inferior endplate D: anterior body |
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Denis scheme: burst
A: both endplates B: superior endplate C: inferior endplate D: rotational deformity E: lateral translation |
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Denis scheme: flexion-distraction
A: bony involving one segment B: soft tissues of one segment C: bony involving two segments D: soft tissues of two segments |
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Denis scheme: fracture-dislocations
A: bony involving one segment B: soft tissues of one segment C: two level injuries |
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AO/Magerl classification based on vector forces
A: compression B: distraction C: rotation |
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TLICS
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thoracolumbar injury classification and severity score
- morphology - neurologic status - posterior ligamentous complex |
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TLICS morphology grading
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compression = 1
burst = 2 translational/rotational = 3 distraction = 4 |
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TLICS neurologic status grading
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intact = 0
nerve root injury = 2 spinal cord/conus medullaris injury complete = 2 incomplete = 3 cauda equina = 3 |
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TLICS PLC grading
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intact = 0
indeterminate = 2 disrupted = 3 |
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TLICS treatment recommendations based on score
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</=3 nonoperative
4 indeterminate >/=5 operative |
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posterior elements making up protective neural arch
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pedicles
laminae transverse processes spinous processes facet (zygoaphophyseal) joints |
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primary thoracic spinal cord vascular supply
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artery of Adamkiewicz
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why artery of Adamkiewicz is in danger
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perfuses retrograde
enters single intervertebral foramen between T9-L2 |
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level conus medullaris ends
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L1-L2
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at what point are compression fractures considered unstable?
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>50% vertebral body height loss
>20-30 degrees angulation multiple adjacent compression fractures |
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thoraco lumbar injury associated with intrabdominal injuries
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flexion-distraction
(chance fractures, seat belt-type injuries) |
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when is spinal injury considered unstable?
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normal physiologic loads cause further neurologic damage, chronic pain, and unacceptable deformity
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factors indicative of instability of burst fracture
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50% canal compromise
15-25 degrees of kyphosis >40% anterior body height loss |
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L1-S1 motor exam
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L1: hip flexor
L2: hip adductor L3: quadriceps L4: anterior tibialis L5: extensor hallucis longus S1: flexor hallucis longus |
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L1-S1 sensory exam
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L1: anterior proximal thigh
L2: middle proximal thigh L3: inferior to patella L4: just above medial malleolus L5: 1st web space S1: lateral border of foot |
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L1-S1 reflex exam
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L1: none
L2: none L3: patella L4: patella L5: none S1: achilles |
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