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Questions and Answers
What is the primary anatomical feature of sacralization of L5?
What is the primary anatomical feature of sacralization of L5?
- Impingement of a prolapsed disc on the nerve root
- Removal of the lamina to increase spinal canal space
- Fusion of the transverse process of L5 to the sacrum on one or both sides (correct)
- Narrowing of the L5-S1 intervertebral disc
Which of the following is NOT a potential symptom of sacralization of L5?
Which of the following is NOT a potential symptom of sacralization of L5?
- Asymptomatic presentation
- Disc protrusion (correct)
- Loss of function
- Lower back pain
What is the primary purpose of performing a laminectomy?
What is the primary purpose of performing a laminectomy?
- To perform a small fenestration (windowing) within the ligamentum flavum
- To increase the potential space in the spinal canal
- To fuse the transverse process of L5 to the sacrum
- To remove a prolapsed intervertebral disc that is impinging on the nerve root (correct)
What is the most important step before performing surgery to remove a prolapsed intervertebral disc?
What is the most important step before performing surgery to remove a prolapsed intervertebral disc?
What is the potential effect of removing the lamina during a surgical procedure?
What is the potential effect of removing the lamina during a surgical procedure?
What is the primary purpose of performing a small fenestration (windowing) within the ligamentum flavum during a surgical procedure?
What is the primary purpose of performing a small fenestration (windowing) within the ligamentum flavum during a surgical procedure?
What is the term for an abnormal lateral curvature or deviation most commonly seen in the thoracic region?
What is the term for an abnormal lateral curvature or deviation most commonly seen in the thoracic region?
Which abnormal curvature is associated with an abnormal increase in the thoracic curvature?
Which abnormal curvature is associated with an abnormal increase in the thoracic curvature?
What is the condition characterized by an abnormal increase in the lumbar curvature along with an anterior tilt of the pelvis?
What is the condition characterized by an abnormal increase in the lumbar curvature along with an anterior tilt of the pelvis?
Which spinal anomaly is defined by the nonfusion of the first and second segments of the sacrum?
Which spinal anomaly is defined by the nonfusion of the first and second segments of the sacrum?
What could be a possible physiological basis for functional scoliosis?
What could be a possible physiological basis for functional scoliosis?
Which abnormal curvature is commonly associated with obesity and pregnancy?
Which abnormal curvature is commonly associated with obesity and pregnancy?
Where is the epidural space located in relation to the spinal cord?
Where is the epidural space located in relation to the spinal cord?
What is the main purpose of administering epidural anesthesia?
What is the main purpose of administering epidural anesthesia?
Which of the following is NOT a common use of epidural anesthesia?
Which of the following is NOT a common use of epidural anesthesia?
What is the first step in administering epidural anesthesia?
What is the first step in administering epidural anesthesia?
At what levels of the vertebral column can epidural anesthesia be performed?
At what levels of the vertebral column can epidural anesthesia be performed?
What is the purpose of the catheter used in epidural anesthesia?
What is the purpose of the catheter used in epidural anesthesia?
Which term can be used interchangeably with rhizotomy?
Which term can be used interchangeably with rhizotomy?
What is the purpose of securing the catheter on the back?
What is the purpose of securing the catheter on the back?
Which nerve-related condition can be treated with rhizotomy?
Which nerve-related condition can be treated with rhizotomy?
What is the primary method used to destroy nerve fibers during rhizotomy?
What is the primary method used to destroy nerve fibers during rhizotomy?
What type of pain can facet rhizotomy address?
What type of pain can facet rhizotomy address?
What is the main purpose of rhizotomy in treating spasticity?
What is the main purpose of rhizotomy in treating spasticity?
Which of the following is a common symptom of a protruded or ruptured disc in the lumbar region?
Which of the following is a common symptom of a protruded or ruptured disc in the lumbar region?
What is the primary cause of a protruded or ruptured disc?
What is the primary cause of a protruded or ruptured disc?
In spina bifida occulta, what is the typical condition of the spinal cord and spinal nerves?
In spina bifida occulta, what is the typical condition of the spinal cord and spinal nerves?
What is the primary distinguishing feature of spina bifida cystica?
What is the primary distinguishing feature of spina bifida cystica?
Which of the following statements about spina bifida occulta is true?
Which of the following statements about spina bifida occulta is true?
What is the primary difference between spina bifida occulta and spina bifida cystica?
What is the primary difference between spina bifida occulta and spina bifida cystica?
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Study Notes
Rhizotomy
- A minimally invasive surgical procedure to remove sensation from a painful nerve by killing nerve fibers responsible for sending pain signals to the brain.
- Can be used to address different types of pain and abnormal nerve activity, such as:
- Back and neck pain from arthritis, herniated discs, spinal stenosis, and other degenerative spine conditions.
- Trigeminal neuralgia (facial pain due to the irritation of the trigeminal nerve).
- Pain in joints, such as the hip and knee, resulting from arthritis.
- Other conditions affecting the peripheral nerves.
- Spasticity (abnormal muscle tightness and spasms).
Sacralization of L5
- A congenital anomaly where the transverse process of L5 fuses to the sacrum on one or both sides, to the ilium, or to both sacrum and ilium.
- Usually presents bilaterally, causing lower back pain.
- The L5-S1 intervertebral disc may also be thin and narrow.
Laminectomy
- A surgical procedure to remove the lamina to increase the potential space and relieve symptoms.
- May require removal of the disc protrusion.
- Importance of identifying the level of the disc protrusion before surgery using MRI scanning and on-table fluoroscopy.
Spina Bifida
- A developmental defect in the vertebral column in which there is an absence of the vertebral arches.
- Types:
- Spina bifida occulta: a defect of the vertebral arch that results from the failure of the development and fusion of the halves of the vertebral arch.
- Spina bifida cystica: a severe form of spina bifida that involves the herniation of the spinal cord and/or meninges through a defect in a number of vertebral arches.
Abnormal Curvatures of the Vertebral Column
- Kyphosis (hunchback): an abnormal increase in the thoracic (1°) curvature.
- Lordosis (saddle back): an abnormal increase in the lumbar (2°) curvature.
- Scoliosis (crookedness): an abnormal lateral curvature or deviation most commonly seen in the thoracic region.
- Lumbarization: a spinal anomaly defined by the nonfusion of the first and second segments of the sacrum.
Epidural Anesthesia
- A local anesthetic injected near the spinal cord and nerve roots.
- Infiltrated in the fat tissue that surrounds the spinal nerve roots in the epidural space using a catheter inserted in the space through an epidural needle.
- Used to:
- Supplement general anesthesia.
- As the main anesthesia in certain surgical procedures involving thoracic, abdominal, pelvic, or lower extremity regions.
- Help control pain after major surgery to the belly or chest.
- Childbirth.
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