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Spine Anatomy PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Spine Anatomy" by Michelle Wilton, CST, MBA.

This medical PowerPoint presentation is about the spine, also known as the vertebral column or spinal column. The spine is a complex structure composed of 33 vertebrae, which are separated by intervertebral discs, and numerous ligaments and muscles. The spine serves as the main support structure for the body and protects the spinal cord, which is the main pathway for nerve impulses between the brain and the rest of the body.

Tags : Spine Anatomy, spine, vertebral column, spinal column, Orthopaedic Surgery, Orthopaedic Surgery PowerPoint presentation

Published on : Jun 23, 2023 | Views : 3055 | Downloads : 7

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Slide 2-

24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 2 Spine Anatomy: Common anatomic problems involve cervical or lumbar spine Cervical Spine (neck, 7 vertebra) chronic neck pain with arm pain, numbness/tingling, indicates an anatomic problem common problems include cervical herniated disc and foraminal stenosis Thoracic Spine (upper back, 12 vertebra) Thoracic spine designed to protect the vital organs of the heart and lungs Not designed for motion, and consequently, injuries to the thoracic spine are rare. Lumbar Spine (lower back, 5 vertebra) Most likely to breakdown from wear and tear (e.g. Osteoarthritis) Two lowest discs (L4-L5 and L5-S1) are the most likely to herniate, causing pain and numbness to the leg and down to the foot (sciatica)
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 3 Spine Anatomy: Tight space leaves little room for movement Alignment of vertebra is important to keep nerves free from impingement Facet joints can be the source of much discomfort if excess bone forms or existing bone degenerates. The facets connect two neighboring vertebrae. Any source of compression on nerves or the spinal cord can cause back pain and associated pain of the arms and legs
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 8 The Vertebral Body (VB) Primary function of vertebral bodies is support and failure leads to complications Key Roles: Carry 80% of the axial loads through VB and disc Endplates: conduit for nutrition of disc
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Differences in Structure of the Vertebral Bodies: Cervical to Sacrum
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 13 Discs are shock absorbers Nucleus Pulposus: Provides shock absorption Annulus Fibrosus: Contains the nucleus pulposus and prevents herniation
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 15 The Function of the Ligaments Prevent Excessive Motion, and Protect the Neural Elements The ligamentum flavum is a strong ligament that connects the laminae of the vertebrae. “Flavum" means yellow in Latin
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 16 Neuroanatomy Brain Spinal Cord Roots Cauda Equina Brachial Plexus Lumbar Plexus Roots Central Nervous System Peripheral Nervous System
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 17 Neuroanatomy Spinal Cord A continuation of the brain Billions of neurons Both ascending and descending pathways Part of the central nervous system Stops at L-1
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 20 Be Smart and Sound Professional The large bundle of nerve tissue in cervical cases is the spinal cord In lumbar cases it is the cauda equina (often referred to as the cauda)
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Spinal Disease Process
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 22 Latin Lesson -otomy = opening -ectomy = removal -spondylo = vertebral lithesis = slippage patho = disease hemi = half lysis = defect itis = inflammation, infection
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 26 The Degenerative Cascade Leading to Osteophytes: Disc ↓ height and volume Compressive loads transfer away from nucleus to margins Sclerosis reduces nutrition Facet joints deteriorate Dysfunctional motion segment Osteophytes develop Osteophytes encroach on neural structures
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 27 Degenerative diseases are the primary cause of disc and/or vertebral failure By age 50, 95% show lumbar disc degeneration Significant disc changes: ↓ Water and proteoglycan content Distorted collagen fibers Lamellar tears Results in: ↓ Disc height and volume ↓ Resistance to loading forces Loses shock absorber effect
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 28 The vertebral bodies are impacted by degenerative change The Vertebral Body Sclerosis: Increased bone formation adjacent to endplates Reduces nutrition diffusing to disc Stiffens endplate, and reduces ability to absorb loads Osteophytes: Formation of small bony spurs Can project into neuro structures
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 29 Degenerative disease can impact the facet joints Facet Joints Key Roles 20% of load Stabilize spine Degenerative Changes Synovial lining ↓ water content Tissue frays Facets override Dysfunction of motion segment
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 30 Stenosis is a very common degenerative disease that may require surgery Stenosis can lead to narrowing of canal and/or foramen Three types: Foraminal Central stenosis: laminectomy or medial facetectomy Lateral recess stenosis: laminectomy, facetectomy and foraminotomy
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 32 Spinal stenosis results in nerve root compression and pain Spinal Stenosis Result of degenerative changes to the spine Facet joints may enlarge and place pressure on the nerve roots Causes pain, numbness, or tingling running down into the legs Source: Spine-health.com
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 33 Treatment Concepts Decompressive: Laminectomy, hemilaminotomy, laminotomy, Microdiscectomy, foraminotomy Reconstructive: Fusion Disc Replacement
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 34 Treatment Concepts Neurologic Decompression to relieve nerve pain Stabilization (fusion) to treat Instability Motion Segment Pain Deformity Disc Replacement to relieve discogenic pain
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 36 A laminectomy procedure is used to treat stenosis Step 1: A midline incision is made on the back and then the spinous processes are removed Step 2: The lamina is removed to open up the spinal canal, decompressing the nerves Step 3: Bone from the facet joints that may be overlying the nerve is dissected away Step 4: Surgeon checks the canal to make sure there are no other sources of compression Source: Spine-health.com
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 39 Common approaches are Posterior (PLIF), Transforaminal (TLIF), and Anterior (ALIF) Posterior Lumbar Interbody Fusion (PLIF) Involves use of a spacer along with PL bone graft Transforaminal Lumbar Interbody Fusion (TLIF) less invasive approach – smaller incisions Anterior Lumbar Interbody Fusion (ALIF) may involve use of cage
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 40 PLF or PLIF Procedure Three-inch to six-inch long midline incision Then, the lamina is removed (laminectomy) which allows visualization of the nerve roots. The facet joints, which are directly over the nerve roots, may then be trimmed to give the nerve roots more room. The nerve roots are then retracted to one side and the disc space is cleaned of the disc material. A bone graft, or anterior interbody cages with bone, is then inserted into the disc space and the bone grows from vertebral body to vertebral body.
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 45 Understanding Complications In Anterior Procedures 1 Carotid Artery 2 Aortic Arch 3 Thoracic Aorta4 Abdominal Aorta 5 Iliac Artery 6 Internal Jugular Vein7 Superior Vena Cava 8 Inferior Vena Cava 9 Iliac Vein
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 47 Spondylolisthesis Most Common Degenerative If degenerative changes progress to a point when the ligaments and joints cannot hold the proper position of the spinal column, then degenerative spondylolisthesis is the result. Isthmic Isthmic spondylolisthesis is due to a specific bony defect in the spine called spondylolysis. Spondylolysis is a defect in a specific region called the pars interarticularis. A pars defect is most commonly the result of repetitive microtrauma during childhood. Other forms include: Congenital (inborn) anomalies, trauma, tumors and bone diseases, and surgical procedures.
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 48 Spondylolisthesis results in misalignment of the vertebra and requires spinal fusion Spondylolisthesis: Two kinds Degenerative: The joints weaken, allowing the vertebra to slip forward Isthmic: The bone above the joint fractures, allowing the vertebra to slip forward
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 51 Isthmic Spondylolisthesis Onset of Back Pain teenager to young adult years Most patients tolerate condition without surgery Very common at 6% white males (in the USA) (25% if your father has it) Very genetic, esp. American Navajos and Eskimos On occasion, radiculopathy develops
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 53 Principles of Surgical Intervention in the Treatment of Spondylolisthesis Decompress Nerve Tissue Pars defect Debridement Foraminal decompression Fusion
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 54 Spondylolisthesis can be corrected for by performing bone fusion Bone Fusion: Eliminates pain at an unstable segment by limiting motion Step 1: The spinous process and some of the lamina are removed Step 2: The bone directly pinching the nerve is removed Step 3: A bone graft is laid in place Step 4: Screws and posts are fixed in place to immobilize the grafts and vertebra Source: Spine-health.com
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 55 The Degenerative Cascade may lead to the need for Discectomy Nuclear Dehydration Biochemical Changes Annular Microtears Annular Incompetancy Herniation Stenosis Vertebral Subluxation
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 56 Degeneration of discs with age can lead to lumbar disc herniation Lumbosacral nerve roots exit the spine separately and join to for the sciatic nerve Pressure on any one of the lumbosacral nerves can cause pain numbness or tingling down into the legs A disc is composed of the outer core for stability (annulus fibrosus) and a soft inner core for shock absorption (nucleus pulposus) Age deterioration of the outer core can result in a tear, allowing the nucleus to push out against the nerve root Source: Spine-health.com
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 57 Degenerative disc disease can ultimately lead to herniation Often called “ruptured disc” Very common pathology L3-4, L4-5, L5-S1 common locations Thought to be a culmination of acute traumatic events to the disc
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 58 Disc problems are usually resolved with surgery when pain is extensive Disc degeneration with age can result in a number of disc problems Ultimately, herniation can occur Source: Spine-health.com
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 60 Micro-discectomy is used to treat nerve compression caused by disc herniation Step 1: After a midline incision is made, the muscles are elevated off the spine and a small window is developed between the lamina (giving access to the spinal canal) Step 2: The nerve root is moved and stabilized to allow access to the herniated disc Step 3: The herniated portion of the disc is the removed, decompressing the nerve root Step 4: Any remaining damaged and loose disc fragments are removed, leaving the healthy disc material in place Source: Spine-health.com
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 62 Spine Anatomy and Procedure References Anatomy: http://spine-health.com/topics/anat/a01.html Disc Problems: http://www.spineuniverse.com/displayarticle.php/article28.html http://www.emedicine.com Surgery: http://spine-health.com/dir/lumbar.html http://www.spineuniverse.com/displayarticle.php/article1465.html www.understandspinesurgery.com
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Appendix
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24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 64 Vertebral Classification Skull (Occiput) C1 (Alantis) C2 (Axis) C3-C6 C7 T1 T2 Subaxial C Spine Cervico-Thoracic Junction Occipito- Cervical Junction Cervical Alanto-Axial
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For more information or to place an order, please contact: SeaSpine 2302 La Mirada DriveVista, CA 92081 760-727-8399 USA 760-727-8809 fax www.seaspine.com 24-Jun-23 © 2016 SeaSpine, Inc. All rights reserved. 75 SeaSpine, the SeaSpine logo, and NanoMetalene are registered trademarks of SeaSpine or its subsidiaries in the United States and/or other countries. Hollywood and Ventura are trademarks of SeaSpine or its subsidiaries. PEEK-OPTIMA is a registered trademark of Invibio and is used under License. © 2016 SeaSpine. All rights reserved.