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1 LUMBAR SPINE SACRUM COCCYX SI JOINTS SCOLIOSIS RT 124 2008-10 WEEK 7
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2 LUMBAR SPINE AP, AP AXIAL (HIBBS) BOTH OBLIQUES LAT, L5-S1 SPOT
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7 LUMBAR SPINE SERIES SEQUENCE AP AP AXIAL (HIBBS) BOTH OBLIQUES LAT, L5-S1 SPOT
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8 AP
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15 AP NO FLEX LEGS FLEX PA
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17 collimation
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18 AP AXIAL HIBBS
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19 “HIBBS” METHOD
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22 Flex legs shield
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23 CRITIQUE The positioning error suggested is insufficient CR angulation
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24 OBLIQUES RPO & LPO
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32 A body E transverse process D pedicle O superior articular facet, left P pars interarticularis, left R inferior articular facet, left I apophyseal (interfacetal) joint, left V disk space
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36 30 – 50 degrees
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37 L5 –S1 30 degrees
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38 The AP and PA oblique projections are helpful in demonstrating spondylolysis. What is the definition of this condition? Spondylolysis is defined as the breaking down of the vertebra, usually at the pars interarticularis of the lumbar vertebrae. It is an acquired bony defect that may affect one or both sides of the lamina between the articular processes of the vertebrae.
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39 Critique? The positioning error suggested is over- obliquity or excessive rotation of the patient.
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40 Zygapophyseal joints and pedicles are posterior to the vertebral body and indicate over-obliquity
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41 AP OBIQUE – CRITIQUE The positioning error suggested is insufficient obliquity or rotation of the patient
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42 LUMBAR SPINE LAT
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48 More on this at the end of the slides
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52 LUMBAR SPINE L5-S1 SPOT
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59 Oblique vs Lat
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61 SPINA BIFIDA
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62 ankylosing spondylitis Ankylosing spondylitis is a rheumatoid arthritis involving the SI joints and spine, It is characterized radiographically by ossification of the outer portion of the annulus fibrosus and osteophyte formation between the vertebrae (bone spurring).
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63 Facets distroyed “BAMBOO SPINE”
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65 spurring
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66 What are the major differences between spondylolysis and spondylolisthesis? Spondylolisthesis is the forward displacement of one vertebra on another vertebra. It is a degenerative or congenital condition predominantly seen at the L5–S1 level. This condition almost exclusively involves the lumbar spine
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67 The AP and PA oblique projections are helpful in demonstrating spondylolysis. What is the definition of this condition? Spondylolysis is defined as the breaking down of the vertebra, usually at the pars interarticularis of the lumbar vertebrae. It is an acquired bony defect that may affect one or both sides of the lamina between the articular processes of the vertebrae.
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68 A body E transverse process D pedicle O superior articular facet, left P pars interarticularis, left R inferior articular facet, left I apophyseal (interfacetal) joint, left V disk space
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69 Spondylolisthesis
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70 CRITIQUE
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71 CRITIQUE
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72 CRITIQUE
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73 CRITIQUE
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75 X-TABLE LATERAL
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76 SACRUM COCCYX AP AXIAL SACRUM – CEPAHLIC COCCYX – CAUDAL LATERAL (s)
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80 Flex legs shield
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84 AP AXIAL L5 SI SPOT HIBBS
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98 SACRAL ILIAC JOINTS AP – AXIAL BOTH OBLIQUES (SIDE UP)
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102 “HIBBS” METHOD
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103 Unilateral (usually bilateral)
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105 PA - With no rotation of patient
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112 SIDE UP (SIDE UP) SIDE DOWN SIDE UP
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113 SPINE – POSITIONS FOR BEST SEEN? INTERVERTEBRAL FORAMEN ZYGOAPOPHYSEAL ARTICUALTIONS C.SP T.SP L.SP SI joints
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114 Scoliosis series
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117 LONG SID 72” + 14 X 36” GRID CASSETTE
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122 SHOULD INCLUDE TO ACETABULUM
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128 72 – 80 “ SID
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133 Scoliosis cassette 14x 36” Different speed screens Top to bottom
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134 Remove bucky tray
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135 OTHER POSTIONS LECTURE ONLY What projections can be taken to determine the range of motion of the spine at the level of the spinal fusion? FLEXION / EXTENSION BENDING (LATERAL)
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136 bending These projections are functional studies of the lumbar spine to determine the range of motion of the spine at the point of spinal fusion. Following spinal fusion surgery, the orthopedic physician or neurosurgeon may order a study to evaluate the flexibility of the spine. These projections will require the patient to assume different positions to determine how much flexibility of the spine has returned. Early signs of scoliosis and herniated intervertebral disk or HNP can be evaluated with these projections.
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138 Flexion / extenison
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140 What is HNP ? HNP refers to Herniated Nucleus Pulposus a situation in which the nucleus pulposus extrudes through an aspect of the annulus fibrosus of the intervertebral disk.
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141 laminectomy The term laminectomy is defined as the surgical removal of the bony arch of one or more vertebrae. Laminectomy is performed to remove a portion of the intervertebral disk to relieve compression of the spinal cord or one of the spinal nerves due to HNP. An aspect of the bony arch must be removed to provide access to the herniated disk.
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143 MORE IMAGE REVIEW NEXT WEEK REVIEW ELSEIVER AS WELL!
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