Epidurals
Anatomy
Imaging
Surgical
RFAs
100
What are the two main components of an epidural steroid injection?
Numbing agent
Corticosteroid
100
What ligament runs down the front of the spine and restricts extension?
ALL
Anterior Longitudinal Ligament
100
What type of MRI WEIGHTED image is this and why?
T1- fluid is dark
100
What centers do our spine surgeons do surgery out of? Looking for at least 2
Hudson Regional
Jersey Shore
Team MD
100
Where do our pain management docs perform procedures? Need at least 2
Team MD at Milburn
Team MD at Woodland park
ASC Old Bridge
Morris County Surgical Center
200
Which levels are most commonly injected as a first approach for an epidural in the cervical spine?
C7-T1 interlaminar
200
How many nerve roots are in the cervical spine?
8
200
If you suspect someone of having a spondylolithesis, what are the proper x-ray views that are needed
6 view
AP, Lateral, Flex, Ext, and Obliques (pars)
Need to visualize the scottie dog
200
What type of metal is the cervical disc (and almost all surgical cages) made out of
Titanium
200
How much percentage relief should a patient have from a branch block to proceed with second block and RFA?
80%
300
What are the three different approaches to a lumbar epidural steroid injection?
Interlaminar, Transforaminal, Caudal
300
Define the following:
Spondylolis
Spondylolysis
Spondylothesis
1. Degeneration of the spine
2. Fracture of the pars
3. Slippage of the vertebra
300
Name this congenital defect
Spine Bifida Occulta
300
What is 1 major benefit of doing a CDA over an ACDF
Allows continued motion at adjacent segments
300
What is the name of the nerve bundle innervating the facet joints called?
Medial branch nerves
400
If someone already has a lumbar fusion, but needs another epidural, what is the epidural approach that is taken?
Caudal
400
What are the 5 layers traversed before reaching the epidural space in an interlaminar epidural injection?
Skin, fat, supraspinous ligament, interspinous ligament, and ligamentum flavum
400
Label the following
400
How long do you have to wait between having an epidural and getting surgery?
4-6 weeks due to increase risk of infection
400
What is the least expected duration of a positive radiofrequency ablation of the medial branches?
6 months
500
What ligament divides the epidural space into right side and left side laterality, making it difficult to get bilateral spread with an interlaminar epidural approach?
Plica mediana dorsalis
500
What structure can be damaged if taking a transforaminal approach to the cervical epidural?
Vertebral Artery
500
Name the following structures
A. Vertebral Artery
B. Disc
C. Spinal Cord
D. Lamina
E. Facet
F. Nerve Root
500
This term describes the failure of vertebrae to fuse together after a spinal fusion procedure
Pseudoarthrosis
500
What muscle is supplied by the medial branch?
Multifidus muscle