A 33-year-old male patient visits his primary care physician complaining of right buttock and right leg...

A 33-year-old male patient visits his primary care physician complaining of right buttock and right leg pain with no known injury. He is employed as a long-haul truck driver and is healthy. Upon examination by a neurosurgeon, the patient exhibits normal range of motion except when raising his right leg that causes sharp pain. The surgeon orders an MRI that shows an L4-L5 herniated disc. The patient is scheduled for a lumbar discectomy.

1. Discuss the differences between a laminectomy and a discectomy.

2. What instruments and/or special equipment will be used during a discectomy?

3. What are the possible complications associated with surgery on the lumbar spine?

4. Why is a multilevel, bilateral laminectomy usually necessary for removal of an intradural spinal tumor?

5. What does CNS stand for? What is it composed of and responsible for?

Solutions

Expert Solution

QUESTION: DISCUSS THE DIFFERENCES BETWEEN LAMINECTOMY AND DISECTOMY.

LAMINECTOMY	DISECTOMY
THE LAMINA OR THE VERTEBRAL BONE IS REMOVED	THE ENTIRE DISK OR THE BONE OVER THE NERVE ROOT IS REMOVED
RELIEVES COMPRESSION OF THE SPINAL CORD DUE TO INJURY, HERNIATED DISC OR TUMOR	RELIEVES TYPICAL LEG PAIN CAUSED DUE TO HERNIATED DISC.
SURGERY REQUIRES HOSPITAL STAY	SURGERY PERFORMED ON THE OUTPATIENT BASIS.

QUESTION: WHAT INSTRUMENTS AND/OR SPECIAL EQUIPMENT BE USED DURING A DISECTOMY?

KERRISON AND LEKSELL RONGEURS.
HANDHELD DRILLS (HIGH SPEED)
SELF-RETAINING RETRACTORS.
PITUITARY RONGEURS.
STRAIGHT AND ANGLED CURETTES.
C ARM ( INTRAOPERATION).
SURGICAL LOUPES.
OPERATING MICROSCOPE.

QUESTION:WHAT ARE THE POSSIBLE COMPLICATIONS ASSOCIATED WITH SURGERY ON THE LUMBAR SPINE?

RECURRENCE OF SYMPTOMS EVEN AFTER SURGERY.
RECURRENCE OF DISK SLIP OR HERNIATION.
NEW BONE FORMATION THAT DEVELOPS COMPRESSION ON THE SPINE.
FORMATION OF SCARRING AROUND THE NERVES FOLLOWING SURGERY.
INFECTION
CLOTTING OF BLOOD IN THE LOWER EXTREMITIES WHICH MAY LEAD TO DEEP VEIN THROMBOSIS.
PULMONARY EMBOLISM .
TEAR OF THE TISSUE THAT COVERS THE SPINAL CORD AND THE SPINAL NERVES (DURAL TEAR)
LEAKAGE OF THE CEREBROSPINAL FLUID (CSF).
NERVE INJURY WHICH MAY LEAD TO PARALYSIS.
HEAVY BLOOD LOSS DURING SURGERY MAY LEAD TO DEATH.

QUESTION: WHY IS A MULTILEVEL, BILATERAL LAMINECTOMY USUALLY NECESSARY FOR REMOVAL OF A.N INTRADURAL SPINAL TUMOR?

MULTILEVEL ,BILATERAL LAMINECTOMY IS REQUIRED FOR THE REMOVAL OF AN INTRADURAL SPINAL TUMOR BECAUSE IT IS NECESSARY TO BE TOTALLY REMOVED SURGICALLY (TOTAL RESECTION).

QUESTION:WHAT DOES CNS STAND FOR?WHAT IS IT COMPOSED OF OR RESPONSIBLE FOR?

CNS STANDS FOR CENTRAL NERVOUS SYSTEM .
IT IS COMPOSED OF NERVOUS SYSTEM THAT INCLUDES THE BRAIN AND THE SPINAL CORD.
IT RECEIVES THE SIGNAL FROM THE BRAIN AND TRANSPORTS IT TO THE PARTS OF THE BODY.
SENSORY, INTEGRATION AND MOTOR ARE THE THREE MAIN FUNCTIONS OF THE NERVOUS SYSTEM.

Nightingale answered 1 year ago

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