TECHNIQUE OUTCOMES OCCUPATIONAL THERAPY TYPES SPINAL FUSION Immobilization of vertebral bodiesmotion segments with instrumentation DISKECTOMY Spinal decompression from vertebral disk herniation ID: 549759
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Slide1
MINIMALLY INVASIVE SPINE SURGERY
TECHNIQUE
OUTCOMES
OCCUPATIONAL THERAPY Slide2
TYPES
SPINAL FUSION- Immobilization of vertebral bodies/motion segments with instrumentation
DISKECTOMY- Spinal decompression from vertebral disk
herniation
. Removal of disk material relieves pressure on spinal cord/root nerves. Slide3
Advantages
Less disturbance of soft tissues, nerves, and muscles during procedure
Less scarring
Decreased length of stay post-operatively.
Less bleeding
Cosmesis
(smaller incision)
Reduced pain and narcotic usage
Quicker return to normal activitiesSlide4
Disadvantages
Requires use of fluoroscopy ( C or O arm) to achieve visualization
Higher exposures to radiation from fluoroscopy
Longer surgical times
High learning curve for surgeons
Not suitable for all patients/cases
Exposes less bone surface area for fusions
More difficult
dural
repair if damagedSlide5
Potential Complication
Infection
Bleeding
Pneumonia/Lung problems
Anesthesia complications
Recurring symptoms
Pseudarthrosis
Hardware fracture
Implant/graft migration
Spinal cord/nerve damage
Post-operative DVT
Dural tear
Transitional Syndrome
Sexual dysfunctionSlide6
Equipment/InstrumentationSlide7
Open vs. MISSlide8
MIS Surgery Video
QSlide9
OT Following Surgery
Instruction in the proper techniques for putting on/taking off your back/neck brace
Reinforcement of BLT Precautions
Transfer procedures: to EOB, Bed to Chair, Bed to Walker, and Walker to Toilet/Shower chair
Instruction in compensatory techniques for
ADL’s
( sock aids,
reachers
, AE/AD devices)
Instruction in toileting, showering, self-care
Education for patient/family/care-givers Slide10
Assistive DevicesSlide11
OT Back Surgery Video Slide12
Bed/Chair Positioning Precautions
HOB elevated no more than 30 degrees
Log roll in bed to turn, never twist
Lie on back with pillow under legs
Lie on side, both knees bent with pillow between knees. Do not put arms under head
Pillow behind back to prevent rolling
Avoid slouching in chairs, keep shoulders, hips, and ears aligned
Choose a chair that has good support
Avoid soft chairs, couches, and recliners
Keep feet flat on floor, and knees level with hips
Do not sit for too long, stand and stretch occasionally
To stand up, slide to edge of chair and use knees and hips to straighten
Use arms to help support and lift if possible Slide13
Questions
References:
http://www.google.com/search?q=back+surgery+assistive+devices&client=safari&rls=en&tbm=isch&prmd=ivns&ei=5Jc6VJn4Ds-LyASHuYDACw&start=20&sa=N
http://orthoinfo.aaos.org/topic.cfm?topic=A00543
http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Minimally%20Invasive%20Spine%20Surgery%20MIS.aspx
http://umm.edu/programs/spine/health/guides/complications-of-spine-surgery
http://www.understandspinesurgery.com/Articles/Read/Minimally-Invasive-Surgery-(MIS)-for-Spinal-Problems
http://www.hopkinsortho.org/JHULumbSpineSurgeryGuide.pdf
http://www.basicspine.com/blog/minimally-invasive-spinal-surgery-used/
http://www.practicalpainmanagement.com/treatments/interventional/minimally-invasive-spine-surgery-who-can-it-help
http://www.zimmer.com/en-AU/hcp/spine/product/pathfinder-minimally-invasive-pedicle-screw.jspx
https://www.youtube.com/watch?v=QYXJv01SvyA
https://www.youtube.com/watch?v=2o00O0l1my4
http://www.ilcnsw.asn.au/items/357?topic_header=
additional_info