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lumbar hemilaminectomy - thanks
Posted: Dec 22, 2013
"A guidewire was placed over the left L4-5 of *5-1* hemilamina." I do not recognize the reference and don't even know where to look to verify it! He says very clearly "left L4-5 of five one hemilamina." Thanks.
Listen for L4-5 AND 5-1 - nm
[ In Reply To ..]
L5-S1 - I believe.
[ In Reply To ..]nm
do you have an anatomical diagram book handy? - basics 101
[ In Reply To ..]When I was starting out, I kept a large book of anatomical diagrams handy so that when something came up, I could look at that body part and learn what it was I was transcribing.
If you look at a diagram of the spine, you will see it divided into segments.
According to Wikipedia, these are the segments:
There are 30 spinal cord nerve segments in a human spinal cord:
7 cervical segments forming 8 pairs of cervical nerves (C1 spinal nerves exit spinal column between occiput and C1 vertebra; C2 nerves exit between posterior arch of C1 vertebra and lamina of C2 vertebra; C3-C8 spinal nerves through IVF above corresponding cervica vertebra, with the exception of C8 pair which exit via IVF between C7 and T1 vertebra)
12 thoracic segments forming 12 pairs of thoracic nerves (exit spinal column through IVF below corresponding vertebra T1-T12)
5 lumbar segments forming 5 pairs of lumbar nerves (exit spinal column through IVF, below corresponding vertebra L1-L5)
5 sacral segments forming 5 pairs of sacral nerves (exit spinal column through IVF, below corresponding vertebra S1-S5)
3 coccygeal segments joined up becoming a single segment forming 1 pair of coccygeal nerves (exit spinal column through the sacral hiatus).
Perhaps an anatomy class would be helpful in working as a medical transcriptionist.
did you read the question? - sm
[ In Reply To ..]the OP thinks she is hearing "of."
more importantly I read the part - basics 101
[ In Reply To ..]where it was said " I do not recognize the reference and don't even know where to look to verify it! "
I provided the reference s/he was lacking. Education is a wonderful thing.
Condescension is NOT a wonderful thing. - (sm)
[ In Reply To ..]I too read the question. What the dictator seemed to say ("of") sounded clear to her, but it simply does not make sense in the context, no matter HOW exhaustive your anatomical knowledge (but I am sure the OP is super grateful for the anatomy lesson anyway).
FWIW I am guessing one of the above suggestions is correct; what she was hearing ("of") was either slurring or misdictating "and" or "L."
I know it is too late to help the OP with that report, but just for my own curiosity I will ask my dad what the deal is with this - he is a spine surgeon. I will update later.
pot - meet kettle - NM
[ In Reply To ..]
Well, yeah, but there is a difference between sarcastic and condescending. - I fully admit to the former. (nm)
[ In Reply To ..]:p
I did not hear the above poster as condescending in any way - jmo
[ In Reply To ..]
agree - nm
[ In Reply To ..]
TO OP - an update on your query... - FWIW (sm)
[ In Reply To ..]OK, this question of yours has really got me stumped, so much so that I felt that I had to ask my dad, who is a spine surgeon, what could possibly be going on behind this dictation fragment of yours. And let me tell you that I know my spinal anatomy, as I have grown up with macabre, detailed 3D plastic spine models all around me my whole life.
So, anyways I asked him, and without the whole context no definitive answer could be supplied, but he thinks the surgeon was probably saying "L4-5 and 5-1," as one of the posters suggested. "But how can a guidewire be at two interspaces at one time?" I asked him. This is the bit that did not make sense to me.
So, the best educated guess, without the full context, is that the guidewire may have been poked in at the L4-5 level, and then subsequently poked in ("redirected" being the fancy term) at L5-1, not actually both interspaces at the same time.
I hope that helps a little bit, and if not, well, then at least now I can stop obsessing over this - lol.
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