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Flashcards in Lower Back Disorders Deck (67)
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1

Define Lordosis

Increased anterior convexity in the curvature of the spine

2

Define Kyphosis

Exaggeration of posterior convexity of the thoracic vertebral column found commonly with OA & osteoporosis

3

Define Scoliosis

Lateral curve of the spine usually right convex thoracic, most of which are idiopathic

4

Define Spondylolisthesis

Anterior slip, bilateral pars defect
Palpable step off with or without neurological symptoms

5

Define Stenosis

Narrowing of the spinal canal or neural foramen producing root ischemia or neurogenic claudication

6

Define Spondylolysis

Stress fracture of pars interarticularis

7

What on physical exam may indicate hip joint pathology?

Decreased internal rotation or external rotation
Reproduction of pain

8

L4 Reflex, Motor, and Sensory

R: patellar
M: ankle
S: medial foot and leg

9

L5 Reflex, Motor, and Sensory

R: none
M: extensor hallucus longus
S: lateral leg & dorsum of foot

10

S1 Reflex, Motor, and Sensory

R: Achilles
M: peroneus longus & brevis
S: lateral foot

11

Parts of a Vertebral Disc

Nucleus pulposus
Annulus Fibrosis

12

Ligaments of the Lumbar Spine

Anterior longitudinal ligament
Posterior longitudinal ligament
Interspinous
Supraspinous

13

Where does the anterior longitudinal ligament lie?

Anterior surface of the vertebral bodies

14

Where does the posterior longitudinal ligament lie?

Posterior surface of vertebral bodies inside the vertebral canal

15

What ligaments connect the spinous processes?

Interspinous
Supraspinous

16

Diagnostic Tests for Low Back Pain

Plain radiographs
Bone scan
Diskography
CT myelogram
MRI
Labs
Tests for neurogenic pain

17

What can a bone scan rule out?

Infection
Occult metastatic tumor

18

What test is an accurate assessment of stenosis?

CT Myelogram

19

What test is the most useful for disc injury?

MRI

20

Which patients should you run labs on for low back pain?

High risk
Unimproved after 8-12 weeks of conservative treatment

21

Patients with High Risk Features for Low Back Pain

Poorly controlled DM
Infection
Nursing home
Hx of CA

22

Symptoms of a Herniated Disc

Some degree of back pain
Pain that radiates into the leg
Shooting or stabbing pain

23

Which is worse: straight leg raise or crossed straight-leg raise?

Crossed straight-leg raise

24

Most Useful Test for Herniated Discs

MRI

25

Treatment for Disc Herniation

Conservative: PT, NSAIDs/steroids, & muscle relaxants; epidural steroid injections
Surgical

26

Reasons for Surgical Treatment of a Disc Herniation

Cauda equina syndrome
Profound motor deficits
Progressive neurologic deficit
Persistent bothersome sciatic pain, despite conservative management for 6-12 weeks

27

Define Spinal Stenosis

Spinal canal narrowing with possible subsequent neural compression

28

Causes of Spinal Stenosis

Facet hypertrophy of the vertebra
Vertebral body osteophytes
Ligamentum flavum hypertrophy
Disc degeneration
Neoplasm
Acromegaly
Paget's disease
Ankylosing spondylitis

29

What is neural claudication due to spinal stenosis exacerbated by?

Standing erect
Downhill ambulation

30

What is neural claudication due to spinal stenosis alleviated by?

Lying supine
Forward flexion