Flashcards in Lower Back Disorders Deck (67)
Increased anterior convexity in the curvature of the spine
Exaggeration of posterior convexity of the thoracic vertebral column found commonly with OA & osteoporosis
Lateral curve of the spine usually right convex thoracic, most of which are idiopathic
Anterior slip, bilateral pars defect
Palpable step off with or without neurological symptoms
Narrowing of the spinal canal or neural foramen producing root ischemia or neurogenic claudication
Stress fracture of pars interarticularis
What on physical exam may indicate hip joint pathology?
Decreased internal rotation or external rotation
Reproduction of pain
L4 Reflex, Motor, and Sensory
S: medial foot and leg
L5 Reflex, Motor, and Sensory
M: extensor hallucus longus
S: lateral leg & dorsum of foot
S1 Reflex, Motor, and Sensory
M: peroneus longus & brevis
S: lateral foot
Parts of a Vertebral Disc
Ligaments of the Lumbar Spine
Anterior longitudinal ligament
Posterior longitudinal ligament
Where does the anterior longitudinal ligament lie?
Anterior surface of the vertebral bodies
Where does the posterior longitudinal ligament lie?
Posterior surface of vertebral bodies inside the vertebral canal
What ligaments connect the spinous processes?
Diagnostic Tests for Low Back Pain
Tests for neurogenic pain
What can a bone scan rule out?
Occult metastatic tumor
What test is an accurate assessment of stenosis?
What test is the most useful for disc injury?
Which patients should you run labs on for low back pain?
Unimproved after 8-12 weeks of conservative treatment
Patients with High Risk Features for Low Back Pain
Poorly controlled DM
Hx of CA
Symptoms of a Herniated Disc
Some degree of back pain
Pain that radiates into the leg
Shooting or stabbing pain
Which is worse: straight leg raise or crossed straight-leg raise?
Crossed straight-leg raise
Most Useful Test for Herniated Discs
Treatment for Disc Herniation
Conservative: PT, NSAIDs/steroids, & muscle relaxants; epidural steroid injections
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
Define Spinal Stenosis
Spinal canal narrowing with possible subsequent neural compression
Causes of Spinal Stenosis
Facet hypertrophy of the vertebra
Vertebral body osteophytes
Ligamentum flavum hypertrophy
What is neural claudication due to spinal stenosis exacerbated by?