4) Spine & Neck Flashcards
What should healthy discs have a lot of?
Water
Spine-Related Problems
- Fx
- Inflammation
- Radiculopathy
- Myelopathy
- Stenosis
- Discogenic Pain
- PN
- Double Crush Syndrome
- Metabolic
- Tumor
- Infection
- Spondylolisthesis
Myelopathy
Pressure on the spinal cord itself
Spondylolisthesis
Benign developmental defect where one vertebral body slips on another; Common in pre-adolescent female gymnasts
Non-Spine Related Problems
- Visceral Issues
- Endocrine Issues
- Hematologic Issues
- Vascular Claudication
- MS or ALS
- Hip Problems
- ST jt pain
- Psychogenic Pain
- Steroid Use
- Cholesterol Meds
Cauda Equina Syndrome
Pt loses B&B fxn, sexual fxn, etc
Anterior Lumbar Interbody Fusion (ALIF)
Done for painful degenerative lumbar disc disease; Often combined w/posterior approach for better stabilization
Advantages of ALIF
- Doesn’t disturb lumbar musculature
- Graft is placed anteriorly so there’s less compression
- Wide exposure is good for multi-level fusion
- Don’t need to retract nerve roots so there’s less chance of nerve damage
- Higher fusion rate than PLIF
Kyphoplasty
Uses a balloon to reduce vertebral compression fx’s
Vertebroplasty
Inserts cement into a fx from trauma, tumor, or osteoporosis
Posterior Lumbar Interbody Fusion (PLIF)
Done for spondylolisthesis, discogenic LBP, or radicular pain
Sx’s of saddle anesthesia
B&B or sexual dysfunction
True or false: Saddle anesthesia is a red flag & a medical emergency?
True
PT Goals
- Relieve sx’s
- Prevent progression & recurrence of sx’s
- Emphasize independence
What part of the spine is the most common place to see degenerative disc changes?
Lumbar Spine
Pattern of degenerative disc changes in 20y/o
Genetics or Athletes
Pattern of degenerative disc changes in 30y/o
Macroscopic changes
What part of the intervertebral disc sees changes? What are the changes & why are they a problem?
- Nucleus Pulposus
* Can’t hold on to H20 anymore so it gets dehydrated, thicker, & fibrotic so the disc doesn’t shock absorb anymore
Other things that happen w/disc degeneration
- Annulosis fibrosis tear
- Disc collapse
- Vertebral compression
Risk factors for disc degeneration
- Age
- BMI
- Genetics
- Smoking
- Atherosclerosis
- Psychosocial Factors
What 3 conditions are associated w/disc degeneration?
Spinal Stenosis, Spondylolithesis, & Cauda Equina Syndrome
Spinal Stensosis
Narrowing of spinal & central canal
Neurogenic Spinal Stenosis
Spinal stenosis w/radiating pain, parasthesia, numbness, & tingling
*Its important to know what exacerbates the pt’s sx’s
Vascular Spinal Stenosis
Spinal stenosis exacerbated by physical activity
Where is the most common place for spondylothesis to occur?
L4-L5
Sx’s of cauda equina syndrome
Pain in upper sacrum, butt, or genetalia parasthesia
