Back Pain Flashcards
Red flags:
Which ages should you worry about?
A history of which 3 conditions are red flag worthy?
A history of the use of which drugs?
What pattern of distribution is worrying?
What are some red flag signs for neurological damage?
Pain - when is it worrying?
Leg claudication is a red flag for which disorder?
50 HIV, TB, carcinoma Steroids Bilateral oor alternating leg pain Bladder, bowel, sexual function deficits. Sensory loss. At night, when supine, no relief Spinal stenosis
Which sort of sensory loss do you get in cauda equina compression?
Saddle anaesthesia
4 most common causes of lower back pain in 15-30y/o?
Mechanical
Prolapsed vertebral disk
Ankylosing spondylitis
Spondylolisthesis
What is spondylolisthesis? Where does it most often occur?
When a vertebra slips forward, often after a break.
5th lumbar
What are 4 most common causes of lower back pain in 30-50y/os? (not including fractures and infective lesions which are present in all ages)
Mechanical
Prolapsed intervertebral disc
Degenerative joint disease
Malignancy
5 most common causes of lower back pain in 50years +? (not including fracture or infective bone lesion, present in all ages)
Degenerative joint disease Osteoporosis Paget's Malignancy Myeloma
When should spinal xrays be performed?
When there are ‘red flag’ symptoms
What is acute intervertebral disk disease also known as?
Prolapse of intervertebral disk
Why is disk prolapse a disk of younger people?
The disk degenerates with age and becomes less able to prolapse
What pain is sometimes accompanies prolapsed disk?
Sciatica
In old people, what is the most likely cause of sciatica?
Osteophytes compressing the nerve root
When there is disk prolapse:
Onset of pain is ___, often following ___ activity. Pain is related to ___ and is aggravated by ___.
When standing, muscle spasms can lead to a ___ ___. The most commonly affected disks are the ___ 3.
sudden strenuous position standing sideways tilt lowest
Which investigations are useful in disk prolapse?
Xrays ofen normal so not v helpful
MRI only used in those for whom surgery is being considered
In chronic disk disease, pain is usually of the ___ type.
When can surgery be considered? What surgery is this? What happens in it?
mechanical
When the pain arises from a single identifiable level and has failed to respond to conservative measures
Fusion surgery. Where little pieces of bone are place in front/behind the spine (in the disk space), so that the bone grows together and fuses that section of the spine.
Spondylolisthesis occurs because of a defect in the __ ____ of the vertebra, this can be ___ or acquired. Small spondylolistheses should be treated conservatively, while large ones with bad symptoms should be treated with ___ ___.
pars interarticularis
congenital
spinal fusion
