Back Prblemso Flashcards
Kyphosis
Increased thoracic curvature
Would erosion or fracture of the anterior part of a vertebrae cause a lordosis or kyphosis
Kyphosis
How can osteoporosis cause kyphosis
Anterior wedging of vertebrae
Kyphoplasty
Vertebroplasty to treat kyphosis
Vertebroplasty
Percutaneous procedure to insert bone cement into a fractured or collapsed vertebrae to provide pain relief and prevent further collapse
Sheuermanns disease
Adolescent condition causing vertebral wedging and kyphosis due to effected epiphyseal growth plates
What are smorls nodes and what condition are they associated with
nucleolus polposus herniates downwards or upwards into the adjacent vertebrae through the vertebral endplate
Scheuermanns
Sheuermans disease symptoms
Pain - nerve impingement
Difficulty breathing - restricted chest expansion
Normal age range for scheuermanns disease diagnosis
12-17yrs
Scheuermanns disease treatment
Physio to incr paraspinals strength
Bracing
Surgery
When is surgery used to treat scheuermanns disease
Curve 65*+
Intractable pain
Neuro issues
Does anterior rotation of the pelvis cause a kyphosis or lordosis
Lordosis
Weakness in which muscles are associated with lordosis
Trunk muscles
Hip flexors
Abdominal
Which spinal curvature can develop in pregnancy and obesity
Lordosis
How can lordosis cause back pain
Impinge spinal nerves
Shortening and tightness in which muscles is associated with lordosis
psoas
Thoracolumbar fascia
Erector spinae
Hamstrings
Gluteals
Why may people with lordosis have bent knees and angled femurs
Move body weight backwards
Flat back syndrome
vertebral column pulled flat due to tilted pelvis
Muscle and postural affects of flat back syndrome
Tight intercostal muscles
Tight hamstrings
Weak hip flexors
Knees flexed
Hips flexed
Head foreward
Scoliosis
Abnormal lateral curvature of spine usually with rotation of vertebrae
Which hormones may be involved in scoliosis
Oestrogen
Relaxin
Does scoliosis cause an apparent or true leg length discrepancy
Apparent due to tilted pelvis
Scoliosis treatment
Brace 20-40*
Vertebral fusion 50+
Harrington rods 50+
What degree of curvature is treated surgically in scoliosis
50*+
Spinal changes with age
Osteophytes and syndesmophytes
Loss of disc height
Loss or incr curves
Spinal stenosis
Ossification of vertebral ligaments
Syndesmophytes
bony outgrowths from the spinal ligaments as they attach to adjacent vertebral bodies
What type of joint is an IVD
Cartilaginous/ symphysis
2 parts of IVD
nucleus polposus
Annulus fibrosus
What causes decrease in IVD height after 30yrs
Nucleus polposus dries out
2 Most common locations of herniated or prolapsed IVDs
L4/L5
L5/S1
Where is pain felt as a result of a herniated IVD
Along distribution of nerve route compressed by nucleus polposus
Cauda equine syndrome
Serious neurological condition caused by compression of the nerve roots forming the cauda equina usually due to IVD herniation
Cauda equine syndrome symtoms
Lower back pain
Unilateral or bilateral sciatica
Saddle and perineal hypothesis or anaesthesia
Bowel/bladder disturbance
Lower extremity motor weakness and sensory defecits
Decr/absent lower extremity reflexes
Saddle anaesthesia
loss of sensation in the buttocks, perineum and inner surfaces of the thighs
Cauda equina treatment
Discetomy
Laminectomy
Burst fracture
Vertebrae breaks in multiple directions and shards may penetrate surrounding tissues
Where can blood collect and haematomas form due to vertebrae fractures
Into nucleus polposus
How can Osteophytes affect the vertebral arteries
Block or compress the vertebral foramen causing compression or bending of the vertebral arteries
Diffuse idiopathic skeletal hyperostosis
Ossification of anterior longitudinal ligament and tissues around spine
Does diffuse idiopathic skeletal hyperostosis cause Osteophytes
Yes but not always
How does diffuse idiopathic skeletal hyperostosis effect IVD height
No effect
How does diffuse idiopathic skeletal hyperostosis effect the sacroiliac joint
No effect
Ankylosing spondylitis
Chronic progressive inflammatory disorder mainly effecting the joints of the spine and axial skeleton
What age group does Ankylosing spondylitis effect and is it more common in males or females
19-25yrs
Male
Effects of alkylosing spondylitis
Bamboo spine
Narrowing and stenosis of sacroiliac joints
Sclerosis and ankylosis of vertebral bodies
Does ankylosing spondylosis effect disc height
No
Bamboo spine
complete fusion of the bones of the spine, turning the spinal column into one long bone, resembling a bamboo stalk
Caused by ankylosing spondylitis
Which antigen is linked to Ankylosing spondylitis
HLA B27
How does HLA B27 effect the gut
Influences gut flora favouring pathogenic bacteria
Predisposes to leaky gut -> inflammatory reactions
Why does antibiotic therapy prevent spondylitis and colitis
Combats pathogenic Git flora favoured by HLA B27
Which joints in the vertebral column are synovial
Zygapophysial joints
C1/C2 pivot joint
Subluxation
Partial dislocation of a joint
Which part of the spine is most commonly effected by RA
Cervical spine
How does RA affect spine
Subluxations
Compression of vertebral arteries
Pannus invades IVD
Which joint most commonly undergoes subluxation in RA
Atlantoaxial joint
