Back Problems

Question 1

What is kyphosis?

Answer 1

Increased thoracic curvature of the spine

Question 2

What is Sherurmann’s disease?

Answer 2

A form of adolescent kyphosis where the epiphyseal growth plates of the vertebral bodies are affected in one or more of the thoracic vertebra leading to wedging and an exaggerated kyphosis

Question 3

What is lordosis?

Answer 3

Where anterior rotation of the pelvis leads to an increased lumbar curvature

Question 4

How may psoas muscle dysfunction lead to a lordosis?

Answer 4

If there is chronic psoas shortening and weakness this will lead to an increased lumbar lordosis as the thorax-lumbar fascia and erector spinae muscles will also shorten.

Question 5

What can lead to an increased lordosis?

Answer 5

Weakened trunk muscles, hips flexors or late pregnancy or obesity

Question 6

What may cause flat back syndrome?

Answer 6

Ankylosing spondylitis, degenerative discs and spinal fusion

Question 7

What is flat back syndrome?

Answer 7

Where the pelvis tilts backwards and pulls the lumbar spine flat

Question 8

What are the symptoms/complications of flat back syndrome?

Answer 8

As a result of the pulling of the lumbar spine, there is tight musculature between the ribs leading to shallow breathing, tight hamstrings and weak hip flexors.

Question 9

What is scoliosis?

Answer 9

Abnormal lateral curvature of the spine (usually with rotation of the vertebrae)

Question 10

What five things seen on a plain radiograph of the spine may indicate a degenerative disorder?

Answer 10

• Osteophytes (syndesmophytes)
• Loss of disc height
• Loss or increase in curves
• Spinal stenosis
• Ossification of vertebral ligaments

Question 11

What type of joint is the intervertebral joint?

Answer 11

Symphysis joint (fibrocartilaginous)

Question 12

What are the two layers of the intervertebral disc?

Answer 12

Annulus fibrosis (outside) and nucleus purposes (inner portion)

Question 13

Describe the composition of the nucleus pulposus

Answer 13

Mainly water with proteoglycans, it is avascular

Question 14

Describe the composition of the annulus fibrosis

Answer 14

Consists of alternating layers of type 1 collagen and the outer third is innervated

Question 15

What collagen is present in the annulus fibrosis of intervertebral discs?

Answer 15

Type 1 collagen

Question 16

What is a herniated disc and where does it most commonly occur?

Answer 16

Where the nucleus purposes seeps out of the intervertebral disc and irritates or compresses the spinal nerve root. This is most common at L4/L5 or L5/S1

Question 17

What is cauda equina syndrome?

Answer 17

A serious neurological condition that can result from impingement from a herniated disc on the cauda equina region of the spinal cord which can lead to reduced sensation or no sensation below this. There may be bone or bladder disturbance also.

Question 18

What are the zygapophysial joints in the spine?

Answer 18

The facet joints between the vertebral spines

Question 19

What type of joint is present between the C1/C2 vertebra?

Answer 19

Pivot joint (atlas on axis)

Question 20

What conditions may cause there to be vertebral-basilar artery insufficiency to supply the spine?

Answer 20

Osteoarthritis or degenerative disc disease

Question 21

What is diffuse idiopathic skeletal hyperostosis?

Answer 21

Involves ossification/calcification of the anterior longitudinal ligament with or without osteophytes. The disc height is maintained and this condition does NOT involve the sacroiliac joint. Affects 50-75 year olds

Question 22

Which joint does diffuse idiopathic hyperostosis NOT affect?

Answer 22

Sacroiliac joint

Question 23

Which ligament is ossified in diffuse idiopathic skeletal hyperostosis?

Answer 23

Anterior longitudinal ligament

Question 24

What is ankylosing spondylitis?

Answer 24

A chronic inflammatory disorder mainly affecting the axial skeleton. It involves narrowing and hardening (sclerosis) of both sacroiliac joints with bone formation across the anterior and lateral margins of the intervertebral discs leading to fusion of the vertebrae.

Question 25

What is the genetic component that may lead to ankylosing spondylitis?

Answer 25

HLA-B27 (a receptor which influences the composition of endogenous gut flora) which can lead to a leaky gut which allows more substances to pass through the barrier and trigger inflammatory reactions.

Question 26

What spinal issues may arise from rheumatoid arthritis?

Answer 26

Commonly causes subluxations in the C1/C2 region of the spine being the most common.