backache and neckache Flashcards
where to nerve roots emerge
vertebral foramina
sciatica characteristic
pain in the leg mainly down the back, radiating to the foo
may be exaggerated by coughing
what is spondylosis
degeneration of the IV disc > increased facet joint loading
what is spondylolisthesis
slippage of one vertebra relative to the one next to it
where is spondylolisthesis commonly seen
lumbar spine
adult forms of spondylolisthesis are commonly caused by what?
fatigue fracture of pars inter-articularis
does spondylolisthesis commonly cause neurological problems?
rarely, even when the slippage is major!
most people require surgery for spondylolisthesis - true or false
false
name of a pars interarticularis fracture without slippage or vertebra
spondylolysis (can exist w/o pain!)
age and sex who usually suffer disc prolapse
< 40, men
symptoms of disc prolapse
acute backache and leg ache. sometimes leg ache occurs and backache doesn’t occur till later
how does prolapse pain differ from referred pain
referred pain usually goes no further than the knee or upper calf whereas root pain usually goes down to the foot
most commonly affected roots by prolapse
between 5th lumbar and sacral
why is prolapse commonly called sciatica
roots from 4th and 5th lumbar and first sacral vertebrae are commonly compressed by discs and they give rise to the peripheral sciatic nerve
procedure carried out before surgical disc removal
myelography (radio-opaque fluid injected followed by X-ray)
do most disc prolapses require surgery
no most recover spontaneously (cells from blood stream absorb disc material)
classical person who gets bony root entrapment
over 40
previous hx of backache
classical symptoms of bony entrapment
acute episode of leg pain radiating to foot usually made worse by exercise
does physio help bony root entrapment
unlikely
is removal of the disc necessary in bony root entrapment?
no this might make condition worse
what may be needed following removal of bone in entrapment
fusion to aid stability
classical age and sex who gets cervical spondylosis
female > 40
presentation of cervical spondylosis
dull neck ache often refereed to shoulders and upper arms + may also experience tingling
management of cervical spondylosis
if no localising signs > analgesia, NSAIDs, soft collar, physio, counselling (its usual for recurrent attacks to occur)
if nerve entrapment confirmed > surgical fusion and decompression
cervical disc disease - higher or lower discs most likely to cause problem?
lower
do sufferers of cervical disc disease tend to have hx of neck trouble
no
what may happen to the neck following cervical disc prolapse
neck muscles may spasm»_space; neck movement may be severely restricted
