backache and neckache

Question 1

where to nerve roots emerge

Answer 1

vertebral foramina

Question 2

sciatica characteristic

Answer 2

pain in the leg mainly down the back, radiating to the foo

may be exaggerated by coughing

Question 3

what is spondylosis

Answer 3

degeneration of the IV disc > increased facet joint loading

Question 4

what is spondylolisthesis

Answer 4

slippage of one vertebra relative to the one next to it

Question 5

where is spondylolisthesis commonly seen

Answer 5

lumbar spine

Question 6

adult forms of spondylolisthesis are commonly caused by what?

Answer 6

fatigue fracture of pars inter-articularis

Question 7

does spondylolisthesis commonly cause neurological problems?

Answer 7

rarely, even when the slippage is major!

Question 8

most people require surgery for spondylolisthesis - true or false

Answer 8

false

Question 9

name of a pars interarticularis fracture without slippage or vertebra

Answer 9

spondylolysis (can exist w/o pain!)

Question 10

age and sex who usually suffer disc prolapse

Answer 10

< 40, men

Question 11

symptoms of disc prolapse

Answer 11

acute backache and leg ache. sometimes leg ache occurs and backache doesn’t occur till later

Question 12

how does prolapse pain differ from referred pain

Answer 12

referred pain usually goes no further than the knee or upper calf whereas root pain usually goes down to the foot

Question 13

most commonly affected roots by prolapse

Answer 13

between 5th lumbar and sacral

Question 14

why is prolapse commonly called sciatica

Answer 14

roots from 4th and 5th lumbar and first sacral vertebrae are commonly compressed by discs and they give rise to the peripheral sciatic nerve

Question 15

procedure carried out before surgical disc removal

Answer 15

myelography (radio-opaque fluid injected followed by X-ray)

Question 16

do most disc prolapses require surgery

Answer 16

no most recover spontaneously (cells from blood stream absorb disc material)

Question 17

classical person who gets bony root entrapment

Answer 17

over 40

previous hx of backache

Question 18

classical symptoms of bony entrapment

Answer 18

acute episode of leg pain radiating to foot usually made worse by exercise

Question 19

does physio help bony root entrapment

Answer 19

unlikely

Question 20

is removal of the disc necessary in bony root entrapment?

Answer 20

no this might make condition worse

Question 21

what may be needed following removal of bone in entrapment

Answer 21

fusion to aid stability

Question 22

classical age and sex who gets cervical spondylosis

Answer 22

female > 40

Question 23

presentation of cervical spondylosis

Answer 23

dull neck ache often refereed to shoulders and upper arms + may also experience tingling

Question 24

management of cervical spondylosis

Answer 24

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

Question 25

cervical disc disease - higher or lower discs most likely to cause problem?

Answer 25

lower

Question 26

do sufferers of cervical disc disease tend to have hx of neck trouble

Answer 26

no

Question 27

what may happen to the neck following cervical disc prolapse

Answer 27

neck muscles may spasm&raquo_space; neck movement may be severely restricted