Biomechanics of Low Back Pain Flashcards
What percentage of adults will experience low back pain sometime during their lifetime?
80%
After the common cold, problems related to the low back are the most frequent cause of lost workdays individuals over what age?
45+
Spondylolisthesis is a defect in what structural anatomy?
pars interarticularis
How do defects to the pars interarticularis occur?(spondylolisthesis)
Fractures often from applying a posteriorly directed shear force to the inferior articular process.
Fracture may come from repeatedly alternating flexion and extension movements, and especially HYPEREXTENSION
Anterior displacement of vertebra (and those above it) in relation to the segment below.
spondylolisthesis
Where do spondylolisthesis usually occur?
L5 (65% of the time)
Do males or females have a higher incidence in spondylolisthesis?
males
What types of athletes are spondylolisthesis more common?
gymnastics, football, weight-lifting, pole-vaulting, and diving
What are the 5 types of spondylolisthesis classifications?
Type 1: Congential Type 2: Isthmic Type 3: Degeneration Type 4: Traumatic Type 5: Pathologic
Developmental abnormalities of neural arch resulting in deformity and anterior vertebral displacement
Type 1: Congenital (spondylolisthesis)
Defects of pars inter articulations (Stress fx)
- MC type in younger patients
- typically occur at L5
Type 2: Isthmic (spondylolisthesis) *
Segmental instability secondary to advanced DDD and posterior DJD
- MC type in older patients (women over 60 esp)
Type 3: Degenerative (spondylolisthesis) *
Acute fx involving neural arch but NOT pars interarticularis
Type 4: Traumatic (spondylolisthesis)
Osseous deformity secondary to local or systematic pathology (Paget’s metastasis, osteoporosis)
Type 5: Pathologic
How many grades of spondylolisthesis are there in the Meyerding Grading System?
4 grades (1-4)
Meyerding Grading System: Grade 1
0-25% anterior slippage
Meyerding Grading System: Grade 2
26-50% anterior slippage
Meyerding Grading System: Grade 3
51-75% anterior slippage
Meyerding Grading System: Grade 4
76-100% anterior slippage
Commented vertebral body fractures with disruption of the anterior and posterior walls of the vertebral body.
Burst Fractures
What do Burst Fractures cause?
severe neurological problems from the retropulsion of bone into the spinal cord
Burst fractures are results of what type of load?
High-energy axial load
- traffic collisions
- falls from a great height or high speed
- some kinds of seizures
What are the fracture classifications of Burst Fractures of the Anterior, Middle, and Posterior columns?
Ant- compression
Middle - compression
Post - Intact
What are the fracture classifications of Chance (seat-belt type) Fractures of the Anterior, Middle, and Posterior columns?
Ant- intact
Middle - Distraction
Post - Distraction
