Chapter 26: Recognizing Some Common Causes Of Neck And Back Pain Flashcards
Where does the anterior longitudinal ligament of the spine connect?
anterior surfaces of vertebral bodies
Where does the posterior longitudinal ligament of the spine connect?
posterior surfaces of vertebral bodies
Where does the ligamentum flavum ligament of the spine connect?
laminae of adjacent vertebral bodies and lies in posterior portion of spinal canal
Where does the interspinous ligament of the spine connect?
between spinous processes
Where does the supraspinous ligament of the spine connect?
tips of spinous processes
What is the study of choice to evaluate the spine?
MRI
What are some common causes of back pain?
muscle and ligament strain herniation of an intervertebral disk degeneration of an intervertebral disk arthritis involving the synovial joints compression fractures trauma to the spine malignancy
Where do most herniated discs occur?
posterolaterally in the lower cervical or lower lumbar spine
What is postlaminectomy syndrome?
persistent pain in the back or legs following spine surgery
What can detect the cause of postlaminectomy syndrome?
Gadolinium-enhanced MRI
What causes degenerative disk disease?
nucleos pulposus dehydrates and degenerates with increasing age
What are the facet joints subject to?
osteoarthritis
What is facet osteoarthritis frequently associated with?
degenerative disk disease and radicular pain
How does Diffuse idiopathic skeletal hyperostosis manifest?
thick, bridging, or flowing calcification/ossification of the ant. longitudinal ligament
Occurs in men over the age of 50
Disk spaces and facet joints are preserved
What are compression fractures caused by and who gets them more commonly?
Secondary to osteoporosis and women
Can compression fractures be seen on xrays?
YES
What do compression fractures usually produce that can be seen on a Xray?
Involve the anterior portion of the body disproportionately causing exaggerated kyphosis in the thoracic spine
What is spinal stenosis and where is it most common?
Narrowing of the spinal canal or neural foramina
Most commonly seen in cervical or lumbar regions
Where are metastatic lesions to the spine most common?
Blood rich posterior aspect of vertebral bodies - especially Pericles
What metastases are most commonly associated with the spine?
Lung
Breast
Prostate
Does multiple myeloma involve the spine and if so, what is it associated with?
YES
Severe osteoporosis = compression fractures
Lyric destruction of the vertebral body
What are important landmarks connecting the lateral cervical spine on Xray and what do they assess?
Three parallel white lines
These lines assess for fracture os subluxation before the patient is moved
What is a Jefferson fracture?
Fracture of C1 commonly seen on Xray as bilateral, lateral fractures offset of the lateral masses of C1
Doesn’t cause neurological deficit
4 fractures in all are produced
What is a hangman’s fracture?
Fracture of the posterior elements of C2
Caused by hyperextension-compression injury
Doesn’t cause neurological deficits
What is a burst fracture?
High-energy axial loading injuries occurring in the cervical, thoracic, or upper lumbar spine
Bony fragments are seen in posterior spinal canal and anterior vertebral body displaced forward
Neurological Deficits occur
What is a chance fracture?
Transverse fractures through the entire vertebral body, pedicles, and spinous process
Occur in upper lumbar-lower thoracic spine
What are locked facets?
Occur due to hyperflexion injury
Inferior facets of one vertebral body slide over and in front of the superior facets of the body below
How will locked facets appear on a lateral Xray of the spine?
Inferior articular facets will lie in front of the superior facets of the body below
What is the naked facet sign?
Occurs in locked facets when the superior articular facets are no longer covered by the inferior facets
