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BMSc - Ortho 2 > Classification of vertebral conditions > Flashcards

Classification of vertebral conditions Flashcards

1
Q

What are the two main classes of vertebral conditions?

A

Related to spondylitides

Related to the nervous tissue

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2
Q

What are the 3 diseases studied that relate to the spondylitides?

A

Aches and sprains
Mechanical back pain
Spondylolisthesis

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3
Q

What are the 2 diseases studied that relate to the nervous tissue?

A

Disc prolapse

Bony root entrapment

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4
Q

What causes the majority of back pain?

A

Awkward twisting or poor lifting - muscle/ligament injuries

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5
Q

When you lift a heavy object you should decrease the distance between the object and the back, why is this?

A

Decreases the leverage and the spinal loading

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6
Q

What is the management of back sprains?

A

Simple analgesia or NSAIDs

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7
Q

What are the two main possible causes of mechanical back pain?

A

Spondylosis

Primary OA

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8
Q

Define spondylosis

A

Degeneration of the intervertebral disc

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9
Q

How do people develop secondary OA with spondylosis?

A

The degeneration of the intervertebrail disc causes increased loading of the facet joints

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10
Q

What are the signs and symptoms of mechanical back pain?

A

Tends to recur - this doesnt mean the condition is deteriorating
No neurological signs

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11
Q

What is the management of mechanical back pain?

A

Physio

NSAIDs and simple analgesics

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12
Q

Why may an osteopath or chiropracter be useful in mechanical back pain?

A

May be able to ease to condition using manipulation

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13
Q

Define spondylolithesis

A

Slippage of one vertebra relative to the one below

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14
Q

Where is spondylolithesis commonly seen?

A

Lumbar spine

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15
Q

The two types of spondylolithesis are congenital and acquired. How does acquired commonly occur?

A

Follows an acture or more likely a fatigue fracture of the pars interarticularis

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16
Q

Why does one vertebra slip over the other in spondylolithesis?

A

Due to a bony abnormality which interferes with the stability of the facet joints and associated bony and ligamentous elements

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17
Q

How does sponylolithesis present?

A

Almost identically to mechanical back pain

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18
Q

How may the presentation of congenital spondylolithesis differ from acquired?

A

Congenital may have neurological signs

This is uncommon in acquired even if major/severe

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19
Q

How do you diagnose spondylolithesis?

A

x-ray

20
Q

What is the management of spondylolithesis?

A

Spinal corset
NSAIDs and simple analgesia
Surgery

21
Q

What is the surgery for spondylolithesis?

A

Fusion of the two affected vertebrae

22
Q

When may surgery be used as a treatment of spondylolithesis?

A

Severe pain - it is a rare management

23
Q

Define spondylolysis

A

A pars interarticularis defect such as a fracture that may be seen on x-ray without forward slipping of the vertebrae

24
Q

What are the management options for spondylolysis

A

Nothing if no pain
Painful - analgesia and conservative methods
Severe - surgical fusion

25
Q

What part of the spine do prolapsed intervertebral discs occur?

A

Lumbar or cervical

26
Q

Who is most commonly affected by a prolapsed intervertebral disc?

A

<40yrs, male

27
Q

What are the symptoms of a prolapsed intervertebral disc?

A

Acute backache and legache

28
Q

What is the characteristic symptom of a prolapsed intervertebral disc?

A

Leg ache passing down the back of the thigh and leg to the foot

29
Q

What event do patients often describe in regards to prolapsed intervertebral disc?

A

Single event of lifting or strain - this is not necessarily the reason, it may arise spontaneously

30
Q

Describe the mechanism of a prolapsed disc

A

An abnormality in the intervertebral disc leads to a prolapse of the nucleus pulposus through annulus fibrosis

31
Q

If the disc prolapses backwards and laterally, what may the patient present with?

A

Nerve root impingement

32
Q

If the disc prolapses posteriorly, what may the patient present with?

A

Spinal cord or cauda equina impingement

33
Q

What vertebrae does a prolapsed disc most commonly affect?

A

L5 S1 - commonly referred to as sciatica

34
Q

What is the main thing to rule out with any back pain?

A

Cauda equina syndrome

35
Q

What is the management of a prolapsed disc?

A

NSAIDs, simple analgesia, rest and gentle, progressive mobilisation

36
Q

Most prolapsed discs recover spontaneously. Why is this?

A

Disc material is absorbed by cells released fro the bloodstream

37
Q

What management should occur if there is persistent pain or an increasing severity of localising signs in relation to a prolapsed disc?

A

Surgical removal of disc material

38
Q

how do you find the site of a prolpased disc?

A

Inject a radio-opaque material into the spinal fluid. the fluid cannot flow where prolapsed disc pressed on the nerve

39
Q

What is the name of the technique used to find the site of a prolapse disc?

A

Myelography

40
Q

Who is most likely to get a bony root entrapment?

A

> 40yrs with a history of mechanical back pain

41
Q

What exacerbates bony root entrapment?

A

exercise

42
Q

What are the symptoms of bony root entrapment?

A

leg pain radiating to the foot

43
Q

What is bony root entrapment commonly caused by?

A

Bony overgrowth around the vertebral foramina where the nerve roots emerge

44
Q

What is bony overgrowth secondary to?

A

Degenerative changes in adjacent facet joints

May degenerate from primary osteoarthritis or as a result of disc degeneration

45
Q

What management of bony root entrapment may make the condition worse?

A

Removal of disc

46
Q

What is needed to free trapped nerve? What is risk of this?

A

Removal of bone

Disturbs spinal stability and lead to need for fusion of the affected vertebrae

BMSc - Ortho 2 (4 decks)

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