Clinical anatomy of vertebral column Flashcards
Degenerative changes associated with the intervertebral disc
Gelatinous NP replaced with fibrous tissue
Weight transferred to AF causing fissures over time
Once fissure reaches peripheries of the IV disc, risk of NP herniation
Age related changes associated with the intervertebral disc
Annular tears occur when the water content declines with age, reducing tension in the AF
Causes of herniated IV disc
Flexion of spine
Jobs involving heavy lifting
Contact sport injuries
Trauma to VC
Where do herniated IV discs commonly occur ?
L4-L5
L5-S1 levels
POSTEROLATERAL : impinging on spinal nerve root
Compress L5 or S1, part of sciatic nerve —> sciatica
Test for herniated IV disc
Straight leg raise
Red flag features of cauda equina syndrome
Lumbar disc herniation
Spondylolisthesis
Vertebral fracture or dislocation
Metastases
Spinal cord compression
Herniated IV disc if above L1/2
Sciatica
Pain or parenthesis in the dermatomal distribution of sciatic nerve (nerve roots of L4-S3) and weakness of those myotomes.
Diagnosis of herniated IV disc
MRI
Clinical findings : straight leg raise test
Treatment of herniated IV disc
Keep active rather than bed-rest
Steroid injection
Physiotherapy
Surgery- last resort
Kyphosis
Excessive convex curvature of spine, especially in the thoracic region.
- look for owls 2 eyes and beak (pedicles and spinous process)
Osteoporosis
Calcium deficiency
Bones appear porous
Bone mineral density decreased on DEXA
Bones become weak
Fracture easily
Spina bifida
Neural tube doesn’t develop/fuse properly
Exact cause unknown
Folate deficiency, some medications
Abnormal number of vertebrae
Lumbarisation of S1
Sacralisation of L5
Spondylosis
Osteoarthritis - degeneration of the spine/facet joint
Common in cervical and lumbar regions
May be associated with bony spurs
Pain is worse on rotation or lateral flexion
